ENDOMETRIOSIS

Endometriosis is a condition in which the inside lining or the endometrium of the uterus is found outside the uterus, usually on the back of the external surface of the uterus, on the ovaries (forming cysts or endometriomas) or on the bowels. Each month when the ovaries produce hormones, just as the normally sited endometrium grows and subsequently sheds during menstruation, these ectopic endometriotic deposits will likewise grow and shed. However unlike the normal endometrium which sheds and comes out through the cervix, these displaced endometriotic tissue and blood have no exit and are trapped, forming adhesions and cysts. Endometriosis may be silent, asymptomatic or it can present as distressingly painful menstrual periods classically lasting throughout the days of menstruation, as pain during intercourse, pain at urination or bowel movements, or as infertility. Treatment will depend on whether the woman wants relief from the pain or she has infertility and wants to have a baby. The treatment for the former would be medications to stop (Gonadotrophin Releasing Hormone Agonist injections, progestogens),) or manage (oral contraceptives) the menstrual cycles while the preferred treatment for for women with infertility is ablation of the endometriotic deposits, excision of endometriomas or lysis of adhesions to free the ovaries and the tubes by laparoscopic surgery.

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