Endometriosis...

What is Endo?

Endometriosis is a condition where endometrial cells and tissue (like the lining of the uterus) are found in the pelvis and occasionally in other places in a woman's body.

Endometriosis may cause pain or infertility by causing scarring and adhesions which may damage a woman's pelvic organs.

What is endometrial tissue?

Endometrial tissue is the normally placed lining of the uterus, which falls away from the inside of the uterus when a period occurs.

How does it occur?

There are a number of theories as to how these cells come to be in the wrong place, but in reality, no one knows for sure.

We know that during a normal period some of the blood flows backwards through the fallopian tubes and ends up in the pelvis. Usually this fluid and any of the cells it contains are absorbed. In some women the cells stick to the pelvic lining, and produce a substance which stimulates the lining of the pelvis to grow blood vessels to supply them with nutrients. Hence, instead of being absorbed, the cells survive and grow.

This is the most logical theory, but we also know that endometriosis can develop in women with blocked tubes, and is occasionally seen in those who are born without a uterus. In this situation it is thought that the lining layer (peritoneum) of the pelvis changes spontaneously into endometriosis cells.

Endometriosis cells, like normally situated endometrial cells are sensitive to hormonal changes. This means that when the lining of the uterus sheds and a period occurs, endometriosis cells also bleed and change. The result of this is that bleeding and irritation occurs in the pelvic lining or wherever the endometriosis cells are.

Who gets Endo?

Endometriosis is common - it occurs in about one in ten women aged 12-50.

In the past it was often said that the typical woman with endometriosis was a white, middle class, career-oriented woman in her late twenties or early thirties who had deferred childbearing. However, the typical discription is a myth and with improved diagnosis since the introduction of laparoscopy endometriosis has been found in the entire spectrum of women. In particular, it has been shown that endometriosis can occur at any time between puberty and menopause and that it is frequently found in women who have had children.

A woman is more likely to develop endometriosis if her mother or sister has it.

Infertility

40% of infertile couples have endometriosis present in the woman.

In situations where the disease process causes distortion and damage to the fallopian tubes and ovaries, the role which endometriosis plays is obvious.

When damaged, the reproductive organs are unable to function normally. Mild endometriosis is also associated with inability to concieve.

Abnormal proteins are released by the endometriosis implant into the pelvis, contirbuting to pain and infertility.

Endometriosis related infertility can be managed by laparoscopic surgery, superovulation (O.I.), intrauterine insemination (I.U.I.), or in vitro fertilisation (I.V.F.).

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Facts & Fiction

FACT: Endometriosis can be found in 10% of women.

FACT: 40% of women with infertility have endometriosis.

FACT: Surgical removal of even mild endometriosis has been shown to improve chances of getting

FACT:Women with untreated endometriosis are more likely to suffer miscarriage.

FACT:Endometriosis if often present for many years before the diagnosis is made.

FACT:When women are cared for by expert surgeons, repeated operations are seldom required.

FACT: Women who have expert treatment for endometriosis are able to lead healthy and normal lives.

FICTION: Endometriosis is cured by pregnancy.

FICTION: All women with endometriosis have pain.

FICTION: Laparoscopic surgery is required every six months 'just in case' the condition has recurred.

FICTION: Ovaries which contain endometriosis should be removed.

FICTION: Drug treatment for endometriosis does not work.

FICTION: Hysterectomy is the best treatment for endometriosis.