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The endometrium is the medical name commonly used for the lining
tissue of the uterus. This lining, just prior to the onset of
the next menstrual period is approximately five millimeters
thick, and at this stage is 'ready' for the implantation of the
products of conception. In the case of endometriosis some of the
cells that are present in the uterine lining, for some unknown
reason seem to migrate up the uterine tubes, attaching itself to
the pelvic organs or lining membrane of the pelvis where it will
grow during the next cycle, just as it would in the lining of
the uterus. Therefore pieces of endometrium exist in places
where they shouldn't, and bleeding during menstruation they
cause severe abdominal pains eventually resulting in scar tissue
within the pelvis. This in turn may block the tube or release
substances which are toxic to sperm. In severe cases large
blood-filled cysts form, causing heavy and painful bleeding
during menstruation, pain during intercourse (particularly in
the case of deep penetration) and extreme discomfort during
vaginal examinations. The diagnosis for this condition will be
confirmed through a laparoscopy, where depending on the severity
and timing, effective treatment for endometriosis can be
offered.
Treating endometriosis
If endometriosis is responsible for infertility, drug therapy
and/or surgery will be necessary. In mild cases the use of
progesterone-type drugs may be sufficient to cure the problem,
but if the endometriosis has caused large cysts that are
affecting the ovaries, then surgery as well as drug treatment
may be required.
Drug treatment would usually involve the use of Danazol, which
will reduce the growth of endometrial tissue, however it does
seem to have negative side effects such as weight gain and
breast size reduction. If the cysts are relatively small it may
be possible for them to be cauterised and destroyed, but if they
are large, abdominal surgery will be necessary, where the
damaged tissues can hopefully be reconstructed and together with
a course of drug treatment, fertility fully restored.
Treatment of this disorder is quite a complicated affair,
therefore it will be necessary for the patient to receive
adequate explanation and counseling so that the best results can
be obtained in the shortest possible time and that any further
signs of endometriosis may be recognised immediately.
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