Cost of laparoscopic surgical excision of  endometriosis £1550.

Key Facts About Endometriosis: Insights and Treatment

Introduction Endometriosis affects approximately 10% (190 million) of women and girls of reproductive age worldwide. This chronic condition is known for causing significant pain and can severely impact daily activities and overall quality of life.

Overview of Endometriosis Endometriosis occurs when tissue resembling the uterine lining grows outside the uterus, leading to chronic pain, especially in the pelvic area, and can complicate pregnancy efforts. This disease can begin with a person’s first menstrual cycle and may continue until menopause. It primarily manifests as chronic inflammatory reactions in the pelvis, which can lead to scar tissue formation. Endometriosis can present in various forms, including superficial implants on the pelvic peritoneum, cystic ovarian endometriosis, and deep infiltrative endometriosis affecting the recto-vaginal septum, bladder, and bowel.

Symptoms of Endometriosis The symptoms vary widely, but they frequently include:

• Severe pelvic pain during menstrual periods
• Pain during or after sexual intercourse
• Painful bowel movements or urination
• Chronic pelvic pain
• Heavy menstrual bleeding or bleeding between periods
• Difficulty getting pregnant
• Gastrointestinal symptoms like bloating and nausea
• Fatigue, depression, and anxiety

Symptoms tend to decrease after menopause, but they may not disappear completely.

Causes and Pathogenesis The exact cause of endometriosis is unknown, and no prevention methods have been established. The disease is believed to possibly stem from:

• Retrograde menstruation, where menstrual blood flows back into the pelvic cavity.
• Cellular metaplasia, or transformation of peritoneal cells into endometrial-like cells.
• Distribution of endometrial-like cells via the bloodstream or lymphatic system, potentially starting from stem cells. The condition is exacerbated by estrogen, but the relationship between hormone levels and disease progression is complex.

Impact of Endometriosis Endometriosis significantly affects social, health, and economic well-being. It can impair an individual’s ability to work or attend school and impact sexual and reproductive health, leading to a diminished quality of life.

Diagnosis and Treatment Diagnosing endometriosis often involves a detailed history of symptoms and may require imaging tests like ultrasound or MRI, and definitive diagnosis often requires surgical assessment via laparoscopy. While there is no cure for endometriosis, treatment aims to manage symptoms and may include:

• NSAIDs and other pain relief medications
• Hormonal therapies such as birth control pills, GnRH analogues, and other hormonal suppressants
• Surgical interventions for removing endometriotic lesions and scar tissue, primarily through minimally invasive techniques like laparoscopy

Prevention and Management Strategies While prevention of endometriosis is not possible, early diagnosis and effective management can mitigate the progression and intensity of symptoms. Treatment strategies are tailored based on symptom severity, desire for pregnancy, and patient preference, considering potential side effects and long-term outcomes.

Challenges and Global Response Awareness and understanding of endometriosis are lacking in many areas, leading to delays in diagnosis and treatment, particularly in low- and middle-income countries. The World Health Organization (WHO) is actively working to improve global awareness and establish effective interventions to manage and treat endometriosis, collaborating with various stakeholders to enhance care and support for those affected.

Conclusion Endometriosis is a complex and often painful disease with a significant impact on individuals’ lives. Efforts to improve diagnosis, treatment, and general awareness are crucial in managing this challenging condition and improving the lives of millions of women worldwide.