Table of Contents
Signs and symptoms of endometriosis
The main symptom of endometriosis is pelvic pain which is most often associated with the patient's menstrual period. This pain is described as being worse in nature when compared to the menstrual cramps and pain that the patient is used to.
The common signs and symptoms of endometriosis include the following:
- Dysmennorhoea (extremely painful menstrual pain) - pelvic pain and cramping can start before menstruation and then carry on for a few days after the menstruation ends. Abdominal and lower back pain can also be involved.
- Dyspareunia, which is pain with intercourse.
- Pain with urination or bowel movements, which occurs during menstruation.
- Excessive bleeding - there may be occasional heavy periods (menorrhagia) or bleeding in-between periods (menometrorrhagia).
- Infertility occurs in endometriosis.
- Other symptoms such as diarrhoea, constipation, fatigue, nausea or bloating during menstrual periods can also be experienced.
The exact cause of endometriosis is not known, but there are a few possible explanations. They are as follows:
- Retrograde menstruation is the most likely cause of endometriosis. Here, endometrial cell containing menstrual blood flows back up the fallopian tubes and into the pelvic area instead of out of the body. These cells then attach to the above-mentioned areas and cause endometriosis there.
- Embryonic cell growth - the cells which line the abdominal and pelvic regions are derived from embryonic cells, and when one of the small areas of the abdominal lining turns into endometrial tissue, then endometriosis occurs.
- Endometrial cell transport - as with retrograde menstruation, endometrial cells are transported to certain pelvic areas, but in this case, via the bloodstream or lymphatic system.
- Surgical scar implantation - endometrial cells can attach to surgical incisions from operations such as a Caesarian section or hysterectomy.
- Immune system disorder - an issue with the immune system may result in the body not being able to recognize and destroy abnormal endometrial tissue. This then increases the chances of endometriosis.
There are a few factors which increase the risk of developing endometriosis and they include the following:
- Women who haven't given birth.
- Medical conditions which prevent the normal passage of menstrual blood.
- Family history of first-degree relatives (sister, aunt, mother) with endometriosis.
- Uterine abnormalities.
- History of pelvic infections.
The most common complication of endometriosis is diminished fertility. 30-50% of women with this condition struggle to get pregnant. Endometriosis can obstruct the fallopian tube which then prevents the sperm and egg from uniting. Damage to the sperm and/or egg can also occur as an indirect cause of endometriosis.
The risk for ovarian cancer increases in women with endometriosis. Since the overall risk of ovarian cancer in women is low to start off with, the risk of ovarian cancer in patients with endometriosis is still relatively low.
Endometriosis-associated adenocarcinoma may develop later on in life in these patients, but this is a rare occurrence.