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Endometriosis
One of the most challenging health conditions, endometriosis affects over 10 million women in the United States alone.

What Is Endometriosis?
Endometriosis is an implantation and growth of endometrial [uterine lining] tissue outside of the uterus, which can result in a variety of problems, including pelvic pain, subfertility, depending on its location and extent. One of the most challenging health conditions, endometriosis affects over 10 million women in the United States alone. In addition, a risk of developing endometriosis in Japanese women is higher than in American women. It is one of the leading causes of pelvic pain and infertility. Though there are many effective treatments, there is no known cure for this desease. Since endometriosis is a progressive desease [Stage I to IV] and can spread like cancer, an early detection and treatment is very important. The diagnosis is confirmed when endometrial cells are identified outside their usual location - inside the uterus.

How Does Endometriosis Affect Women?
Endometriosis can be found outside the uterus, inside and outside the ovaries, or implanted upon the fallopian tubes, large and small intestines, the appedix, the bladder wall and the urethra, as well as anywhere else in the body. When women have their period, the endometriosis also responds to the menstrual cycle's hormonal signals, causing a period-like bleeding from the endometriosis sites. When the endometriosis bleeds, women may have sensations of deep pain or cramping. The body responds to the bleeding by surrounding it with inflammation, often causing ahesions and leaving scar tissues. Endometriosis is estimated to be present in 15-20% of all reproductive-age American women and as many as 40% of infertile women, and 80% of women with chronic pelvic pain.

Besides infertility, women suffering from endometriosis experience severe pain during their menstrual cycle or during intercourse, excessive or irregular bleeding, urinary or bowel problems in conjunction with menstruation. Other symptoms associated with endometriosis may include fatigue, acute pain with bowel movements, lower back pain, diarrhea, constipation or other intestinal upset, bleeding during bowel movement or urination during a patient's period.

The amount of pain is not necessarily related to the extent or size of growths. Some women have minimum endometriosis [Stage I] but suffer from severe pelvic pain with each cycle. On the other hand, about one third of advanced stage endometriosis patients [Stage III-IV] experience no pain. Since endometriosis is progressive, early diagnosis and treament of the symptoms is essential in order to prevent further spread of the desease and to restore a normal pelvic anatomy, as well as to prevent fertility problems.

How Can Endometriosis Be Detected?
Ultrasound scans can detect the presence of endometriomas [chocolate cysts] in the ovaries, yet cannot detect much smaller modular lesions on the abdominal wall. Physical exams by an experienced gynecologist can detect such subtle signs of endometriosis as: retroverted uterus, painful nodularities on the posterior cul de sac or uterosacral ligaments. Often, patients need to be examined during their periods in order to catch more signs of endometriosis. Typically, diagnostic laparoscopy is the definitive way endometriosis and its extent is diagnosed. Laparascopy is usually both a diagnostic and therapeutic outpatient surgical procedure, which is performed by inserting a small fiberoptic telescope into the abdomen to look for endometriosis scars and adhesions

courtsy(Dr SHAFIQUE UR REHMAN CHAUHDRY)
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