Endometriosis

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Endometriosis

• By Cipriano Montes

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What is Endometriosis?

• Endometriosis was described more than 100 years
  ago and microscopic ovarian endometriosis by
  1899. Endometriosis was discovered by John
  Albertson Sampson, M.D.. Endometriosis is a
  condition in which the tissue that normally lines
  the uterus (endometriosis) grows in other areas
  of the body, causing pain, irregular bleeding,
  and frequently infertility. The tissue growth
  typically occurs in the pelvic area, outside the
  uterus, on the ovaries, bowel, rectum, bladder,
  and the delicate lining of the pelvis, but it can
  occur in other areas of the body as well.

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Symptoms

• Increasingly painful periods
• Lower abdominal pain or pelvic cramps that can be
  felt for a week or two before menstruation and/or
  during menstruation
• Pelvic or low back pain that may occur at any
  time during the menstrual cycle
• Pain during or following sexual intercourse
• Pain with bowel movements
• Premenstrual spotting
• Infertility
• Note Frequently, symptoms are not present. In
  fact, some women with severe cases of
  endometriosis have no pain at all, while some
  women with only a few small adhesions have severe
  discomfort.

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What causes Endometriosis?

• The cause of Endometrosis is unknown. However,
  a number of theories have been proposed, although
  none have been proven. Here are a few
• Coelomic Metaplasia
• Heredity
• Immunology
• Latrogenic transplantation
• Retrograde menstruation
• Transplantation theory

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Diagnosis

• The only way a positive diagnosis of
  Endometriosis can be made currently is via
  surgery. One method to remove diseased tissue
  combines laparoscopy with laser surgery. The
  laser is connected to the laparoscope and
  positioned so that its intense light beam is
  directed through the laparoscope onto the tissue
  to destroy it. The procedure usually is done
  without an overnight hospital stay and requires
  only about a week's recovery time at home. There
  is no proven prevention for endometriosis.
  However, some women with endometriosis who
  successfully become pregnant find that they are
  free of the disease afterwards. Pregnancy also
  tends to delay the onset and progression of the
  disease in susceptible women. Sometimes medicine
  is not enough. Surgery may be needed to remove
  diseased tissue or to correct misaligned organs.

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Who has Endometriosis?

• About 5 million American women and girls, some as
  young as 11, have endometriosis, according to the
  association.

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Drug Treatment

• Drugs for endometriosis should not be taken by
  women who are, or who may be, pregnant. The
  earliest drug approved to treat endometriosis was
  Danocrine (danazol), a synthetic steroid related
  to the hormone testosterone. Taken orally, in
  pill form, Danocrine changes endometrial tissue,
  shrinking and eliminating implants in some cases.
  Side effects include fluid retention, weight
  gain, and masculinizing effects such as voice
  change, hairiness, and reduction of breast size.
  Other side effects include menstrual
  irregularities, hot flashes, and vaginal dryness.

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Other drugs, related to gonadotropin-releasing
hormone (GnRH), act in a different way to
decrease the hormones that make abnormal implants
grow. One version is a nasal spray called Synarel
(nafarelin acetate). In clinical studies,
Synarel, at 400 or 800 micrograms a day (within
the prescribed dosage range), was comparable to
Danocrine at 800 milligrams a day (the
recommended dosage) in relieving the clinical
symptoms of endometriosis (such as pain) and in
reducing the size of implants. Side effects
include non-menstrual vaginal bleeding or ovarian
cysts during the first two months of use,
cessation of menstruation, hot flashes,
headaches, decreased sex drive, vaginal dryness,
acne, reduction in breast size, and a small loss
in bone density. In clinical trials, about 10
percent of the patients experience nasal
irritation from the spray.
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Women taking endometriosis drugs need to watch
for problems such as difficulty breathing or
chest or leg pain, which may indicate a blood
clot and should be reported to the doctor
immediately. Other possible severe side effects
include irregular heart rhythms. Frequent
checkups are needed to monitor effects such as
possible thinning of the bones. A patient should
immediately report any new or worsened symptoms
to the doctor. However, it's normal for
endometriosis symptoms to temporarily worsen when
a woman begins taking medicine.
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Lifestyle

• The monthly pain and heavy menstrual periods of
  chronic endometriosis can be frustrating and
  painful, and can lead to conceiving and
  infertility problems. But today, with prompt
  diagnosis and treatment, a young woman's life can
  often return to normal. Dealing with chronic
  pelvic pain can be challenging. Exercise often
  helps to relieve or lessen pelvic pain and
  menstrual cramps. Eating well and getting enough
  rest also helps the body to manage pain.
  Practicing relaxation techniques such as yoga and
  meditation help to ease pain too.