Endometriosis: Menstrual Cycle and Staff

The most common symptoms of endometriosis include a history of painful periods not relieved by oral non-steroidal anti-inflammatory drugs (NSAIDS).

In addition to pain during menstruation, the pain of endometriosis can occur at other times of the month. There can be pain with ovulation, pain associated with adhesions, pain caused by inflammation in the pelvic cavity, pain during bowel movements and urination, during general bodily movement like exercise, pain from standing or walking, and pain with intercourse. But the most desperate pain is usually with menstruation and many women dread having their periods. Pain can also start a week before menses, during and even a week after menses, or it can be constant. There is no known cure for endometriosis.

Lupron endometriosis treatment leads to a reduction of estrogen levels which stops endo from growing or slowing down its growth, eventually, fertility is restored. Many women with endometriosis may go through surgery to improve chances of conception. Eventually, if one becomes pregnant and have endometriosis, the pregnancy will be at risk, however with the doctors help one can successfully carry the pregnancy to term and have a safe delivery. Sometimes, pregnancy may improve the signs of endo, although they are most likely to come back after giving birth, one is done with breast feeding or the periods return to

Scarring can be to blame. The great news is that medical treatments might help someone overcome fertility, and pregnancy itself may relieve some signs of endometriosis. Can it be fibroids? Endometriosis is one reason for severe pain. The pain may be due to another condition, such as fibroids, which can be growths of the muscular tissue of the uterus. Fibroids can cause bleeding and cramps. The pain of fibroids or endometriosis may flare up at times of the

A fibroid is “a tumor or lump made of muscle cells and other tissue that grow within the wall of the uterus” (Illinois Department of Public Health, 2015). According to the UCLA Obstetrics and Gynecology team, “fibroids are the most frequently seen tumors of the female reproductive system… twenty to fifty percent of women of reproductive age have fibroids, although not all are diagnosed. Some estimates state that up to thirty to seventy-seven percent of women will develop fibroids sometime during their childbearing years… in ninety-nine percent of fibroid cases, the tumors are benign” (UCLA Health, 2016). Uterine fibroids are the most common cause for a hysterectomy. A hysterectomy is the surgical removal of the uterus. “Hysterectomy is the second most frequently performed surgical procedure (after cesarean section) for U.S. women who are of reproductive age… By the age of sixty, more than one third of all women have had a hysterectomy” (National Women’s Health Network, 2015).

Infertility and ovarian cancer are very serious problems that can be developed in women with endometriosis. Infertility is the main problem associated with endometriosis. It can be a major setback for seemingly healthy couples that want to start a family. “Endometriosis is associated with infertility in 30-40% of sufferers (World Endometriosis, 2011)” “The presence of endometriosis may involve masses of tissue or scarring (adhesions) within the pelvis that may distort normal anatomical structures, such as Fallopian tubes, which transport the eggs from the ovaries. Alternatively, endometriosis may affect fertility through the production of hormones and other substances that have a negative effect on ovulation, fertilization of the egg, and/or implantation of the embryo” (MedicineNet, 2013). Although

Endometriosis can be most simply defined as abnormal growth of the tissue that normally lines the uterus, outside the uterus. This chronic disease can range from mild to severe. Mild to moderate endometriosis can lead to infertility and severe cases could be life threatening. Due to the prevalence of this condition, a common concern is fertility in women. There is much debate about how effective treatment via ablation is in fertility.

Women who suffer endometriosis often undergo conservative surgery such as a laparoscopy or laparotomy in an effort to remove the endometriosis without damaging normal tissue and the reproductive organs ( Hogg & Vyas, 2015.) A laparoscopy allows surgeons to examine the pelvis, abdomen and organs through a small incision usually near the navel ( The Royal Australian And New Zealand College of Obstetricians and Gynaecologists, 2006) In an effort to create more space to work in, the surgeon expand the abdomen cavity using carbon dioxide gas which is inserted through a needle. The needle is then replaced by the laparoscope for the doctor to examine the uterus, fallopian tubes, ovaries and other organs (The Australian and New Zealand College of Obstetricians and Gynaecologists, 2006). Using the small incisions created in the patients’ abdomen, the doctor will insert surgical instruments and begin to cut and remove damaged tissue. Once the endometrial tissue is removed, the doctor will remove the instruments and put a single stich in the incision (The Australian and New Zealand College of Obstetricians and Gynaecologists, 2006) A successful laparoscopy manages chronic pelvic pain by delaying or stopping the progress of endometriosis (The Australian and New Zeeland College of Obstetricians and Gynaecologists, 2006). Alternatively, the surgeon may decide to perform a

Endometrial cells that shed during menstruation are transported through the fallopian tubes and enter the pelvis, attaching to pelvic structures. Cells can travel outside the pelvis through the lymphatic and blood vessels, during menstruation this tissue responds to hormonal changes and bleeding which can cause inflammation to the surrounding tissue. Inflammation can lead to fibrosis, and fibrosis leads to adhesions that can be painful. (docucare, 2017) Menorrhagia can occur with endometriosis because of the hormone build up caused by the thicken of the uterine wall. (Mayo Clinic 2017)

Menorrhagia can have hormonal or non-hormonal causes. Uterine fibroids, or myomas, are a common non-hormonal cause. (1) Clinically, there are three main categories of myomas, classified according to their site in the uterus: subserosal myomas grow in the outer portion of the uterus, intramural myomas develop within the uterine wall, and submucosal myomas grow just below the lining of the uterine cavity and close to the endometrial cavity. This last group of myomas, the submucosal, that have the most effect on menorrhagia.(4,5) Because of their location on the endometrium, these myomas place pressure on the uterine lining that builds with each menstrual cycle. This, in turn, can cause heavy bleeding. Even very small submucosal myomas may cause very heavy bleeding.(4,5) Myomas in the submucosal location specifically may cause abnormal uterine bleeding or subfertility, and are agreeable to hysteroscopic removal. The European Society of Gynecological Endoscopy (ESGE) classifies submucosal myomas as Type 0 if the entire lesion is intracavitary, Type I if less than 50% extends into the myometrium, and Type

Endometriosis is a condition in which pieces of the tissue similar to the endometrium, which is the lining of the uterus, grow in other parts of the body. Just as the uterine lining sheds in response to monthly normal cycles, so does this misplaced tissue. Since there is no outlet for the blood which is discarded from the tissue buildup, it just falls onto surrounding organs causing swelling and inflammation. Due to this repeated abnormal cycle of events, scar tissue and adhesions develop in the area of the endometrial implanted tissue.

In the journal article, An Unusual Case of Asymptomatic Spontaneous Umbilical Endometriosis Treated with Skin – sparing Excision, the author discusses the study of an unusual case of umbilical endometriosis in a healthy thirty nine year old healthy female. “Medical research proves that endometriosis usually affects woman that have a difficult menstrual cycle accompanied with a great amount of pain” (WebMd). “Umbilical endometriosis is a rare buildup of endometriosis in the umbilical cord, due to the known history that the disease is typically a manifestation outside of the uterus as a result of tissue built up” (Arkoulis N).

Endometriosis affects “up to ten percent of all women in their reproductive years from as young as age eight to post-menopause. In Australia alone, about 600,000 females suffer from this condition…” (Saba, 2015). Endometriosis is a chronic condition where the tissue that lines the uterus (this is known as the endometrium) (Wilson, 2017) begins to grow outside the uterus and attach to other organs such as the Fallopian tubes and ovaries in the body. Endometriosis is usually found in the pelvis and it often causes lesions. Lesions are any abnormal tissues or organ damage that may cause pain, infertility and permanent scarring (WHRIA, 2014).

Endometriosis occurs when the endometrial tissue, normally located inside the uterus, lines the outside. The condition most commonly affects the ovaries and peritoneum, and affects approximately 10% of women in the United States (Barnhart et. el. 2002). The misplaced endometrial tissue continues to act as it would in the usual situation; the tissue thickens, breaks down, and bleeds with the menstrual cycle. Since there is no exit path for the tissue to leave the body, the tissue becomes trapped inside the abdomen, causing severe pain (Mayo Clinic, 2013).

Uterine fibroids affect 3 out of 4 women (Mayo Clinic, 2014). They are non-cancerous but they can cause pain and discomfort. This paper will discuss who can be effected by Uterine fibroids and its effects on the female reproductive system. This paper will show the three types of fibroids that develop in or near the uterus. It will discuss the symptoms and when a diagnosis is needed. This paper will also look into the various forms of treatment including medications and surgery.