Endometriosis is a gynecological condition marked by intense pain in the background of endometrial implants with uterine consistency and characteristics. Usually, the implants scattered around the endometrial cavity have tissue that has the morphology and consistency of uterine tissue. Complications often arise since the implanted tissue cycles in sync with that in the uterine cavity. The cyclic thickening and breakdown of the implanted tissue cause it to accumulate in the affected area of the body. Irritation leads to further complications due to the scar tissue that results in adhesions of various body tissues, therefore, leading to pathological organ alterations (Olive, 1997). Endometrial cells are usually found scattered in various parts of the body such as the cervix, uterus vulva, and many others. In some rare situations, this tissue presents in remote areas such as the skin, lungs, and the brain. There is a high incidence of the disease with statistics estimating that up to 176 million people suffer from this gynecological condition. The United States alone accounts for 5 million in this figure. The pathophysiology of endometriosis is complex due to the probable complications likely to arise from this condition. Therefore, this condition not only causes pain but is associated with psychological symptoms leading to reduced productivity in work and school.
The cause of endometriosis has not yet been established. However, scholars have gone ahead to postulate theories as to the possible causes of this condition. Retrograde menstruation is by far the most discussed among the probable cause of endometriosis. In this theory, scientists hold the notion that menstrual blood flows back into the ovarian tubes instead of the conventional route (Leyendecker, 2000). However, there is a need for additional investigation to establish why only a certain percentage and not all women with retrograde menstruation present with endometriosis.
Embryonic cell growth is also a possible mechanism through which endometriosis occurs. Embryonic cells that are thought to be present in various parts of the pelvis and abdomen possibly develop into uterine tissue. This is thought to happen because the embryonic tissue has the potential to develop into almost any body tissue due to its multi-potent nature (Olive, 1997).
Endometrial cell transport has been studied adequately as a possible cause of this condition. The lymphatic system is thought to transport cells of endometrial consistency to various parts of the body causing them to be implanted elsewhere.
Endometriosis presents with diverse symptoms. Importantly, other gynecological conditions such as ovarian cysts and pelvic inflammatory disease can present similarly, therefore, becoming valid differential diagnoses for endometriosis. Pain is the most common symptom of this disease (Leyendecker, 2000). Usually, the pain comes in the form of severe cramping that is refractory to common painkillers such as NSAIDS. Moreover, it can present as pelvic pain or prolonged the lower back pain. Menses that last longer than seven days may point towards a possible diagnosis of endometriosis. Gastrointestinal symptoms such as diarrhea and constipation may be present in some cases. Some patients may experience pain during sexual intercourse and intermenstrual bleeding.
Conservative management is the treatment of choice for initial management of endometriosis. However, surgical intervention is often considered in advanced cases of the condition. There are numerous approaches to the management of endometriosis. Over the counter pain medications are indicated for relieving the pain. Hormone therapy has proved successful with researchers proposing the use of gonadotropin releasing agonists as one of the priority treatment options. Surgery is done in extensive cases with radical hysterectomy in cases not managed by hormone therapy (“Managing Endometriosis”, 2007).
Leyendecker, G. (2000). Redefining Endometriosis: Endometriosis is an entity with extreme
pleomorphism. Human Reproduction, 15(1), 4-7. http://dx.doi.org/10.1093/humrep/15.1.4
Managing endometriosis. (2007). Prescriber, 18(12), 61-62. http://dx.doi.org/10.1002/psb.97Olive, D. (1997). Endometriosis. Philadelphia: W.B. Saunders.
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