SHARES
Girls: “Urgh, why are there so many paperwork to do?”
Girls: “Oh my, this weather is insane!”
Girls: “Why can’t you love me the way I loved you?”
Hormones! We girls blame everything on the hormones in the body whenever we are depressed, angry, frustrated, in pain or even elated. Everything is intensified with hormones! But, to a lot of women out there, nothing’s more suffocating than having menstrual pain. Worse is, the same feeling comes every month at the most random moment and place. As a woman living in a sophisticated world now, we ought to know more about our body condition. A female’s abdominal pain could be due to any reason like appendicitis, menstrual pain, and food poisoning. One condition everyone, especially the ladies, should bring a close concern to is called endometriosis.
What is Endometriosis?
Endometriosis is a benign gynecological disorder where some fragments of the endometrium tissue appear outside the uterus. It occurs in 2-10% of women of reproductive age, regardless of age and ethnicity.
To begin with, let’s focus on the endometrial lining AKA womb lining of the uterus. If you are wondering where does the menstrual blood come from, this is the part where it usually sheds off every month when there is no ovum attached on it. It gets thickened slowly each day and when it’s the time of the month, the thickened endometrium will slough off due to hormonal changes and voila! Menstruation occurs.
Endometriosis happens when fragments of the endometrial cells are located elsewhere (the dark spots depicted above), and react in the same way as the normal endometrial cells in the uterus. They build up slowly, they break down, and they bleed, all in the wrong location. But how?
Ever heard of retrograde menstruation?
John Sampson from new york was the one who proposed this theory which was widely accepted until today. In retrograde menstruation, some of the blood backflows to the direction of the tubes, reaching the ovary and the surroundings, include pelvic peritoneum, ureter, large and small bowel, ligaments and sometimes scars. The retrograded blood will invade the tissue by developing a blood supply in order to grow.
Image Source – Williams Gynaecology
Causes of Endometriosis
Other causes that might lead to the development of endometrial cells in other parts of the body are due to lymphatic spread, immune system dysfunction, genetic factors and environmental toxins.
- Lymphatic spread
Findings of endometrial tissue at unusual places suggest this theory about the lymphatic spread of tissue.
- Immune system
Menstrual tissue and endometrium that are refluxed into the peritoneal cavity are usually cleared by immune cells, which then suggests the involvement of the immune system in endometriosis.
- Genetic factors
It is found that 5.9 percent of female siblings and 8.1 percent of the mothers of affected women had endometriosis too.
- Environmental toxins (dioxin)
Waste products of the industrial area if accidentally consumed by way of contaminated food and accidental contact will predispose the development of endometriosis.
Sites and symptoms
The symptoms could vary in different individuals, depends on the site where the tissue has invaded. Some people are asymptomatic, but typically the females with endometriosis will suffer from chronic pain and infertility.
o Pelvic pain
o Menstrual pain
o Pain during sexual intercourse – this is due to the tension on involved ligaments, usually after years of pain-free intercourse.
o Pain during urination – endometriosis should be suspected if the urine culture is negative, and if the individual is a female of course.
o Pain during defecation – may be associated with constipation, diarrhea, and blood in stool!
The affected ovary looks something like this:
No, those are definitely not Nutella-filled scones! Ovarian endometriomas are a common manifestation of endometriosis. When the menstrual debris has accumulated in the ovary, it forms a dark-brown cyst filled with chocolate-appearing fluid.
Here comes the ultimate concern: Infertility
“How possible would it be to have children?”
This is the most worrying question of all, especially to those of reproductive age. The reason why the fertility is affected is because endometriosis causes adhesion of other tissues, which halted the transport of the eggs. Also, in moderate or severe endometriosis, the tube and ovary are often distorted, resulting in impairment of fertility.
Endometrial changes in the uterus increase the difficulty of the egg to attach to it. Other studies suggest that sperm function may be altered in women with endometriosis.
With the advancement of science and technology today, it is possible still to get pregnant in the early 30s with endometriosis. However, this has to depend on the symptom severity, location of the endometriotic lesion, and age of the individual.
How can this be treated?
Medical treatment:
1) painkillers
2) hormonal pills
Surgical treatment:
1) lesion and adhesion removal
2) endometrioma excision
3) hysterectomy with bilateral salpingo-oophorectomy: removal of uterus and fallopian tubes and ovaries
4) post-operative hormonal replacement
Having endometriosis can make a person very vulnerable to emotional changes because it can affect your daily life. Talk to your doctor, talk to your loved ones. You would be surprised at how much they actually care about you.
References:
by Angie Loh
A medical student with nothing but passion and a pen. Poems and novels never fail to make me feel alive. I'm inspired to make the world a better place and fill it with a little bit more love. But first, where's my coffee? View all articles by Angie Loh.
