Endometriosis Symptoms and causes

The uterus is part of the female reproductive system where a fetus grows. It consists of a serous layer, muscles, and an inner lining. Endometriosis is characterized by the growth of endometrial tissue in places outside the uterus, known as implants or lesions. This condition is common among women aged 30-40 and can pose a barrier to fertility for many women. However, various treatments can help manage symptoms and improve the chances of conception.

What is Endometriosis:

Endometriosis, also known as endometriosis, takes its name from the word "endometrium" (the uterus). In a normal state, endometrial tissue lines only the uterus, but in cases of endometriosis, this tissue may grow outside the uterus in areas such as:
1- On or beneath the ovaries.
2- Fallopian tubes (which carry eggs or zygotes to the uterus).
3- Behind the uterus or on the tissues that support the uterus.
4- On the intestines or bladder.
5- It may also grow in the vagina, rectum, and rarely, endometrial tissue has been found in other parts of the body such as the brain, lungs, and skin. The growth of endometrial tissue in unusual locations can cause various problems because it will swell and bleed, similar to when it is inside the uterus during menstruation, causing pain and other symptoms as these areas of the body are not prepared for it, making it difficult to drain the bleeding blood.
It can also cause other problems such as: blockage of fallopian tubes, formation of fibrous tissues and adhesions, inflammation, severe pelvic pain, difficulty conceiving, bowel and bladder problems.

How do I know if I have endometriosis:

There are various symptoms you may experience if you have endometrial tissue outside the uterus, including:

1. Pain: This is the most common symptom in women with endometriosis and can take several forms, including:
   • Chronic (long-term) pain in the pelvic area and lower back.
   • Severe pain during menstruation, which may worsen over time.
   • Deep and intense pain during sexual intercourse.
   • Intestinal pain; sometimes pain during urination as well. In rare cases, you may notice blood in urine or stool.
2. Bleeding between menstrual periods.
3. Decreased fertility, where women struggle to conceive despite multiple attempts.
4. Digestive issues: diarrhea, constipation, bloating, nausea, especially during menstrual periods.

How do I know if I have endometriosis:

In fact, any girl or woman can develop endometrial tissue outside the uterus, but it is more common in women aged 30-40. You may be more susceptible if you:
1- Have not given birth before.
2- Have long menstrual periods (lasting more than 7 days).
3- Have short menstrual cycles.
4- Have a family history of endometriosis (such as mother, aunt, or grandmother).
5- Have other health issues that prevent normal blood flow from the body during menstruation.

But what is the cause of endometriosis:

In fact, there is no clear and specific cause behind endometrial tissue migration, but new studies point to a range of possible reasons and factors that may be behind this problem, including:
1- Genetic factors: Since endometrial tissue migration runs in families, we may find both mothers and daughters affected, suggesting a genetic component.
2- Immune system issues: The immune system may fail to recognize and destroy endometrial tissues growing outside the uterus. Immune system disorders and certain types of cancer are more common in women with endometriosis.
3- Surgery: During abdominal surgeries such as cesarean sections or hysterectomies, endometrial tissues may be inadvertently transferred to other areas like surgical scars.
4- Blood flow issues during menstruation: Blood and endometrial tissues may flow into other areas like the fallopian tubes and pelvis.

Diagnosis:

If you are experiencing symptoms of endometriosis, talk to your doctor. Your doctor may discuss your symptoms and perform one or more of the following tests to determine if you have endometriosis:
1- Pelvic exam and ultrasound: Scarring and large cysts behind the uterus or near the ovaries may indicate endometriosis. Ovarian cysts may also be a sign of endometriosis. Vaginal ultrasound may be used.
2- Magnetic resonance imaging (MRI) is another common imaging test that can help diagnose endometriosis in the presence of other symptoms.
3- The doctor may prescribe medications if symptoms and diagnostic signs are absent:
*Specific hormone medications and GnRH antagonists reduce estrogen production and alleviate pelvic pain. Once the medication is stopped, symptoms may
4- Laparoscopy: A type of surgery that allows doctors to look inside the pelvic area to see endometrial tissues. It is a definitive diagnostic method, as doctors can sometimes diagnose endometrial inflammation just by visual inspection. In other cases, they may need to take a small tissue sample for microscopic examination to confirm.

Treatment for endometriosis:

There is no cure for endometriosis, but treatments are available for the symptoms and problems it causes. Discuss your treatment options with your doctor.

• Hormonal therapy: Hormonal therapy only works while being taken and its effects disappear upon discontinuation. It is best for women who do not experience severe pain or symptoms.
  • Birth control pills or injections help stop bleeding and reduce or eliminate pain.
  • Intrauterine device (IUD) can help reduce pain and bleeding. Hormonal IUDs protect against pregnancy for up to 7 years but may not help with pain and bleeding due to endometriosis in the long term.
• If you are trying to conceive, your doctor may prescribe a Gonadotropin-releasing hormone (GnRH) agonist to regulate reproductive glands. This medication inhibits the body from producing hormones responsible for ovulation, the menstrual cycle, and the growth of the uterine lining. This treatment causes temporary cessation of menstruation but also helps control the growth of endometrial inflammation. Once you stop taking the medication, your menstrual cycle resumes, but you may have a better chance of conceiving.
• Surgical treatments for severe pain, including procedures to remove patches of endometrial implants or cutting some nerves in the pelvis. Surgery may involve laparoscopy or major surgery.
• Your doctor may also prescribe various pain-relieving medications if you are experiencing severe pain.

Pregnancy and Endometriosis:

Endometrial implants can block certain reproductive areas or alter the shape of the pelvis and reproductive organs, making it difficult for sperm to fertilize the egg, thus preventing embryo formation.
The immune system, which usually helps defend the body against disease, may attack the embryo due to an immune system imbalance.
The uterine lining (endometrial layer where implantation occurs) may not develop as it should.
If you experience any signs or symptoms of endometriosis, you should talk to your doctor, as there are many treatments and interventions that can help manage this problem and prevent its progression.
You can also take several preventive measures such as:
1- Regular exercise.
2- Avoiding excessive consumption of caffeinated beverages. Studies indicate that consuming more than one caffeinated beverage daily, especially sodas and green tea, can raise estrogen levels.
3- Avoiding large amounts of alcohol (which can also increase estrogen levels).