Endometriosis
The Disease
The tissue that lines the uterus (womb) is known as the endometrium. Endometriosis is a condition where tissue similar to the endometrium is found outside of the uterus, mainly within the pelvis, such as the ovaries or tissues supporting the uterus but also less commonly the appendix, bowel, or bladder. While the exact cause of endometriosis is uncertain, a number of theories exist: it is likely that several factors contribute to the formation of endometriosis, including familial predisposition, environmental and immunological factors, reversal of menstrual flow and changes in the lining of the pelvic cavity. Endometriosis affects 1:10 women.
The Problem
Like the endometrium inside the uterus, the implants swell and react to the monthly hormonal cycle. Inflammation occurs around this tissue. The body responds by surrounding the affected area with scar : the scar tissue (adhesions) may result in damage to other pelvic structures and may cause these to stick together. Over time, the endometrial tissue may also enlarge and form cysts (endometrioma), particularly in the ovaries.
The symptoms of endometriosis are variable and don't always correspond to disease severity: even severe disease may not have many symptoms. However, symptoms may include pain (with periods, ovulation, intercourse, when passing urine or opening bowels) or continuous pelvic or lower back pain or difficulty falling pregnant (infertility).
The Solution
Most importantly, the diagnosis of endometriosis needs to be made in a timely manner. Management then preferably occurs in a multi-disciplinary team of health care professionals in collaboration with the woman, her reproductive expectations, her specific disease pattern, her support, family network and the resources available in a given healthcare setting.
The key to effective management is knowledge: the Endometriosis Network facilitates research, education and dissemination of information.
More information on the National Action Plan for Endometriosis