Endometriosis is a condition in which the endometrium, the tissue that lines the lining of the uterus or womb, begins to develop outside the uterine cavity. Endometrial tissue has the ability to develop in the ovaries, fallopian tubes, and even the pelvic region.

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Endometriosis Stages

Endometriosis is classified into four phases based on the size, depth, and location of the implant. They progress from:

Minimal, when growth is superficialMild, where there may be slight scarringModerate, where there is significant scarringSevere endometriosis typically results in cysts. Infertility is common

How do endometriosis occur?

Although the exact etiology of endometriosis is uncertain, several possibilities include:

Retrograde menstruation:

Most women experience this as a typical monthly procedure, however the body generally clears the tissues spontaneously. Endometriosis occurs when this tissue adheres to the pelvic or abdominal organs or the wall. However, it is unknown why this occurs in just certain women.

Immune system: It may be that some women’s immune system is not able to get rid of the tissue therefore women with low immune system may be more at risk of endometriosis.

Lymphatic or circulatory spread: Some tissue cells may migrate across the body in the bloodstream or other channels to other regions of the body.

Metaplasia: This occurs when one type of cell can change and become a different kind of cell; the cause of this is relatively unknown.

How endometriosis affects fertility?

Although endometriosis might reduce your chances of pregnancy, most women with moderate endometriosis are not infertile. Without treatment, an estimated 70% of women with mild to severe endometriosis will get pregnant. If you have endometriosis and are having difficulty conceiving, consult with your doctor, who may advise you or send you to the appropriate reproductive experts.

The exact nature of the link between infertility and endometriosis is unclear but the severity of the condition and location of the tissue appears to have an effect. For example, it is unclear how a few areas of endometriosis may influence your chances of becoming pregnant, but if you have severe endometriosis, the alterations to your uterus are likely to decrease your possibilities. 

What is the treatment for endometriosis?

Pain alleviation:

Discomfort relievers suppress inflammation and assist to alleviate pain. Also pain relieving anesthesia is an option.

Hormone therapy:

Endometriosis may be reduced or eliminated with a variety of hormone therapies.

The combination oral contraceptive (COC) pill or patch contains the estrogen and progesterone hormones and works by preventing ovulation as well as pregnancy. The other benefits include being lighter, shorter, and less uncomfortable.

The intrauterine devices- this is a small T-shaped device which releases the hormone progestogen. This helps to reduce the pain and makes periods flow milder.

Testosterone or progesterone derivatives

GnRH agonists - these medications block the ovaries from producing oestrogen, resulting in temporary and reversible menopause or pseudomenopause.

Surgery:

Surgical therapy is determined on the location and amount of endometriosis.It includes simple endometriotic spot ablation, cyst fulguration or excision, and hysterectomy.It may be performed by laparoscopy or open surgery (laparotomy).

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