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Endometriosis
Endometriosis
is a common cause of pelvic pain and infertility (40%) in women.
The lining of the uterus is composed of endometrial cells which
have the capability to divide rapidly. This rapid division increases
the vascularity of the endometrium thus preparing it to accept the
developing fetus. Endometriosis occurs when the cells that normally
line the uterus travel to other parts of the body, attach to various
organs grow and divide. Endometrial cells require the hormone estrogen
for sustained growth.
The
most widely held theory of how endometriosis develops hypothesizes
that endometrial cells "slough off" during the menstrual
cycle and flow back through the fallopian tubes into the pelvic
cavity. Once in the pelvic cavity endometrial cells can attach to
any organ including the ovaries, uterus, spleen, kidneys, and bowel
and have been seen in areas such as the lung. As the endometrial
cells grow they obstruct organs, such as the tubes, and sometimes
cause complete blockage and/or organ penetration. The severity of
endometriosis is categorized by stages one(less severe) to stage
5 (severe).
Sometimes
medications such as
Lupron are effective endometriosis treatments. These drugs suppress
FSH and LH hormone production leading to dramatically lower estrogen
levels. When endometriosis is present in the infertile female, it
is usually removed surgically via laparoscopy.
When
fertility is an issue, the diagnostic/treatment laparoscopy
should always be performed by a reproductive specialist. Specialists,
such as Dr. McWilliams, undergo years of advanced training in delicate
microsurgery and can often remove the endometriosis during the diagnostic
laparoscopy. Meticulous care must be taken to remove all of the
endometrial implants.
Endometriosis
also has a genetic component and its incidence is higher in daughters
of women who have/had the disease.
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