26 November 2013
Causal Analysis: Endometriosis
Endometriosis is a problem that many women have in their childbearing years, usually between the ages of fifteen to forty-nine. Having this gynological condition means that the endometrium (a type of tissue that lines the uterus) is also growing somewhere outside of the uterus. This does not always cause symptoms, and usually is not dangerous or life threatening, but it does pose some risks. This disease can cause severe pain and other problems as well. The clumps of endometrium that grow outside of the uterus are called implants. These “implants” typically grow on the ovaries, the fallopian tubes, the outer wall of the uterus, the intestines, or other organs in the abdomen, but in some rare cases they have spread to areas and organs beyond the abdominal region. How can this cause problems? Each month a woman’s body releases hormones that cause the endometrium to thicken and get ready for an egg. If the woman gets pregnant, the fertilized egg attaches to the endometrium and starts to grow. If the woman does not get pregnant, the endometrium breaks down, and her body will shed it as blood. This is called her menstrual period. When a woman has endometriosis the implants of tissue outside of the uterus act just like the tissue lining the inside of the uterus. During the menstrual cycle, they get thicker, then break down and bleed. The problem is, that since these implants are on the outside of the uterus, the blood cannot flow out of the body. The implants then get irritated and painful. Sometimes they form scar tissue or fluid filled sacs called cysts. The scar tissue and cysts can make it difficult for a woman to become pregnant. The most common symptom of endometriosis is pelvic pain. Pain may be felt before, during, and after menstruation, during ovulation, in the bowel during menstruation, when urinating, during or after sexual intercourse, or even in the lower back region. Other symptoms may include diarrhea, constipation, abdominal bloating, heavy or irregular bleeding, and fatigue. The first symptoms of primary endometriosis usually begin at menarche, when menstruation first begins, and usually worsen with each menstrual period. By the time a girl who has endometriosis is in her early to middle teens, she may have such severe menstrual pain, nausea, and vomiting that she is unable to get out of bed. For many women, the pain of endometriosis can unfortunately be so severe and debilitating that it impacts her life so that she may not be able to perform her day-to-day activities. The quality of life for women affected by endometriosis is diminished because of this, as well as subfertility, higher body mass index, fatigue, and on average eleven hours of lost productivity per week, which severely compromises work and educational opportunities (Farrell 37). According to Dr. Elizabeth Farrell, a gynecologist, founding member of Jean Hailes for Women’s Health, and an adjunct senior lecturer in the department of obstetrics and gynecology at Monash University; 1 in 10 women of reproductive age are affected by endometriosis, equating to over 176 million women worldwide. This figure includes 50-70% of women with chronic pelvic pain and 38% of infertile women. There are different hypotheses as to what causes endometriosis. Unfortunately, none of these theories have ever been entirely proven, nor do they fully explain all the mechanisms associated with the development of the disease. Thus, the exact cause of endometriosis remains unknown. Most scientists working in the field of endometriosis do agree, however, that endometriosis is exacerbated by oestrogen. Consequently, most of the current treatments for endometriosis attempt to temper oestrogen production in a woman’s body in order to relieve her of symptoms. Because the exact cause is unknown, there are currently no treatments, which fully cure endometriosis. Several theories for the...
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