Endometriosis Flashcards
What is endometriosis?
This is a long term condition where cells similar to those of the endometrium, grow outside of the uterus typically in the uterus or fallopian tubes.
Also in parts of the abdominal cavity like the bladder, intestines and diaphragm.
What is the endometrium?
A layer of epithelial tissue that lines the uterus; the endometrium breaks down and is shed on the process of menstruation.
What causes endometriosis?
The cause is unknown, but there are several theories:
• Genetics: the conditions runs in families and is more prevalent in some ethnic groups.
• A malfunction of the immune system.
• Cells from the endometrium spread through the body in the blood stream or lymphatic system.
• Retrograde menstruation.
• Cellular metaplasia.
What is retrograde menstruation?
Instead of flowing out of the body through the vagin during menstruation, endometrial cells may flow backwards through the fallopian tubes into the peritoneal cavity.
This is the space surrounding the organs in the abdomen.
What is cellular metaplasia?
When cells change from one form to another.
Cells outside of the uterus change into endometrial like cells and start to grow.
Stem cells can give a rise to this.
It then spreads through the lymphatic system.
This usually occurs in response to inflammation.
What are the symptoms of endometriosis?
• Pelvic pain in lower abdomen or back (this can be mild or severe pain, but is worse during menstruation).
• Pain during and after sex.
• Pain when urinating and when defecating.
• Nausea.
• Constipation.
• Diarrhoea.
• Blood in urine/stool.
• Heavy periods.
• Infertility.
What is the emotional impact of endometriosis?
• Anxiety
• Fear
• Lonliness
• Depression
• Embarrassment
How does endometriosis cause lesions and adhesions?
Endometrial cells growing outside of the uterus form lesions and adhesions.
These bleed during each menstrual period, causing inflammation and scaring.
Adhesions and lesions cause damage to tissues, which heals to scar tissue.
This scar tissue can bind organs together, meaning the ovaries can bind together with the nearest organs.
What percentage of people with endometriosis are infertile?
About 40%.
What is thought to cause infertility in those with endometriosis?
• This is possible a result of inflammation interfering with contraception.
• More advanced endometriosis can cause lesions and adhesions which distort the anatomy of the pelvis, impairing fertilisation.
• The ovaries become blocked with endometrial cells. This means an egg can’t be released, making it harder to get pregnant. The cells can also damage eggs through inflammation.
Why is endometriosis pain worse during menstruation?
The release of the follicle stimulating hormone (FSH) every month during menstruation causing the endometrial cells to become inflamed.
How is endometriosis diagnosed?
• Transvaginal ultrasound
• Laparoscopy
How long does it take for endometriosis to get diagnosed?
Diagnosis of endometriosis takes on average 8 years in the UK, with a third of sufferers consulting their GP 6 times or more before being diagnosed, as they’re told their symptoms are trivial or normal.
How does a transvaginal ultrasound help to diagnose endometriosis?
This is the first step in testing.
This uses an ultrasound transducer inserted into the vagina to visualise the organs within the pelvic cavity.
This can identify lesions and adhesions.
How does a laparoscopy help to diagnose endometriosis?
This is the only way to accurately diagnose the extent and severity.
This is a surgical procedure that inserts a small camera inside the abdominal cavity to view the lesions and adhesions.
