Endometriosis is an extremely common disorder that affects ladies in their reproductive years. It occurs when endometrial tissue (in other words, the lining of the womb), grows outside of the cavity that contains the uterus. It can implant and grow anywhere within the abdominal cavity, and has occasionally been found to grow even further through the body.
These growths can result in scar tissue which causes organs to bind together. This scar tissue is known as ‘adhesions’. Often, ladies with endometriosis don’t have any symptoms, however it can cause severe menstrual cramps, pain during sex and infertility.
Surgery is the only effective treatment option – particularly in order to preserve fertility. Alternatively, medication can be used to alleviate the symptoms of endometriosis.
The most common theory as to the cause of endometriosis is the concept that the backward flow of menstrual discharge (through the tubes and into the pelvis) causes endometrial cells to implant on the ovaries or in the uterine cavity. Another possible cause is changes in the immune system which is responsible for clearing abnormal cells and bacteria from the body. There also seems to be a genetic link.
Endometriosis in the early implant stage looks like small, flat patches of dark ‘paint’ sprinkled on the pelvic surface. Endometriosis can invade the ovary, causing blood-filled cysts that are often called “chocolate cysts” due to their dark colour. These cysts can be small, or large and can burst. Endometriosis can bind the uterus, fallopian tubes, and intestines together. It can move into the tissue that separates the rectum from the vagina, and occasionally could even grow into the bladder wall.
Menstrual cramping is one of the most common symptoms. Other symptoms include pain during sex (usually caused by the scar tissue binding organs together), abnormal bleeding, and infertility.
Diagnosing endometriosis cannot be done based on symptoms, and it is essential to visit a qualified doctor (preferably a fertility specialist) for diagnosis. Some of the testing for endometriosis will include a pelvic exam, a laparoscopy (surgical procedure enabling the doctor to see into the pelvis with a camera), ultrasound, and blood tests.
There are a few treatment options for endometriosis: hormone medication can be used to simulate pregnancy or menopause (both of which inhibit endometriosis), the oral pill, surgery and lastly, pregnancy.
Endometriosis is a disease with vast emotional consequences for women. The pain is often debilitating, while women may avoid sex and blame themselves. Endometriosis affects millions of women around the world, and it often goes unnoticed. Contact the Endometriosis Society of South Africa (ESSA) for further information.