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Endometriosis: Endometrial
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A definite cause of endometriosis has not been discovered. Some researchers believe that, in some women, small pieces of the uterine lining flow backward through the fallopian tubes and into the abdomen during the menstrual flow. The endometrial implants then attach and grow. Others believe all women have some endometrial tissue that becomes misplaced, but the immune system destroys it. The immune system of women who develop endometriosis is unable to destroy the tissue. There may ... be a link between exposure to the chemical dioxin, commonly found in weed killers, and endometriosis.
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The hormone derivative danazol is a medication frequently used to treat endometriosis. During treatment with danazol, estrogen levels are often reduced to low levels similar to natural menopause. This state is sometimes called pseudo-menopause. Danazol is thought to work indirectly by affecting the hormones produced by the brain which cause ovulation, and directly by affecting the endometrial implants.
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Progestin-releasing IUDs can be very helpful for many women with endometriosis, particularly an advanced version called the levonorgestrel-releasing intrauterine system, or LNG-IUS (Mirena). Studies suggest that the LNG-IUS reduces endometrial cell proliferation and increases cell self-destruction. Progestin released by the IUD mainly affects the uterus and cervix and causes fewer widespread side effects than other forms of progestins.
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The cause of endometriosis is unknown. It is not completely understood if the endometrial tissue moves to other locations from the uterus or develops there as a result of cell changes. Women at higher risk for endometriosis include those who have never given birth, those who have had female surgical proceduresand those with menstrual periods that last longer than eight days.
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Manipulation of the endogenous hormonal milieu is the basis for the medical management of endometriosis. As oestrogen is known to stimulate the growth of endometriosis, hormonal therapy has been designed to suppress oestrogen synthesis, thereby inducing atrophy of ectopic endometrial implants or interrupting the cycle of stimulation and bleeding. Withdrawal of oestrogen stimulation causes cellular inactivation and degeneration of endometriotic implants but not their disappearance.
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Supplemental hormones are effective in reducing or eliminating the pain of endometriosis. That's because the rise and fall of hormones during a woman's menstrual cycle causes endometrial implants to thicken, break down and bleed. In fact, if hormonal therapy has little to no effect on your symptoms, consider questioning the diagnosis of endometriosis or its relationship to your symptoms.
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