Endometriosis

1. Endometriosis By: Leon Richardson Period 2 5-8-12

2. What is Endometriosis • Every month, a woman's ovaries produce hormones that tell the cells lining the uterus to swell and get thicker. The body removes these extra cells from the womb lining when you get your period. • If these cells implant and grow outside the uterus, endometriosis results. The growths are called endometrial tissue implants. Women with endometriosis typically have tissue implants on the ovaries, bowel, rectum, bladder, and on the lining of the pelvic area. They can occur in other areas of the body, too. • Unlike the endometrial cells found in the uterus, the tissue implants outside the uterus stay in place when you get your period. They sometimes bleed a little bit. They grow again when you get your next period. This ongoing process leads to pain and other symptoms of endometriosis. • The cause of endometriosis is unknown. One theory is that the endometrial cells shed when you get your period travel backwards through the fallopian tubes into the pelvis, where they implant and grow. This is called retrograde menstruation. This backward menstrual flow occurs in many women, but researchers think the immune system may be different in women with endometriosis. • Endometriosis is common. Sometimes, it may run in the family. Although endometriosis is typically diagnosed between ages 25 - 35, the condition probably begins about the time that regular menstruation begins.

3. Symptoms of Endometriosis • Painful periods • Pain in the lower abdomen before and during menstruation • Cramps for a week or two before menstruation and during menstruation; cramps may be steady and range from dull to severe • Pain during or following sexual intercourse • Pain with bowel movements • Pelvic or low back pain that may occur at any time during the menstrual cycle

4. Signs and Tests for Endometriosis • Pelvic exam • Transvaginal ultrasound • Pelvic laparoscopy

5. Treatments for Endometriosis • Exercise and relaxation techniques • Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil) and naproxen (Aleve), acetaminophen (Tylenol), or prescription painkillers to relieve cramping and pain. • Medications to control pain • Hormone medications to stop the endometriosis from getting worse • Surgery to remove the areas of endometriosis or the entire uterus and ovaries • Treatment to stop the endometriosis from getting worse often involves using birth control pills continously for 6 - 9 months to stop you from having periods and create a pregnancy-like state. This is called pseudopregnancy. This therapy uses estrogen and progesterone birth control pills. It relieves most endometriosis symptoms. However, it does not prevent scarring or reverse physical changes that have already occured as the result of the endometriosis. • Progesterone pills or injections. • Gonadotropin-agonist medications such as nafarelin acetate (Synarel) and Depo Lupron to stop the ovaries from producing estrogen and produce a menopause-like state. Side effects include hot flashes, vaginal dryness, and mood changes. Treatment is usually limited to 6 months because it can lead to bone density loss. It may be extended up to 1 year in some cases. • Pelvic laparoscopy or laparotomy to diagnose endometriosis and remove all endometrial implants and scar tissue (adhesions). • Hysterectomy to remove the womb (uterus) if you have severe symptoms and do not want to have children in the future. One or both ovaries and fallopian tubes may also be removed. If you do not have both of ovaries removed at the time of hysterectomy, your symptoms may return

6. Prognosis • Hormone therapy and laparoscopy cannot cure endometriosis. However, these treatments can help relieve some or all symptoms in many women for years. • Removal of the womb, fallopian tubes, and both ovaries gives you the best chance for a cure. Rarely, the condition can return.