![]() How is endometriosis diagnosed?Ī discussion about your symptoms and a physical examination should provide your doctor with enough information to determine if you might have endometriosis. These conditions are also more common in women with endometriosis. ![]() Other conditions that have overlapping symptoms include irritable bowel syndrome, chronic fatigue syndrome and tension of the pelvic floor muscles. Sometimes period pain can occur without a visible cause (‘primary dysmennorrhoea’). Adenomyosis, when endometrial tissue grows in the muscle of the uterus, is another reason for severe pain with periods. pain when passing a bowel motion or passing urine during period timeĪll of these symptoms have other possible causes, and sometimes more than one cause can be present.pelvic pain at other times of the menstrual cycle.Many women have endometriosis with no symptoms or problems but this is not always the case. Endometriosis does seem to run in families, so you will be more likely to have it if your mother or sister has had it. One theory is that during menstruation, fragments of the endometrium pass backwards through the fallopian tubes and into the pelvis where it attaches and grows.Ībout one in ten of those assigned female at birth have endometriosis. Patients presenting with minimal disease may have debilitating pain, whereas other clients with severe stage III–IV disease are asymptomatic (Hsu et al., 2010).The exact cause of endometriosis is still unknown. Interestingly, the objective signs and subjective symptoms associated with pelvic pain do not always correlate. Tends to increase in severity premenstrually then subside with menses cessation (Mao & Anastasi, 2010).Chronic pelvic pain (> 6 months, most common sx).Determining diagnosis based soley on clinical presentation is challenging due to the wide range of symptoms, which can often overlap with several other gynecologic and nongynecologic conditions, including chronic pelvic inflammatory disease and irritable bowel disease (Mao & Anastasi, 2010). The clinical presentation of endometriosis varies greatly in severity, symptoms, and impact on the physical, social, and mental health of the woman. Altered immunosurveillance: endometriosis occurs either when the immune system is overwhelmed by menstrual back flow, or when a defective system allows the lesions to escape immunosurveillance, establish a blood supply, and continue to thrive.However, this theory does not account for gravity-dependent locations of implants, which constitute the majority of distant endometriotic implants (Bloski & Pierson, 2008). This could explain how endometriotic implants migrate to locations such as lungs, bone, and skin. Vascular and lymphatic spread: endometrial tissue infiltrates the local blood supply and lymphatic systems, and subsequently travels to distant sites in the body.Celomic metaplasia: celomic cells, which differentiate from peritoneal cells, become endometrial cells that respond to triggers such as menses, toxins, or immune factors in a cyclic manner (Mao & Anastasi, 2010).While widely accepted, this cannot be the sole cause of endometriosis because a majority of women experience some degree of retrograde menstruation, however few develop endometriosis (Mao & Anastasi, 2010). Sampson’s theory: endometrial cells reflux through the fallopian tubes into the abdominal cavity, leading to implantation onto the peritoneum. ![]() Rather, several theories have been proposed and researched: There is no unifying theory regarding the origin of endometriosis. Endometriosis is one of the leading causes of chronic pelvic pain and infertility in reproductive-age women, regardless of ethnicity or socioeconomic status (Bloski & Pierson, 2008). The inflammation can lead to fibrosis, scarring, adhesions, and pain. Endometriosis is a chronic inflammatory, estrogen-dependent disease where ectopic implantations lead to an inflammatory reaction that may result in scar tissue (Burney & Giudice, 2012).īleeding during the menstrual cycle causes inflammation, which triggers cytokines, chemokines, growth factors, and protective factors to migrate to the area. Primarily these locations are found to be the pelvic peritoneum, ovaries, and rectovaginal septum. This is the portion of the uterus that changes throughout the menstrual cycle, becoming thick and rich with blood vessels to prepare for pregnancy, then shedding if the woman does not become pregnant (Burney & Giudice, 2012).Įndometriosis is defined as the presence of endometrial glands and stroma in ectopic locations, or locations other than the interior of the uterus. The endometrium is the mucous membrane layer that lines the inside of a female’s uterus.
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