What Is Endometriosis? Symptoms, Causes and Treatment

Understandingwhat endometriosis iswill help us learn more about this condition which, although it affects 1 in 10 women, is still fairly unknown. The associated symptoms includeextreme, debilitating pain,which can appear from an early age, andheavy blood loss. So far, some studies have been carried out to discover why it occurs, but it is still not known for certain.

What is endometriosis?

The endometrium is thetissue that lines the uterine cavityand, as it is subject to hormonal cycles, it grows and thickens every month. When the hormonal stimulus stops, it sheds and isexpelled through the vagina, which is what we call menstruation. However, women with endometriosis developtissue similar to the endometrium invarious parts of their body, which is oestrogen-dependent and works in exactly the same way as endometrial tissue. Therefore, as it responds to hormonal cycles, it formsadhesions and implantsthat stick to or infiltrate nearby or upper organs. This causes irritation, inflammation, problems in carrying out their normal functions, blood infiltration and means thatthey end up sticking to one another.It is most commonly found in the ovaries, the fallopian tubes and the ligaments of the uterus. However, it can spread further and be found around the rectum, the vagina, thebladder, the intestines, the kidneys or the ureters. In the most severe cases, tissue has even been found in thebrain, lungs and heart.

Endometriosis and its symptoms

The most importantendometriosis symptomsare excessive bleeding andsevere, debilitating pelvic painduring periods, which may begin days beforehand and continue after they have finished. Other common signs to be aware of when askingwhat endometriosis isare as follows:

• Abdominal pain.
• Abdominal bloating.
• Nausea and vomiting.
• Constipation or diarrhoea.
• Heavy blood loss during menstruation or between cycles.
• Pain during sex.
• Pain when passing stools or urinating.
• Chronic lower back or pelvic pain, not related to menstruation.

Infertility occurs inalmost half of womenwith this condition and is due to multiple causes. Adhesions distort the anatomy of the ovaries, uterus and fallopian tubes, whichmakes movement difficultfor sperm and the fertilised egg. In addition, because the ovaries are affected by the build-up of this tissue and the resulting formation ofendometriomas, the eggs become low quality and implantation becomes more difficult. Added to this is the removal of part of the reproductive organs or even all of them, as well as inducing achemical menopauseto stop its progression or relieve discomfort. Depending on the intensity of the pain, you may takeanti-inflammatory medicines and painkillersfor pain, such as ibuprofen or paracetamol, or stronger ones in cases of severe pain.

Causes of endometriosis

It is stillnot known what endometriosis is, what causes itor why it happens. One hypothesis refers to certainclusters of cellsthat may be carried by the lymphatic or blood circulation to other parts of the body. Another is that ofretrograde menstrual flowthrough the fallopian tubes, which then spreads and implants in the pelvic cavity. This could explain its presence in that area, but not in other organs. Nowadays, this theory is considered outdated. Some of the risk factors are as follows:

• First period at an early age (before 11 years old).
• Very long menstrual periods, lasting more than 7 days.
• Short cycles, less than 28 days long.

• Family history.
• High oestrogen levels.

Endometriosis and pregnancy

When we talk aboutendometriosis and pregnancy, it is important to mention that many sufferers will be able to become pregnant (with or without professional help). However, this condition causes anincrease in complicationsduring pregnancy in some cases. The most common problems are these:

• Premature birth, before week 37 of pregnancy.
• Miscarriage.
• Ectopic pregnancy, outside the uterus.
• Pre-eclampsia (high blood pressure and kidney damage).

Of course, it must be made clear that, although pregnancy reduces symptoms because there is no hormonal stimulation or menstrual cycles, pregnancy does not cure endometriosis.This is essential when explainingwhat endometriosis is.

Diagnosis and treatment

Before starting any type of treatment, it is necessaryto reach an accurate diagnosis.To do this, in addition to taking a medical history and carrying out an examination including a pelvic exam, further assessments must be performed. Understandinghow endometriosis is detectedis essential, as it is very difficult to diagnose. In fact, it takes an average of10 yearsbecause many people consider suffering that much with periods ""normal"".

Abdominal or vaginal ultrasound

Abdominal and vaginal ultrasound can provide guidance, but it does not prove that what is seen is this tissue. Cysts or tumours can be seen easily,althoughadhesions and implants cannot.

MRI scan

This is a more accurate examination than the previous one, as it also makes it possible to observeimplants, adhesions and other damage.It is essential before surgery.

Laparoscopy

This technique makes it possible todiagnose the conditiondefinitively through direct visualisation of the organs. Through small incisions, tissue samples are taken and cysts, adhesions and implants are removed.

What treatments are available?

Endometriosis has no cure.Treatments are used to slow its progress, especially after major surgery, and to achieve symptom remission for a time. Even so, the tissue will grow back. Early diagnosis is essentialto stop or delay the progression of the disease at an early age and thus prevent the affected organs from being lost in many cases. Once it has been diagnosed, therapy with hormones and strong painkillerscan be started, aimed at controlling the symptoms. If the response is not as expected, thebest treatment for endometriosisis surgery. In 50% of cases, patients achieve symptom relief for a prolonged period, but this is not always so. So, what is endometriosis?It is a common gynaecological condition, with no cure, very painful, and one that reduces sufferers' quality of life. That is why it is crucial to know its name, its symptoms, and to understand thatextreme period pain is real and not normal.