Endometriosis
Scant research on endometriosis means
women’s voices are left unheard
Cultural taboos and GP reticence mean diagnosis of the abnormal lining of the uterus is often delayed by years
W
This misplaced
tissue acts
like it would
in the uterus,
thickening,
breaking
down, and
bleeding
with each
menstrual
cycle but
has no way
to leave the
system and
becomes
trapped
60
MARCH 2020
ith a perplexing progression and
a seemingly high incidence rate,
endometriosis appears to be more
widespread in Asia than in any other region of the
world.
The condition occurs when tissue similar to what
normally lines the uterus, known as the endometrium,
grows outside it, at times causing tremendous pain.
Despite its apparent prevalence in the region, a
cultural reluctance by doctors and patients to discuss
gynaecological matters often delays diagnosis, leaving
many women finding out too late that they have the
condition.
Endometriosis most commonly involves the ovaries,
fallopian tubes, and the tissue lining the pelvis. In
some cases, endometrial tissue may spread beyond
the pelvic area to other organs, including the lung and
bowel.
This misplaced tissue acts like it would in the
uterus, thickening, breaking down, and bleeding with
each menstrual cycle but has no way to leave the
system and becomes trapped.
When this happens in the ovaries, cysts called
endometriomas may form. Surrounding tissue can
become irritated, eventually developing scar tissue
and abnormal bands of fibrous tissue known as
adhesions that can cause pelvic tissues and organs to
stick to each other.
Despite research, endometriosis remains an
enigmatic disease with an as yet unknown cause.
According to a recent review, there is growing
evidence that hormonal and immune factors create a
pro-inflammatory microenvironment that encourages
the persistence of endometriosis. This also relates
to the disease’s two main symptoms of pain and
infertility.
Endometriosis can cause pain that is sometimes
severe, especially during periods. It’s also common
for patients to experience pain during or after sex,
excessive bleeding, and difficulty with urination and
bowel movements. Infertility can be another symptom.
Though there is no cure, medical and surgical
options are available to help reduce the symptoms and
manage potential complications. Over-the-counter
medication, such as ibuprofen, is not always effective.
Taking supplemental hormones can sometimes
relieve pain and stop the progression of endometriosis
by regulating the monthly hormonal changes that
promote tissue growth.
By preventing the monthly buildup of endometrial
tissue, birth control pills, patches, and vaginal rings
can reduce or even eliminate the pain in less severe
endometriosis.
For women with severe pain for whom hormonal
treatments do not work, conservative surgery to
remove or destroy endometrial growths is a possibility.
Laparoscopy, a minimally invasive surgery, is used
to both visualise and diagnose endometriosis and
to remove the endometrial tissue. A surgeon makes
small incisions in the abdomen to surgically remove
the growths or burns or vaporises them. But lasers are
now more commonly used to destroy the misplaced
tissue.
GlobalHealthAndTravel.com