Endometriosis

What is endometriosis?

Endometriosis is a common condition affecting patients of child-bearing age. It can cause severe pain and lead to infertility in some people.

Endometriosis occurs when the lining of the uterus (the endometrium) starts growing on surfaces of other organs in the pelvis. The endometrium may grow on the ovaries, fallopian tubes, the outer surface of the uterus, pelvic cavity lining, vagina, cervix, vulva, bladder or rectum.

Patients may experience painful cramps in the lower abdomen, back or in the pelvis during menstruation, heavy menstrual bleeding or painful bowel movements.

What causes endometriosis?

The exact cause for endometriosis is not known, although there are a number of theories. One such theory is called retrograde menstruation, whereby it is thought that endometrial cells contained in menstrual blood flow back through the fallopian tubes to the pelvic cavity rather than leaving the body. The cells then stick to the pelvic walls and to the surfaces the of pelvic organs, where they continue growing.

While retrograde menstruation is the most popular theory for the cause of endometriosis, it is clear that it is not the only cause, as many people with retrograde menstruation do not develop the condition.

Other theories for the cause of endometriosis include; embryonic cell growth, where the cell lining of pelvic cavities has cells that turn into endometrial cells; surgical scar implantation, where endometrial cells attach to a surgical incision; endometrial cell transport, which hypothesises that blood vessels or lymph fluid may transport endometrial cells to other pelvic organs; and immune system disorder theories, which suggest that a problem with the body’s immune system may make the body unable to destroy endometrial tissue growing outside the uterus.

How is endometriosis diagnosed?

The gold standard for the diagnosis or exclusion of endometriosis is laparoscopic surgery. This procedure is performed through small incisions in the abdomen or pelvis with the aid of a camera. Dr Andreadis performs diagnostic laparoscopies with many patients, in order to diagnose and treat endometriosis.

How is endometriosis treated?

The management of endometriosis varies depending on the patient’s circumstances. The level of pain a patient is suffering and the degree to which infertility is an issue may impact the way in which the doctor treats the condition.

Options for effective management of endometriosis range from pain relief, hormonal therapy and surgery, to changes in diet, exercise and activity levels. Complementary therapies such as acupuncture, herbs and massage may also be recommended.

The future of endometriosis diagnosis

Dr Andreadis was involved in groundbreaking research on endometriosis, which aimed to evaluate improved methods of diagnosing or excluding the condition. Endometriosis can be a debilitating condition, and requires an experienced practitioner for effective management. Dr Andreadis is determined to improve patient outcomes, both in terms of their quality of life and future fertility.

Read the paper here.