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Endometriosis

Endometriosis is a common medical condition where the tissue lining the uterus (the endometrium, from endo, "inside", and metra, "womb") is found outside of the uterus, typically affecting other organs in the pelvis. The condition can lead to serious health problems, primarily pain and infertility. Endometriosis primarily develops in women of the reproductive age. more...

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Symptoms

A major symptom of endometriosis is pain, mostly in the lower abdomen, lower back, and pelvic area. The amount of pain a woman feels is not necessarily related to the extent of endometriosis. Some women will have little or no pain despite having extensive endometriosis affecting large areas or endometriosis with scarring. On the other hand, women may have severe pain even though they have only a few small areas of endometriosis.

Symptoms of endometriosis can include (but are not limited to):

  • Painful, sometimes disabling menstrual cramps (dysmenorrhea); pain may get worse over time (progressive pain)
  • Chronic pain (typically lower back pain and pelvic pain, also abdominal)
  • Painful intercourse (dyspareunia)
  • Painful bowel movements or painful urination (dysuria)
  • Heavy menstrual periods (menorrhagia)
  • Nausea and vomitting
  • Premenstrual or intermenstrual spotting (bleeding between periods)
  • Infertile Women present with endometriosis may lead to fallopian tube obstruction despite no history of "endometriotic type" pain.

In addition, women who are diagnosed with endometriosis may have gastrointestinal symptoms that may mimic irritable bowel syndrome, as well as fatigue.

Patients who rupture an endometriotic cyst may present with an acute abdomen as a medical emergency.

Epidemiology

Endometriosis can affect any woman of reproductive age, from menarche (the first period) to menopause, regardless of her race, ethnicity, whether or not she has children or her socio-economic status. Most patients with endometriosis are in their 20s and 30s. Rarely, endometriosis persists after menopause; sometimes, hormones taken for menopausal symptoms may cause the symptoms of endometriosis to continue.

Current estimates place the number of women with endometriosis between 2 percent and 10 percent of women of reproductive age. About 30 percent to 40 percent of women with endometriosis are subfertile. Some women do not find out that they have endometriosis until they have trouble getting pregnant. While the presence of extensive endometriosis distorts pelvic anatomy and thus explains infertility, the relationship between early or mild endometriosis and infertility is less clear. The relationship between endometriosis and infertility is an active area of research.

Anecdotally, endometriosis has been observed in men taking high doses of estrogens for prostate cancer.

Extent

Early endometriosis typically occurs on the surfaces of organs in the pelvic and intraabdominal areas. Health care providers may call areas of endometriosis by different names, such as implants, lesions, or nodules. Larger lesions may be seen within the ovaries as endometriomas or chocolate cysts (They are termed chocolate because they contain a thick brownish fluid, mostly old blood). Endometriosis may trigger inflammatory responses leading to scar formation and adhesions. Most endometriosis is found on structures in the pelvic cavity:

Read more at Wikipedia.org


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Vitamins C and E effective against endometriosis pain
From Townsend Letter for Doctors and Patients, 8/1/04 by Alan R. Gaby

Fifty-nine women (aged 19-41 years) with pelvic pain and a history of endometriosis and/or infertility received either a placebo (n = 13) or a combination of vitamin E (1,200 IU/day) and vitamin C (1,000 mg/day) (n = 46) for two months. It was not specified whether the treatment allocation was randomized or blinded. At the end of the treatment period, levels of inflammatory markers in peritoneal fluid, which was collected by laparoscopy, were significantly lower in the supplemented group than in the placebo group. Forty-three percent of the women in the supplemented group reported an improvement in everyday pain, compared with none of the women in the placebo group. Twenty-four percent of the women in the supplemented group reported an improvement in dyspareunia, compared with none of those in the placebo group.

Comment: These results suggest that supplementation with vitamins E and vitamin C can relieve pain and improve dyspareunia in women with endometriosis. Although it is not clear how these vitamins work, they are known to reduce oxidative stress, which is often increased in women with endometriosis. Prior to this study, there had been very little research on the use of natural substances for the treatment of endometriosis. Other antioxidants, such as selenium, zinc, carotenoids, vitamin A, and flavonoids, should also be investigated as potential treatments for this common and painful condition.

Johnson K. Antioxidant therapy quickly improves endometriosis pain. Fam Pract News 2004(March 15):75.

COPYRIGHT 2004 The Townsend Letter Group
COPYRIGHT 2004 Gale Group

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