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EndometriosisEndometriosis – General InformationEndometriosis is a disease which affects the female patient’s reproductive organs. The disorder is located in the edometrium, the tissue that lines the inner layer of the uterus and becomes implanted in the outside layer of the uterus, generally on the surface of the fallopian tubes, ovaries and the tissue of the pelvis. There are also cases in which the disease can spread beyond the patient’s pelvic area. During the usual menses, the patient’s uterus secretes hormones that have the role of thickening the walls to prepare it for a future pregnancy. The normal bleeding, which appears monthly, is caused by the thickening of the lining of the uterus, when the hormone levels decrease. In most of the cases, the endometrial tissue is located in another place of the body and acts in its normal way. Every month, the tissue thickens and the level of hormones increases, and decreases. The tissue breaks down and the woman starts to bleed. Due to the fact that the blood has no exit and no where to go it gets trapped and irritates the surrounding tissues. The blood causes the appearance of cysts that can form the scar tissue and adhesions, a type of tissue the binds organs to each other. During the binding process, the patient experiences pain, usually in the pelvic area. Endometriosis can also affect the fertility of the female patient. However, in most clinical cases, the pelvic pain can be caused by other conditions, and that is why the patient has to see the doctor.Endometriosis – SymptomsEndometriosis can be mild, moderate and severe, and, if it is left untreated, over time, it can worsen. There are cases in which the female patient suffering from this disease has no symptoms at all, and the condition is discovered after doing a routine operation such as tubal ligation. But, there are also cases in which Endometriosis can cause signs and symptoms which can include painful menstrual cycles, a condition called dysmenorrheal, and appears a pelvic pain and cramping before the period, and can progress to lower back and abdominal pain, during the menses. The patient can also experience pain during the ovulation or pain deep in the pelvis during intercourse. The pain can also be present when the patient makes usual activities such as bowel movements or urination. Another symptom for the disease is the excessive bleeding, which has two forms, menirrhagia, with severe bleeding during the period, and menometrorrhagia, bleeding between menstrual cycles. Endometriosis can also be diagnosed in patients who seek medical treatment for infertility. Female patients have cramps during the periods which are normal, but the patients who suffer from this disease experience more severe cramps during the menstrual cycle. The cramps and pain worsen over time, if the disease is left untreated. Although the main symptom of the disease is pain, there are patients that have more severe scarring and have little or no pain at all. It is important to seek medical support when the patient experiences one of the symptoms above.Endometriosis – TreatmentUsually, doctors use medications and surgery to treat Endometriosis. The medication treatment consists in pain drugs and hormone therapy, and surgery treatment in hysterectomy. There are many pain relievers that can be prescribed for Endometriosis, but the main drug is ibuprofen, recommended as Advil, which is essential in relieving menstrual cramps. The hormone therapy is applied to relieve the symptoms of pain. The menstrual pain is caused by the production of hormones during the menstrual cycle, leading to a thickening of the endometrium, the lining of the uterus. The hormonal therapy can include oral contraceptives, gonadotropin-releasing hormone (Gn-RH) agonists and antagonists, danazol, medroxyprogesterone and aromatase inhibitors. The oral contraceptives have the effect on controlling the hormones that cause the build up of endometrial tissue. These medicines can be taken to relieve the pain too. When a female patient starts the oral contraceptives treatment, she will have a lighter and shorter menstrual flow each month. Gonadotropin-releasing hormone (Gn-RH) agonists and antagonists are some drugs that have the effect of blocking the production of ovarian hormones. They also prevent menstruation and reduce the production of estrogen, shrinking the endometrial implants. If the drugs are administered for at least several months, they can put Endometriosis in remission, creating a menopause. There are some side effects caused by the gonadotropin-releasing hormones which include hot flashes and vaginal dryness. Danazol can also be used to treat Endometriosis. It is a medicine that blocks the secretion of ovarian hormones, relieving the symptoms. It has several side effects such as acne and facial hair. Medroxyprogesterone is an injectable medicine which prevents menstruation and thickening of the endometrial implants, relieving the symptoms. It can also have several unpleasant side effects which can include weight gain and depressed mood. Aromatase inhibitors can also be used to treat the disease. Due to the fact that they are very effective in treating breast cancer, these inhibitors can be prescribed for this disease too. Some doctors say the aromatase inhibitors are as effective as the other hormones; the only difference there is between them is that they cause fewer side effects. If the medication treatments prove to be ineffective, the doctor can recommend the surgical approach. In the severe cases of Endometriosis, hysterectomy can be the best therapy option the patient has. The hysterectomy procedure consists in the removal of both ovaries, but there are cases in which the doctor can remove the whole damaged uterus. This operation can be risky, because it can lead to the appearance of severe complications such as infections, bleeding and injury in the bladder, rectum and ureter area. It can also cause the development of other malfunctions such as pulmonary embolism, characterized by several blood clots on the legs that can travel to the lungs. Hysterectomy is an effective operation with no chances for the disease to recur. The patient can not carry a pregnancy anymore after the operation is done. After these operations, doctors can prescribe chemotherapy for full recovery. |
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