Endometriosis
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Definition/Description[edit | edit source]
Endometriosis is a female reproductive disorder which affects the lining of the uterus, otherwise known as the endometrium.[1] This estrogen-dependent disorder is defined by the presence of endometrial tissue outside of the uterus and becomes apparent after the start of menses.[2]
In a typical monthly menstrual cycle, endometrial cells lining the uterine walls are stimulated through a release of horomones and multiply in order to provide an ideal environment for egg fertiliztion.[3] If fertilization of the egg does not occur, the uterus sloughs off the lining of blood (endometrial tissue) and menstrual flow occurs for 3 to 5 days.[2]
When affected by endometriosis, endometrial tissue is misplaced outside the uterus in various places. Despite the location of the tissue, the same monthly menstrual cycle occurs.[1] The misplaced tissue engorges with blood, as it would in the uterine lining. Since this blood has no course to drain out of the vagina it remains where it is resulting in "chocolate cysts" wherever endometrial cells are located.[2] In addition to cysts, trapped blood may lead to scar tissue, adhesions and irritation of the surrounding tissue which causing pelvic pain and fertility problems.[1]
Blood deposits or ectopic implantation may occur anywhere in the body but most commonly affects the ovaries, fallopian tubes, broad ligaments, bladder, pelvic musculature, perineum, vulva, vagina, or intestines.[2][1] It has been discovered that endometrial tissue has the ablility to migrate through the body, and in less common cases has been found in the abdominal cavity, kidneys, small bowel, appendix, diaphragm, pleura, bone and even the brain.[2]
Prevalence[edit | edit source]
The incidence of Endometriosis has been on the rise in Western countries for the last 40 to 50 years.[2] Although there are statistics in the literature, the true prevelence of endometriosis is unknown because many women remain asymptomatic.[4] It has been reported that endometriosis occurs in a wide range of 7%- 60% of all women.[2] Further Reports in 2008 revealed that endometriosis occurs in 7%-10% of women in the general population, 2%-50% of women suffering from infertility, and 71%-87% of women with chronic menstrual pain.[5] Unlike many common disorders, there have been no correlations between endometriosis and specific populations. Endometriosis has been shown to affect women of all race, cultures, ethinic origins, socioeconomic status, and geographic backgrounds.[2]
Characteristics/Clinical Presentation[edit | edit source]
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Associated Co-morbidities[edit | edit source]
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Medications[edit | edit source]
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Causes[edit | edit source]
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Systemic Involvement[edit | edit source]
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Medical Management (current best evidence)[edit | edit source]
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Physical Therapy Management (current best evidence)[edit | edit source]
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References[edit | edit source]
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- ↑ 1.0 1.1 1.2 1.3 Endometriosis. MayoClinic.com. Sept. 11, 2008. Available at: http://www.mayoclinic.com/health/endometriosis/DS00289. Accessed : February 17, 2010.
- ↑ 2.0 2.1 2.2 2.3 2.4 2.5 2.6 2.7 Goodman C., Fuller K. Pathology: Implications for the Physical Therapist. St. Louis, Missouri: Saunders Elsevier; 2009.
- ↑ Endometriosis. MedlinePlus Medical Encyclopedia. January 2010. Available at: http://www.nlm.nih.gov/medlineplus/ency/article/000915.htm. Accessed: February 17, 2010.
- ↑ Edwards, M. Understanding Endometriosis. Practice Nurse. December 2009; 38, 10: Proquest Nursing and Allied Health Source. pgs 22-25. Accessed: February 17, 2010.
- ↑ Ozakan S., Arici A. Advances in Treatment Options of Endometriosis. Gynecologic and Obstetric Investigation. October 2008; 67: 81-91. Accessed: February 18, 2010.