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Health Promotion with Lee Anne
Introduction
THERE is little awareness of women’s health in Zimbabwe. As a result, most conditions go undiagnosed or misdiagnosed due to the lake of knowledge in communities. Endometriosis is a painful, chronic disease that has a prevalence of about 10 percent in women worldwide.
Aetiology
It occurs when tissue like that which lines the uterus (tissue called the endometrium) is found outside the uterus. This condition usually occurs in the abdomen, on the ovaries, fallopian tubes, and ligaments that support the uterus; the area between the vagina and rectum; the outer surface of the uterus; and the lining of the pelvic cavity. Other sites for these endometrial growths may include the bladder, bowel, vagina, cervix, and in abdominal surgical scars.
They are rarely found in the lung, arm, thigh, and other locations.
What happens is that this misplaced tissue develops into growths or lesions which respond to the menstrual cycle in the same way that the tissue of the uterine lining does. What I mean by this is; each month the tissue builds up, breaks down, and sheds.
Menstrual blood flows from the uterus and out of the body through the vagina, but the blood and tissue shed from endometrial growths has no way of leaving the body.
This results in internal bleeding, breakdown of the blood and tissue from the lesions, and inflammation that causes pain, infertility, scar tissue formation, adhesions, and bowel problems.
Risk Factors
Several factors place you at greater risk of developing endometriosis, such as:
Never giving birth
One or more relatives (mother, aunt or sister) with endometriosis
Any medical condition that prevents the normal passage of menstrual flow out of the body
History of pelvic infection
Uterine abnormalities
What are the signs and symptoms
Pain before and during periods
Pain with sex
Infertility
Fatigue
Painful urination during periods
Painful bowel movements during periods
Other Gastrointestinal upsets such as diarrhoea, constipation, nausea.
In addition, many women with endometriosis suffer from:
Allergies
Chemical sensitivities
Frequent yeast infections
Diagnosis is considered uncertain until proven by laparoscopy, a minor surgical procedure done under anesthesia. A laparoscopy usually shows the location, size, and extent of the growths. This helps the doctor and patient make better treatment choices.
Causes
At this stage the cause of endometriosis is unknown. However, there is a theory that (transtubal migration theory) suggests that during menstruation some of the menstrual tissue backs up through the fallopian tubes, implants in the abdomen, and grows.
Some health professionals believe that all women experience some menstrual tissue backup and that an immune system problem or a hormonal problem allows this tissue to grow in the women who develop endometriosis.
Another theory suggests that endometrial tissue is distributed from the uterus to other parts of the body through the lymph system or through the blood system. A genetic theory suggests that it may be carried in the genes in certain families or that some families may have predisposing factors to endometriosis.
Another theory suggests that remnants of tissue from when the woman was an embryo may later develop into endometriosis, or that some adult tissues retain the ability they had in the embryo stage.
Treatment
Endometriosis can be treated with medications and/or surgery. The goals of endometriosis treatment may include symptom relief and/or enhancement of fertility
Medical treatment of endometriosis
Nonsteroidal anti-inflammatory drugs or NSAIDs (such as ibuprofen) are commonly prescribed to help relieve pelvic pain and menstrual cramping. These pain-relieving medications have no effect on the endometrial implants or the progression of endometriosis. However, they do decrease prostaglandin production, and prostaglandins are well-known to have a role in causing of pain.
As the diagnosis of endometriosis can only be definitively confirmed with a biopsy, many women with complaints suspected to arise from endometriosis are treated symptomatically without a firm diagnosis being established.
Under such circumstances, NSAIDs are commonly used as a first line empirical treatment. If they are efficacious in controlling the pain, no other procedures or medical treatments are needed.
If they are ineffective, additional evaluation and treatment will be necessary.
Since endometriosis occurs during the reproductive years, many of the available medical treatments for endometriosis rely on interruption of the normal cyclical hormone production by the ovaries.
Oral contraceptive pills (oestrogen and progesterone in combination) are also sometimes used to treat endometriosis.
The most common combination used is in the form of the oral contraceptive pill (OCP). Sometimes women who have severe menstrual pain are asked to take the OCP continuously, meaning skipping the placebo (hormonally inert) portion of the cycle.
Continuous use in this manner will generally stop menstruation altogether. Occasionally, weight gain, breast tenderness, nausea and irregular bleeding may occur. Oral contraceptive pills are usually well-tolerated in women with endometriosis.
Many women suffering from this condition have come together to form support groups. These help them share information about the condition, how to rise above it and help come up with interventions to better deal with the condition.
Endometriosis is a very wide topic so please feel free to email me for more info at [email protected]. Or follow my blog www.healthpromotionbyleeanne.worldpress.com Lee-Anne Hall, Bsc Physiotherapy. “Take care of your busy body, you owe that to your family”.
Online Reporter