It occurs when the glandular tissue of the uterus lining is found outside the uterus in the pelvis, ovaries or other pelvic organs.
The exact cause for the endometriosis is not known, but it is thought to relate to menstrual cycle processes, or genetic factors, or developmental abnormality during the growth of the embryo, or may be modified by environmental factors and hormonal or immune system issues.
Understanding endometriosis, its impact, and the available treatments is essential for those affected and their healthcare providers.
An Australian publication reported there were more than 34,000 hospitalisations in Australia related to endometriosis in 2016-2017. It is most commonly diagnosed in women in their 30s and 40s, though it can occur in any woman who menstruates.
Despite its prevalence, endometriosis is often underdiagnosed due to the normalisation of menstrual pain and the variability of symptoms.
Symptomology of endometriosis can be extremely variable between individuals. It can cause painful cramps in the lower abdomen, back or in the pelvis during menstruation, pain during intercourse, abnormal bleeding between periods, painful bowel movements or urination, and infertility. Some women can have no symptoms as well. Because of the variability in presenting symptoms, and non-specific nature of some of the symptoms, diagnosis can be challenging and often delayed.
Diagnosis of endometriosis may be suspected when clinical history is suspicious, or abnormalities are seen on ultrasound, MRI or CT scan. Sometimes, raised levels in the tumour marker in CA125 can also suggest endometriosis.
However, the only direct way to diagnose endometriosis is by visualising it during laparoscopy (day procedure under general anaesthesia) where a thin long camera is inserted through an incision in the abdomen and a biopsy is taken for histopathological testing.
While there is no cure for endometriosis, a range of treatments exists to help manage symptoms and improve quality of life. Treatment plans are highly individualised, based on symptom severity, the extent of the disease, and desire for fertility.
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