Taking a Look at Endometriosis

Fibroids are becoming more and more common in women in the United States. It is estimated that 171 million women in the U.S. were affected by this condition in 2013(6). About 20% to 80% of women develop fibroids by age 50 (6). As many as three out of four women may have uterine fibroids in her lifetime (4). Fibroids, also known as uterine leiomyoma, are benign tumors that can be found in women of childbearing age due to its dependence on estrogen and progesterone (7). They are made of muscle cells and other tissues that can grow around or in the uterus or womb. With fibroids, a single cell divides repeatedly, eventually creating a firm, rubbery mass distinct from nearby tissue (2). Some fibroids even go through growth spurts where they grow and shrink on their by itself. There are women with fibroids who have no symptoms at all. If they do, it may consist of heavy or painful periods, frequent

Endometriosis is a common but often underdiagnosed disease in women during active reproductive years of 25 to 35 years. Endometriosis is an estrogen dependent chronic pelvic disorder that can cause severe pain and adversely affect fertility. Endometriosis is described as the occurrence of endometrial glands and connective tissue called stroma in the extra uterine mucosa located throughout the pelvis (Solnik, 2015). Therefore, as Family Nurse Practitioner (FNP) accurately diagnoses this disease, this patient population can increase the awareness become educated about endometriosis treatment options.

Janet presented with uterine fibroids, otherwise referred to as leiomyomas. These tumours are composed of muscular tissue and are found within the uterus. Research has found no direct cause of leiomyomas however, it is known that the development and growth are dependent on ovarian hormones (Brown, Edwards, Seaton, & Buckley, 2015). Levels of these hormones vary throughout a woman’s life depending on her age and genetic predisposition; risk of developing leiomyomas is lowest in prepubescent and post-menopausal women and highest during pregnancy (Tinelli & Malvasi, 2014). An increase in hormone production causes these fibroids to grow rapidly.

It has been suggested that endometriotic lesions release factors which are detrimental to gametes or embryos, or, alternatively, endometriosis may more likely develop in women who fail to conceive for other reasons and thus be a secondary phenomenon; for this reason it is preferable to speak of endometriosis-associated infertility.

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 (Stoppler, 2011). The severity of your pain isn't necessarily a reliable indicator of the extent of the condition. Some women with mild endometriosis have extensive pain, while others with advanced endometriosis may have little pain or even no pain at all (Staff, 2010). Endometriosis is sometimes mistaken for other conditions that can cause pelvic pain, such as pelvic inflammatory disease (PID) or ovarian cysts. It may be confused with irritable bowel syndrome (IBS), a condition that causes bouts of diarrhea, constipation and abdominal cramping. IBS can accompany endometriosis, which can complicate the diagnosis (Staff, 2010).

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

According to National Women's Health Information Center (NWHIC), in the United States, approximately one-third of all hysterectomies are performed for uterine fibroid (Right Diagnosis, 2015). The 2nd most frequent condition that leads to hysterectomies is endometriosis

Endometriosis occurs when tissue typically found inside the womb grows in other portions of the body. As hormones change throughout the menstrual period, this tissue breaks down and can cause painful adhesions, or scar tissue. Doctors do not know why endometrial tissue grows outside the womb, but they've several theories. Heredity plays a role, and some cells could be present from birth. Another theory suggests that blood containing cells flows back through the rectal tubes and to the thoracic cavity rather of out from the body. These cells are believed to adhere to organs and maintain bleeding and growing with time.

Risk factors associated with uterine fibroids are: women of childbearing years, women who are approaching menopause, African American heritage, and obesity. Signs and symptoms of fibroids can be asymptomatic, mild, or severe. Some symptoms may

There are many different risk factors for endometriosis. Never giving birth, having relatives diagnosed with endometriosis, medical conditions that prevents the flow of normal menstruation, any history of pelvic infection, or uterine abnormalities are all examples of possible risk factors for endometriosis (Mayo Clinic, 2013). Having endometriosis increases a woman’s chances of infertility as well as possibly developing ovarian cancer.

A woman who has a mother or sister with endometriosis is six times more likely to develop endometriosis than the general population. Other possible risk factors include:

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

No one knows for sure what causes this disease, but it is a common health condition that affects 11% or more than 6.5 million of American women. This targets women from the ages 15 to late 40’s. 1 out of 10 women suffer from this invisible disease. Endometriosis targets

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)

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.