Endometriosis

Endometriosis is a condition where the endometrial tissues are displaced from inside the uterus to elsewhere in the body, such as on the outside of the uterus, ovaries, fallopian tube, bladder or bowel.

During a normal menstrual cycle, the endometrial lining of the uterus builds up with blood and tissue that is ready to receive an embryo. When an embryo does not implant, the lining sheds and is released through the vagina, and a women’s menarche or period occurs. With endometriosis, endometrial tissue continues to act normally, building up and shedding with each menstrual cycle. However, when it is trapped elsewhere in the body, there is nowhere for the lining to escape to. This can result in inflammation or cysts of endometrial blood and tissue called endometriomas, which may lead to pain, discomfort, and infertility for women. Endometriosis can also lead to adhesions, which are scars in the abdomen that cause infertility.

Approximately 30-50% of women who have endometriosis have infertility issues. Some symptoms of endometriosis are painful periods, pain during intercourse, infertility, lower back pain, fatigue and pain during bowel movements at the time of menstruation. Endometriosis may have an immunological component to it, so women may also experience eczema, chemical sensitivities and allergies.

Causes of Endometriosis

It is uncertain what exactly causes endometriosis, however there are many theories. One theory suggests that renegade endometrial tissue is backed up out of the fallopian tubes into the abdomen, however many women without endometriosis experience this phenomenon as well. Another suggests that endometrial tissue is transported from the uterus via blood and lymph to other areas of the body. Researchers also theorize that it is genetic and that women are predisposed to having endometriosis because their immune system cannot handle properly disposing of these tissues. There is also a theory which suggests that embryonic tissue that a woman retains into her adulthood can turn into endometriosis, or that certain adult tissues are able to change to endometrial tissue, under specific conditions. Women who have had surgery may experience endometriosis, suggesting that surgical transplantation is responsible.

The environment has also been studied as a cause of endometriosis. Exposure to dioxins (from the incineration of certain plastics) and PCB’s (pesticide chemicals) is thought to be a possible cause. In a case study where rhesus monkeys were exposed to dioxins, 79% of the colony developed endometriosis. There is concern that the incineration of medical supplies, such as PVC tubing from medical plastics like IV lines, releases dioxins into the environment. These chemicals infiltrate pastures, are ingested by livestock, and eventually passed on to humans.

Treatment

A physician may initially diagnose a patient with endometriosis because of symptoms; however, a true diagnosis cannot be made until a laparoscopy is performed. While under general anesthesia, small incisions are placed in the abdomen and a laparoscope is used to visualize the endometriosis inside the pelvic cavity. The endometriosis is graded on severity. Women who have severe cases benefit more from the laparoscopic removal of endometriosis and endometriomas than women who have light to moderate endometriosis. Some women experience an increase in fertility up to approximately nine months following surgery.

Surgery by laparoscopy is the most thorough means of removing current endometriosis but does not prevent future symptoms. The use of a hormone regimen, like birth control pills, to reduce the estrogen in the body can help with pain symptoms and the development of future endometriosis but does not remove current endometriosis. Alternative practices like Traditional Chinese Medicine (TCM), which uses herbs and acupuncture, have been noted as being helpful with the management of symptoms. TCM is offered at CNY Healing Arts (www.cnyhealingarts.com).

Because many women with endometriosis will have problems having children, many will also need the help of assisted reproductive technologies like artificial insemination (IUI) or In Vitro Fertilization (IVF).