NAIROBI, Kenya – Endometriosis is a chronic condition where tissue similar to the lining inside the uterus, known as the endometrium, starts to grow outside the uterus.
This abnormal growth leads to severe pelvic pain, inflammation, and can make it difficult for those affected to conceive.
According to the World Health Organization(WHO), endometriosis can start at a person’s first menstrual period and last until menopause, with symptoms often persisting even after.
The misplaced endometrial-like tissue causes chronic inflammation, leading to the formation of scar tissue (adhesions, fibrosis) in the pelvic region, and, in rare cases, in other parts of the body.
The inflammation and scarring can result in several lesion types, including superficial endometriosis on the pelvic peritoneum, cystic ovarian endometriosis (endometrioma) in the ovaries, and deep endometriosis in the recto-vaginal septum, bladder, and bowel.
What is the exact cause of endometriosis?
The exact cause of endometriosis remains unknown, making it a complex disease to understand and manage.
However, there are theories that explain its existence including retrograde menstruation where menstrual blood flows backward through the fallopian tubes into the pelvic cavity, allowing endometrial cells to implant and grow outside the uterus, another cause may be cellular metaplasia where cells outside the uterus change into endometrial-like cells, and stem cells which might contribute to the disease by spreading through blood and lymphatic vessels.
Other factors, such as estrogen dependency, contribute to the inflammation, growth, and pain associated with endometriosis.
Endometriosis often manifests as severe pelvic pain, particularly during menstrual periods.
Other symptoms include pain during sex, urination, or defecation, chronic pelvic pain, heavy menstrual bleeding, infertility, bloating, nausea, fatigue, depression, and anxiety.
However, some individuals may experience no symptoms, complicating the diagnosis.
Due to its variable symptoms, endometriosis is challenging to diagnose. Healthcare providers rely on a detailed history of menstrual symptoms and chronic pelvic pain.
Advanced imaging techniques, such as ultrasonography or MRI, and surgical procedures like laparoscopy, can help confirm the diagnosis.
Is there a cure for endometriosis?
While there is no cure for endometriosis, various treatments can manage its symptoms and improve the quality of life for those affected.
These include using medications such as NSAIDs and analgesics for pain relief, and hormonal treatments like GnRH-analogues, birth control pills, IUDs, vaginal rings, implants, injections, and patches to control pain and slow disease progression.
Another treatment option is laparoscopic surgery to remove endometriosis lesions and scar tissue, which may alleviate pain and improve fertility.
Treatment plans are tailored to individual needs, considering effectiveness, side effects, long-term safety, costs, and availability.
Those seeking pregnancy may need fertility treatments such as ovarian stimulation with intrauterine insemination (IUI) or in vitro fertilization (IVF).
