endometriosis…

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pelvic laparoscopy, endometriosis, abnormal menstrual periods, endometriosis, the endometrium, tissue that, lines the uterus, grows in other areas, causing pain, irregular bleeding, frequently infertility, tissue growth typically occurs, in the pelvic area, outside, the uterus, on the ovaries, bowel, rectum, bladder, delicate lining, the pelvis, occur in other areas, endometriosis, a number of theories have been proposed, retrograde-menstruation theory proposes that endometrial cells, loosened, menstruation, "back up", the fallopian tubes, pelvis, where they implant, grow, in the pelvic, abdominal cavities, immune-system theory suggests that a deficiency, in the immune system allows menstrual tissue to implant, grow in areas other than the uterine lining, another theory suggests that the cells lining the abdominal cavity, spontaneously develop endometriosis, a genetic theory proposes that certain families, exhibit predisposing factors that lead to endometriosis, once the endometrial cells implant in tissue outside, the uterus, become a problem, each month the ovaries produce hormones that stimulate the cells, the uterine lining to multiply, prepare, fertilized egg, swell, thicken, endometrial cells outside, the uterus also respond to this signal, lack the ability to then separate themselves, surrounding tissue, slough off, next menstrual period, bleed a little bit, heal, stimulated again, next cycle, ongoing process, cause scarring, adhesions, in the tubes, ovaries, around the tubal fimbriae, fingerlike projections, end, the fallopian tubes, adhesions, make transfer of an ovum, ovary, fallopian tube difficult, impossible, stop passage of a fertilized egg down the fallopian tube, uterus, growing cells, penetrate the tough covering, the ovary, to multiply, cells, collect large amounts of blood, form what, appropriately, an ovarian blood cyst, endometrioma, ovarian blood cysts have been known to grow, size of a hen's egg, an orange, painful, over time the collected blood darkens, cysts, "chocolate cysts", endometriosis, common problem, occurs in an estimated 10% of women, reproductive years, prevalence, 35% among infertile women, endometriosis is typically diagnosed between the ages of 25, problem probably begins, the time that regular menstruation begins, a woman who has a mother, sister, endometriosis has a risk of developing endometriosis that is 6 times greater than, the general population, risk factors include early onset of menstrual periods, regular menstrual cycles, periods lasting 7, increasingly painful periods, lower abdominal pain, pelvic cramps, by felt, week, two, menstruation, menstruation, pain, cramps steady, dull, quite severe, pelvic, low-back pain, occur at any time, menstrual cycle, pain, following sexual intercourse, pain, bowel movements, premenstrual spotting, infertility, not be present, in fact, women, severe cases of endometriosis have no pain at, women, a few small adhesions have severe discomfort, a pelvic examination, reveal, tender nodules, a lumpy consistency, found, in the posterior vaginal wall, adnexa, ovary regions, felt in healed wound scars, those from episiotomy, c-section, pain, uterine motion, uterus fixed, retroverted, a pelvic ultrasound test, detect an endometrioma on an ovary, a laparoscopy is necessary, definite diagnosis, most patients, start treatment, treatment depends on the the degree of symptoms experienced, extent, determined, laparoscopy, woman's desire, future childbearing, woman's age, observation the appropriate treatment, younger women, minimal disease, important to have the woman maintain a regular schedule of examinations, every 6 to 12 months, to note any changes, progression, medications, focus on several strategies, analgesic therapy, treating the discomfort, the disease only, women, mild to moderate premenstrual pain, no pelvic examination abnormalities, no immediate desire to, become pregnant, "pseudopregnancy", a state resembling pregnancy, achieved, hormonal drug regimens, approach was developed in response, observed regression of endometriosis, pregnancy, pseudopregnancy, induced using oral contraceptives containing estrogen, progesterone, takes 6 to 9 months, relieves most, prevent scarring, adhesion left by the disease, potential side effects, breakthrough spotting, limit this treatment option, progesterone medications by themselves, another effective hormonal treatment, endometriosis, progesterone pills, injections, side effects of these agents, depression, weight gain, breakthrough spotting, a problem, patients, "pseudomenopause", a state resembling menopause, was developed, a means of treatment, the observation that endometriosis regresses after menopause, danazol, a weak androgenic, male characteristic, hormonal drug, reduce natural levels of estrogen, progesterone to low levels, the use of danazol superior, "pseudopregnancy" regimens in controlling symptoms, progression, the disease in women, moderate-to-severe endometriosis, due to possible side effects from danazol, prescribed less often then some newer medications, a new class of antigonadotropin drugs has been developed that also produces a "pseudomenopausal" state in women, drugs, synarel, depo lupron, trade names, prevent stimulation, the pituitary, the production of fsh, follicle stimulating hormone, lh, luteinizing hormone, stops the ovary, from producing estrogen, potential side effects of these drugs, menopausal symptoms, hot flashes, vaginal dryness, mood changes, early loss of calcium, bones, effects on bone density, treatment of endometriosis, one of these agents, limited to 6 months, surgery, either laparoscopy, laparotomy, reserved, women, severe endometriosis, adhesions, infertility, conservative surgery attempts to remove, destroy, the outside endometriotic tissue, remove adhesions, restore the pelvic anatomy to, close to normal, nerve removal, neurectomy, rarely be performed, surgery, a means of relieving the pain associated, endometriosis, definitive surgery is appropriate, the woman, severe symptoms, no desire, future childbearing, type of surgery involves abdominal removal, the uterus, hysterectomy, ovaries, fallopian tubes, remaining adhesions, endometriotic implants, hormonal replacement therapy indicated after removal, the ovaries, tailored, individual woman's needs, fertility rates in women, mild endometriosis, very high, therapy, enhanced fertility after surgery, endometriosis depends on the extent, the endometriosis, pregnancy rates, achieved after conservative surgery in women previously considered to be infertile, approximately 75%, mild endometriosis, 50-60%, moderate cases, 30-40%, severe cases, infertility, result from endometriosis, not in every patient, endometriosis is mild, endometriosis has been known to recur after a hysterectomy, complications, rare, few cases endometriosis implants, obstructions, the gastrointestinal, urinary tracts, symptoms of endometriosis occur, back pain, symptoms recur after treatment of endometriosis, screening, endometriosis, mother, sister has been diagnosed, endometriosis, unable to, become pregnant after 1 year of attempting to conceive, no proven prevention, endometriosis, women, a strong family history of endometriosis, consider taking oral contraceptive pills, prevent, slow down the development.