Endometriosis
| Endometriosis | |
|---|---|
| Specialty | Gynecology |
| Symptoms | Pelvic pain, infertility, painful periods |
| Usual onset | Adolescence or early 20s |
| Duration | Since first period, to the end of life. |
| Causes | Unknown |
| Risk factors | Family history, early first period, short cycle length |
| Diagnostic method | Based on symptoms, medical imaging, tissue biopsy |
| Differential diagnosis | Adenomyosis, irritable bowel syndrome, interstitial cystitis |
| Treatment | NSAIDs, continuous birth control pills, hormonal IUD (coil), surgery |
| Frequency | Roughly 10% of women of reproductive age |
Endometriosis is a disease in which tissue similar to the lining of the uterus, the endometrium, grows elsewhere in the body. The tissue most often grows close to the uterus, such as on the ovaries, fallopian tubes, or the lining of the pelvis. It can also appear on the bowel, bladder, and sometimes also in different body parts, lungs, heart etc.
Symptoms vary widely between individuals. Some have no symptoms, while for others it is a debilitating disease. Common symptoms include pelvic pain, heavy and painful periods, pain with bowel movements, painful urination, painful sex, fatigue and infertility. Beyond physical symptoms, endometriosis can affect a person's mental health and social life. The exact cause is not known. Possible causes include backwards menstrual period flow, genetic factors, hormones, and problems with the immune system.
A presumed diagnosis can be made based on symptoms and medical imaging; laparoscopy (keyhole surgery) with a biopsy can provide definite confirmation. Other causes of similar symptoms include adenomyosis, uterine fibroids, irritable bowel syndrome, and interstitial cystitis. On average, it takes 5–12 years from the start of symptoms to receive a diagnosis and many patients report being incorrectly told their symptoms are trivial or normal.
While there is no cure for endometriosis, several treatments may improve symptoms. This includes pain medication, hormonal treatments or surgery. The recommended pain medication is usually a non-steroidal anti-inflammatory drug (NSAID), such as naproxen. Taking the birth control pill continuously or using a hormonal IUD (coil) is another first-line treatment. Additional hormonal treatment can be tried if the pill or IUD are not effective. Endometriosis can be removed surgically in women whose symptoms are not relieved by other treatments, or to help with infertility.
Worldwide, endometriosis affects approximately 10% of the female population of reproductive age, representing about 190 million women. Symptoms typically start in adolescence or early 20s and tend to improve after menopause. A majority of individuals benefit from drug treatment, even though drugs may lose effectiveness over time. Endometriosis can return after surgical removal.