Introduction

The uterus in a woman’s body has a special lining made of endometrial tissue known as the endometrium. With each menstrual cycle, the body forms a fresh endometrium to get ready in case an egg is fertilised. Endometriosis happens when this endometrial tissue starts growing outside of the uterus, where it doesn't belong.

What is Endometriosis?

Endometriosis can affect women who are between 15 and 44 years old. It develops around or on reproductive organs found in the pelvic area or abdomen such as:

• Fallopian tubes
• Ligaments near the uterus (uterosacral ligaments)
• Pelvic cavity lining
• Ovaries
• Outer side of the uterus
• Area between the uterus and either the rectum or the bladder

Less, it might develop on or near the:

• Bladder
• Cervix
• Intestines
• Rectum
• Abdomen (stomach area)
• Vagina or vulva

Symptoms of Endometriosis

Pain and infertility occur most often with endometriosis. Pain linked to this condition can appear as:

• Cramping during periods that spreads to the stomach or lower back
• Discomfort during or after intimacy
• Other possible signs include:
• Issues like diarrhoea or constipation during periods
• Feeling tired or lacking energy
• Periods that are heavy or not regular
• Pain while urinating
• Bleeding or spotting between periods

What Causes Endometriosis?

• Doctors are not sure about what causes endometriosis, but there are a few theories about what it might be.
• Transport through blood or lymph systems: The bloodstream or lymphatic system moves endometrial tissue to other parts of the body much like how cancer cells migrate and spread.
• Direct cell attachment after surgery: Endometrial cells might stick to the abdominal walls or other areas of the body following surgeries like a hysterectomy or C-section.
• Family history connection: Endometriosis tends to run in certain families suggesting a possible genetic cause behind it.
• Retrograde menstruation: Instead of leaving the body during periods, endometrial tissue flows backwards into the fallopian tubes and abdomen. Other body cells might turn into endometrial cells and begin growing where they shouldn't, outside the endometrium.

Risk Factors for Endometriosis

Some factors raise the chance of endometriosis. Research finds these include:

• An unusual uterus
• Starting
• your period before turning 11
• Menstrual cycles being shorter than 27 days on average
• Periods that are very heavy and last more than seven days

Diagnosing Endometriosis

Doctors look at your medical history or perform a physical exam to suspect endometriosis. They may also use different techniques to figure out if you have it.

• Ultrasound: A transvaginal ultrasound uses a small wand placed inside the vagina to check the uterus, pelvic area, and reproductive parts.
• MRI: Magnetic waves provide internal images of reproductive tissues and organs
• Laparoscopy: The doctor cuts a small opening in the abdomen to insert a thin tube. This tube has a camera and light attached. This test allows doctors to confirm the endometrial tissue growth.
• Biopsy: When abnormal tissue is seen, the doctor might scrape off some cells with a tool and send them to a lab for testing.

Treatment for Endometriosis

There is no permanent cure for endometriosis, but doctors can suggest ways to manage it. The right solution depends on factors like your symptoms and age. They also consider whether you want children when deciding the best approach. Treatment options are:

Medications:

• Birth control pills using oestrogen and progesterone to balance hormones
• Progestins to halt both periods and the growth of endometrial tissue
• Medications that block ovarian hormones with gonadotropin-releasing hormone antagonists
• Hormone-blocking options like gonadotropin-releasing hormone agonists to prevent ovarian hormones

Using laparoscopy to deal with endometriosis:

• People with severe endometriosis, unrelenting pain, or difficulty getting pregnant might require surgery. Doctors often recommend laparoscopy as the go-to method to treat endometriosis.

Laparotomy to Treat Endometriosis:

• Sometimes, doctors might perform a laparotomy instead of a laparoscopy to treat endometriosis. This involves making a bigger cut in the abdomen to take out the endometrial tissue. This type of surgery is rare.

Hysterectomy to address endometriosis:

• A hysterectomy means surgically removing the uterus. It is something doctors might suggest to treat endometriosis. Sometimes, they might also suggest removing the ovaries, which is called an oophorectomy, either alongside or separate from the hysterectomy.