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Endometriosis

Endometriosis

Endometriosis is a reproductive problem that affects millions of women and girls around the world.1,2 It causes painful, life-impacting symptoms and may affect work and school attendance.1,2

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What is Endometriosis?

Endometriosis occurs when endometrial tissue, the tissue that normally lines the inside of the uterus, grows outside the uterus.1,3 When it grows in places it should not normally be, most commonly on the ovaries and the pelvic peritoneum1 (the membrane that lines the inside of the abdomen and pelvis),4 inflammation and scar tissue develop in the pelvic area.2

 

Endometriosis is illustrated below:

 
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Endometriosis Causes and Risk Factors

While the cause of endometriosis is unknown,5 suggestions include:
  • Genetics (passed down by family members with the same condition).5
  • Immune system problems.5
  • Lymph system abnormalities that may cause the development and spread of endometrium cells.5
However, none of these fully explain why endometriosis occurs.5
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Endometriosis Symptoms

Common symptoms of endometriosis include:1
  • Painful periods.
  • An irregular menstrual cycle (not having a period regularly each month).
  • Pelvic pain.
  • Pain during sex.
  • Infertility.
  • Nodules (lumps) on the ligaments of the uterus, which can be felt during a physical examination.
  • Masses or cysts on the ovaries, which can be felt during a physical examination.
  • A uterus that is ‘tipped backwards’ (retroverted).
Women with endometriosis are also likely to have depression and anxiety.1

Did You Know? There is not enough data on how many people in a community of African women suffer from endometriosis. More locally focussed research into this difficult condition is needed.6

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Diagnosing Endometriosis

A patient with endometriosis symptoms may undergo a series of diagnostic tests:5
  • A physical (pelvic and vaginal) examination by a general practitioner (GP).
  • An ultrasound scan or MRI done by a healthcare professional or other specialist.
  • A laparoscopy done by a surgeon – keyhole surgery where a tiny camera is used to look for patches of endometriosis tissue.
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Impact of Endometriosis

Endometriosis affects approximately 10% of women and girls of reproductive age globally (190 million people).2 It can severely affect a patient’s quality of life, causing stress and fatigue.7 Painful periods can also make it difficult or even impossible to attend work or school.2
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Treatment of Endometriosis

  • Non-steroidal anti-inflammatory drugs (NSAIDs) or oral contraceptive pills can be used to manage pelvic pain and regulate periods.1
  • Hormonal therapies, like progestogens and antiprogestins, or gonadotropin-releasing hormone (GnRH) analogues may also be used.1
  • Severe cases may require surgery, either to cut away the endometriosis tissue or to remove the uterus (a hysterectomy).1
Medical References

Medical References

  1. Solnik MJ, Sanders A. Endometriosis - Symptoms, diagnosis and treatment. BMJ Best Practice. Last reviewed July 1, 2024. Accessed August 9, 2024
 
  1. Endometriosis. WHO. Accessed August 9, 2024. https://www.who.int/news-room/fact-sheets/detail/endometriosis
 
  1. Endometrial. National Cancer Institute. Accessed August 9, 2024. https://www.cancer.gov/publications/dictionaries/cancer-terms/def/endometrial
 
  1. Kalra A, Wehrle CJ, Tuma F. Anatomy, abdomen and pelvis, peritoneum. In: StatPearls. StatPearls Publishing; 2024. Accessed August 9, 2024. http://www.ncbi.nlm.nih.gov/books/NBK534788/
 
  1. NHS.UK. Endometriosis. Last reviewed September 5, 2022. Accessed August 9, 2024. https://www.nhs.uk/conditions/endometriosis/
  5b. Jerman LF, Hey-Cunningham AJ. The role of the lymphatic system in endometriosis: A comprehensive review of the literature. Biol Reprod. 2015;92(3):64. doi:10.1095/biolreprod.114.124313  
  1. Wanyoike GJ, Parkar R, Wanjiru NS. Systematic review of prevalence of endometriosis among indigenous Africans. OJOG. 2017;7(8):835-845. doi:10.4236/ojog.2017.78084
 
  1. Warzecha D, Szymusik I, Wielgos M, et al. The impact of endometriosis on the quality of life and the incidence of depression—A cohort study. Int J Environ Res Public Health. 2020;17(10):3641. doi:10.3390/ijerph17103641
 
  1. Antiprogestin. National Cancer Institute. Accessed August 12, 2024. https://www.cancer.gov/publications/dictionaries/cancer-terms/def/antiprogestin
 
  1. Gonadotropin-releasing hormone. National Cancer Institute. Accessed August 12, 2024. https://www.cancer.gov/publications/dictionaries/cancer-terms/def/gonadotropin-releasing-hormone
 
  1. Laparoscopic surgery. National Cancer Institute. Accessed August 12, 2024. https://www.cancer.gov/publications/dictionaries/cancer-terms/def/laparoscopic-surgery
 
  1. Laparoscopic surgery. National Cancer Institute. Accessed August 12, 2024. https://www.cancer.gov/publications/dictionaries/cancer-terms/def/laparoscopic-surgery
 
  1. Progestogen. Merriam-Webster Dictionary. Accessed August 12, 2024. https://www.merriam-webster.com/dictionary/progestogen
 
  1. Ultrasound. National Cancer Institute. Accessed August 12, 2024. https://www.cancer.gov/publications/dictionaries/cancer-terms/def/ultrasound
 

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