Endometriosis generally occurs in young to middle age females after the start of the menstrual period.
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CAUSES:
A) Retrograde menstruation- sometimes shedding endometrial cells travel backward to the adjacent organs nearby uterus like ovary, fallopian tube during periods
B) Vascular and Lymphatic spread- endometrial cells may travel to the distant organs like abdomen, scars through blood vessels and Lymphatic vessels.
C) Transformation of other organs cells into endometrial cells
D) Implantation of endometrial cells to other sites during surgical procedures.
E)Genetic- close relatives of a patient with endometriosis have a high risk of developing the disease as compared to the normal population.
RISK FACTORS
Following factors increase the risk of developing endometriosis:
a)No history of giving birth
b)Start of the menstrual period at an early age
c) Cessation of the menstrual cycle (menopause) at an older age
d)Short menstrual cycles — for example, less than 27 days
e)Heavy and prolonged menstrual bleeding
f)Having higher levels of estrogen in the body
g)Low body mass index
h)One or more close relatives with endometriosis
i)Reproductive tract abnormalities
SYMPTOMS
A) Lower abdomen pain mainly during the time of periods(Dysmenorrhoea)
B) Painful intercourse ( Dyspareunia)
C)Infertility
D) Abnormal vaginal bleeding
E) Burning urination and blood in urine
F) Pain during bowel movements
G) Others-Constipation , bloating
H) Risk of ovarian cancer increases in ovarian endometriosis.
DIAGNOSIS
A) History of pt
B) Pelvic examination by doctor
C) Ultrasound or MRI of pelvis and abdomen
D) Laparoscopic examination by the surgeon.
TREATMENT
A) Pain control by a warm bath, pain killers
B)Hormonal therapy
C) treatment of infertility by IVF
C) Surgery- may be conservative by removing endometrial implants in the body or by total removal of uterus, ovary and fallopian tube