Cedars Sinai Marina del Rey Hospital Alert: COVID-19 (CORONAVIRUS) information for patients and visitors LEARN MORE >>

The Basics of Endometriosis

Jamie Lipeles';

By Jamie Lipeles

Posted on July 10th, 2018 in Gynecology

The Basics of EndometriosisAs any sufferer can confirm, endometriosis is a disease which causes significant pain, being able to also lead to serious complications of the reproductive system, such as infertility.

It entails the tissue which lines the inside of the uterus, medically known as endometrium, abnormally growing outside of the organ.

Thereby, excess tissue can develop on the ovaries, the fallopian tubes, as well as within the pelvic region. If endometrium grows on the ovaries, cysts known as endometriomas may eventually form.

Endometriosis is a very common disease, affecting 1 in 10 women of reproductive age. While it is easily treatable, it remains the last condition of the female reproductive system women receive medical attention for. At the moment, 176 million women struggle with endometriosis worldwide. Infertility, which is often a symptom of the disease, occurs in 30% to 50% of endometriosis patients. Due to the normalization of symptoms, there is a delay of 3 to even 11 years between the onset of the condition and diagnosis.

What Are the Causes of Endometriosis?

While the exact causes of the disease are unknown at the moment, there are several theories with regard to why endometriosis develops. According to one of these hypotheses, endometriosis appears as a result of endometrial tissue which reaches unusual locations within the pelvic cavity due to the retrograde flow of menstrual debris. Even though it is certain that retrograde menstruation in and of itself cannot give way to endometriosis, it is considered a risk factor.

Another theory refers to coelomic metaplasia, a process which involves primitive cells residing in the lining of the pelvic organs turning into endometrial tissue over time. Finally, it was found that having a family history of endometriosis also makes you susceptible to the disease. Accordingly, women who have a close family member suffering from endometriosis are up to 10 times more prone to being diagnosed with it than those who do not.

In addition to the potential causes discussed above, researchers have identified the following risk factors for endometriosis:

  • having your first period before the age of 11
  • periods lasting for more than 5 days
  • heavy bleeding during your period
  • low body weight
  • giving birth to your first child at an older age
  • excessive alcohol consumption

What Are the Most Common Symptoms of Endometriosis?

Most women who suffer from endometriosis experience the following symptoms:

  • painful periods (dysmenorrhea)
  • pain during or after sexual intercourse
  • heavy periods (menorrhagia)
  • infertility
  • bleeding between periods (menometrorrhagia)
  • painful bowel movement, particularly during your period

Furthermore, if you have endometriosis, you may also notice one or more of the signs below:

  • diarrhea or constipation
  • fatigue
  • bloating
  • general pelvic pain
  • depression
  • pain in the lower back
  • blood in your urine, especially during your period
  • frequent yeast infections
  • various allergies

How Is Endometriosis Diagnosed?

After describing your symptoms to your gynecologist, they will conduct a physical examination during which your pelvic area will be felt for abnormalities such as:

  • cysts on your reproductive organs
  • scars behind your uterus

Following the physical exam, they might order a transvaginal or abdominal ultrasound, a test which will provide the specialist with images of the inside of your pelvic area. Although ultrasound cannot diagnose endometriosis per se, it can be useful in identifying endometriomas.

Nonetheless, laparoscopy is the only procedure following which your doctor will be able to tell with certainty whether you have endometriosis or not. It is a minimally invasive surgical procedure which involves a surgeon examining the inside of your pelvic region through several small incisions with the aid of a fiberoptic camera.

A Recent Study Finds a New Way to Diagnose Endometrial Disease

Endometrial diseases such as endometriosis and cancer can now be diagnosed through a new way, which the biomedical researchers at KU Leuven have found. They have been successful in growing the three-dimensional cell structures from the diseased tissues of patients. Apart from unraveling the diseases, this biobank is also helpful to test new drugs. Earlier in 2017, the researchers at KU Leuven had developed ‘organoids’ from a healthy endometrium. These ‘organoids’ were three-dimensional cell structures that were grown in a petri dish using the tissue fragments and cells derived from clinical biopsies. The organoids were an exact replica of the original endometrial tissue.

After this research, the team has even moved on further and developed organoids of endometrial diseases such as:

The organoids are the same as the diseased tissue and therefore can be used to study the effect of drugs. This study also shows that the organoids of endometrial cancer in different patients are sensitive to chemotherapy drugs in a specific way. Further research is needed to check whether such types of tests can be helpful in the clinical treatment of individual patients, which may be called personalized medicine.

How Is Endometriosis Treated?

Unfortunately, there is no cure for endometriosis, but the symptoms can be considerably alleviated with medication such as pain relievers and birth control pills. However, the use of these drugs is not recommended in the long run, as they may cause serious side-effects.

If medication proves ineffective in the management of endometriosis pain, surgery is recommended as a last resort treatment. Depending on the severity of the case, surgical treatment will entail either the removal of the endometrial tissue alone or the resection of the cervix, uterus, and ovaries (total hysterectomy).

Obstetrics and Gynecology Care at Cedars Sinai Marina del Rey Hospital

If you have abdominal pain or excessive bleeding and are wondering whether you might have endometriosis, schedule an appointment with our skilled medical team at Cedars Sinai Marina del Rey Hospital.

Our comprehensive facility can provide you with a fast diagnosis and a treatment plan based on the extent of the disease, and the severity of pain.