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| Endometriosis, the presence of endometrial tissue (lining cells of the uterus) outside the uterine cavity, can be found both inside and outside the uterus. When found inside the myometrium, muscle tissue of the uterus, it is called adenomyosis. | ||||||||||||||
| The age range of this condition is anytime during the woman’s reproductive life. In other words, from puberty to menopause. | ||||||||||||||
| Adenomyosis can cause heavy bleeding, severe cramping during periods and an enlarged, boggy uterus which is tender on pelvic examination. However, sometimes no signs or symptoms are found. | ||||||||||||||
| Endometriosis can be found anywhere outside the uterus. It is most often found on the pelvic organs, including ovaries, fallopian tubes, surface of the uterus, and ligaments supporting and surrounding the uterus. It can also be found on the bowel, bladder and almost any other organ in the body. | ||||||||||||||
| The cause of endometriosis is unclear and has been debated for years. There does seem to be a family tendency for the disease. About 20% of women have a relative with endometriosis. | ||||||||||||||
| Endometriosis can cause pelvic pain, severe menstrual cramping, painful intercourse, premenstrual staining, heavy periods, diarrhea, blood in the urine and stool, and infertility. Many times even severe endometriosis causes no symptoms at all. It is often found during an infertility evaluation. | ||||||||||||||
| On physical examination, an immovable, backward uterus, ovarian cysts, and nodules found on the utero-sacral ligaments which are located behind the uterus may be found. | ||||||||||||||
| However, even with symptoms of endometriosis and physical examination findings that are consistent with endometriosis, a diagnosis of endometriosis CANNOT be made except by direst visualization with a laparoscope and possible biopsy if there is a question of the findings. Neither sonograms, x-rays, nor physical examination can give a definite diagnosis. | ||||||||||||||
| Endometriosis can now be treated both medically and surgically to decrease pain and increase pregnancy chances and is not a definitive reason for hysterectomy any more. | ||||||||||||||
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| PRELIMINARY STUDY: Endometriosis may increase cancer risk | ||||||||||||||
| (Please
understand that this is a preliminary study only. If you have concerns
about this, please ask your care giver.)
By Ann Quigley Endometriosis, a disease that affects women in their reproductive years, may be linked to an increased risk of cancers such as malignant melanoma, breast and ovarian cancers in patients and their families, according to preliminary research presented at a press conference in Manhattan on Wednesday. "Endometriosis may well be a lot more serious that people have thought, and because of that we all need to keep our antennae up," Mary Lou Ballweg, president of the Endometriosis Association, told Reuters Health. "If it is serious, we need to be diagnosing it better. We can't be telling these women for years on end that it's in their heads, or it will be better when they have a baby, which is what women typically were told." In addition to presenting study data, Ballweg also announced launch of the Milwaukee, Wisconsin-based Association's research initiative in partnership with Vanderbilt University, in Nashville, Tennessee. The initiative will examine immune, hormonal, and environmental aspects of endometriosis. Endometriosis occurs when tissue similar to that of the endometrium, the uterine lining, is also found in areas outside the uterus, such as on the lining of the abdomen and pelvis, the bowel, bladder and ovaries. The presence of this tissue can cause internal bleeding, scar tissue formation, and inflammation, and can result in pelvic pain, painful menstruation, infertility, and abnormal vaginal bleeding. According to the results of an Endometriosis Association survey of 4,000 of its members, endometriosis sufferers appear to have an increased risk of breast cancer, melanoma, and ovarian cancer compared with other women. Their families too, may also have a higher than average risk of these conditions, as well as of non-Hodgkin's lymphoma. But the researchers caution that this data is very preliminary. "It's of value, but you have to look at it as: these are women who are members of the Endometriosis Association who are willing to send in a questionnaire. The data, while it's very important to collect, doesn't necessarily represent an unbiased source," Dr. Kevin Osteen, director of the Women's Reproductive Health Research Center at Vanderbilt University Medical School, told Reuters Health. "This sort of data gives us keys as to what the connections might be between disease processes, but there needs to be more research and certainly broader based epidemiology studies before that data can be confirmed." The health problems experienced by women with endometriosis and their families have been tentatively linked -- by one study published in 1993 on rhesus monkeys -- to environmental exposure to toxins such as dioxin. With a grant from the Environmental Protection Agency, Osteen's research group has been performing additional research on how dioxin may affect the endometriosis disease process. "We have data that we will be publishing soon that shows how dioxin can affect steroid hormone action in a way that could be connected with the disease process. There is no precise information about how much exposure one would have to have, or whether one's exposure is actually a part of the disease process," Osteen said. "Nobody wants to be an alarmist, because in modern society you can't avoid being exposed to dioxin. We just want to look at the basic mechanisms that dioxin might utilize within the endocrine/immune system, and use that information to help develop some therapeutic options -- if it (dioxin exposure) is found to be a part of the diseases process," he added. **Dioxin is contained in almost all US produced tampons. A bill, Dioxin and Women's Health, was presented in Congress by Rep. Carolyn Maloney asking for an independent agency other than the FDA to look at this issue. MJB |
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