4530 Endometriosis Endometriosis is a common condition that occurs

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Endometriosis is a common condition that occurs when endometrial tissue (the lining of the
uterus) grows outside the uterus, typically onto the fallopian tubes, ovaries or pelvic cavity.
This tissue responds to monthly hormonal changes just like the normal endometrial tissue
inside the uterus, resulting in inflammation, bleeding and pain.

No one knows for sure what causes endometriosis, but some theories suggest it is caused by
defects in cell formation and development, inherited tendencies or failures in the immune

The average age of women diagnosed with endometriosis is between 25 and 40 years of age.
Most cases resolve when menopause starts, but the condition may continue if a woman
receives hormone replacement therapy (HRT).

According to some estimates, 25 percent to 50 percent of infertile women suffer from

Note your symptoms
Diagnosing endometriosis is difficult because the symptoms are not the same in all women.
Typical symptoms include pelvic pain, menstrual cramps, irregular bleeding and infertility.

Women whose menstrual periods become more painful than previously, with the pain
occurring just before and at the beginning of the menstrual flow, may have endometriosis.
Abnormal uterine bleeding, especially heavy flows, rectal bleeding and pain during sexual
intercourse are also common symptoms.

If endometriosis is suspected, your doctor will perform a pelvic and rectal examination and
possibly laboratory tests. Immunologic and imaging tests may be used but by themselves do
not provide a definitive diagnosis; imaging techniques include ultrasound Laparoscopy is a
surgical procedure that can provide a definitive diagnosis and may be performed to rule out
other conditions with similar symptoms such as pelvic inflammatory disease (PID) and
tumours of the colon, rectum, ovaries or uterus.

Individualized treatment
In general, the objectives of any medical treatment for endometriosis are to control pain and
improve or protect fertility. The choice of treatment will be based on the stage of the disease
(mild, moderate or severe). Another major consideration is a woman’s specific reproductive
concerns: women who want to have children may receive different treatment than women
who do not or a woman who has completed her family.

For mild to moderate cases, a common treatment, hormonal therapy is considered appropriate,
commonly prescribed drugs include danazol, medroxyprogesterone acetate, oral

Reviewed on 2006-10-07                  Copyright Reserved                            Page 1 of 2
contraceptives and gonadotropin-releasing hormone agonist (GnRH). If the endometriosis is
in a mild or moderate stage, hormonal treatment is usually successful in alleviating pain and
controlling disease progression.

Pain medications that may be recommended include over-the-counter non-steroidal anti-
inflammatory drugs (NSAIDS), such as aspirin and ibuprofen. Stronger doses or other drugs
may be prescribed by your doctor. NEVER give aspirin to children/teenagers. It can cause
Reye’s syndrome, a rare but often fatal condition. If you have a chronic illness, are
pregnant, or routinely take prescribed or over-the-counter medications, talk to your doctor or
pharmacist before taking any new medications.

Surgery generally involves the removal of excess endometrial tissue from places it does not
belong. Procedures that are commonly performed include dilation and curettage (commonly
known as a D & C), laparoscopy (also performed for diagnostic purposes), laparotomy (that’s
open abdominal surgery), hysterectomy (removal of the uterus) or oophorectomy (removal of
the ovaries).

Possible complications
Complications include heavy vaginal and/or rectal bleeding, with chronic bleeding leading to
anaemia. For some women with moderate to severe symptoms, chronic pain causes significant
disability and stress, as does the possibility of infertility. Infertility caused by endometriosis
may in addition be difficult for some women to accept.

Call your doctor immediately if . . .
You suspect endometriosis and
   • Your symptoms suddenly worsen
   • You have severe pain or bleeding (saturating one pad an hour)
   • You are pregnant and have any vaginal bleeding or abdominal /pelvic pain

If the symptoms of endometriosis continue to interfere with your personal and professional
life, your doctor may want to re-evaluate your treatment plan.

Reviewed on 2006-10-07                   Copyright Reserved                              Page 2 of 2

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