CAUSES OF ENDOMETRIOSIS Although there are a number of theories, the cause of endometriosis remains unknown. THEORIES One well known theory is Sampsons theory of retrograde menstruation - where during menstruation (periods) there is a backflow of menstrual tissue up through the fallopian tubes and into the pelvic cavity. It is now known that retrograde menstruation occurs in most menstruating women however, what remains unclear is why endometriosis developes in some women but not others. Again there are theories but no definate facts as to why this should be, such as dysfunction of immune system and a hormone related response. Another theory suggests that endometrial tissue is spread to other parts of the body via the lymphatic or circulatory systems. The genetic theory - suggests that women have genetic factors predisposing them to developing this disease. This is presently being researched by Oxford University. If other females in your family suffer from this disease you may be able to help further research in this area, or if you ar simply interested in this theory. you will find a link to this site in our links to sites of interest. Environmental toxins / chemical theory, - it has been proven through studies that certain environmental toxins such as dioxin and petrochemicals can exacerbate endometriosis, therefore, it is now being queried that they may actually be involved in the development of this disease. Embryonic theory - here it is suggested that endometriosis is a congenital condition where  tissues remaining from the embryonic stage of development has the ability to develop into e.g. endometrial tissue.

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Endometriosis is a common, painful, chronic disease affecting many women in their reproductive years.    In endometriosis, endometrium like tissue is found outside the uterus in different areas of the body. Endometrium is the tissue that lines the uterus, which in response to hormonal commands builds up breaks down and is shed every month during menstruation (periods).    The misplaced tissue develops and responds to the same hormonal commands, however unlike menstrual blood which flows out of the body, the blood and tissue shed from endometrial growths has nowhere to go.    This causes internal bleeding, inflammation of surrounding areas, formation of scar tissue and dense adhesions.   This can be associated with, for example pain, infertility, bladder and bowel problems.

WHAT IS ENDOMETRIOSIS?

We would like to extend a very warm welcome to ScotEndo a support group for sufferers of the disease Endometriosis. The group was launched on National Endometriosis Awareness day, the 4th of July 2001. The idea of ScotEndo Support Group developed when it became apparent that there was a distinct lack of support available in Scotland not only for those who suffer from endometriosis but also for their families, friends and those who care. Based in the Dunbartonshire area just beside Loch Lomond, our aim is not only to give this much needed support but also to raise awareness of this unfortunately all too common disease. To find out when our next local support group meeting is planned please check out our news and updates page.

SIGNS & SYMPTOMS The amount of pain experienced or severity of symptoms are not necessarily  related to the extent or size of growths. Some women experience no pain/symptoms of having endometriosis and it is only discovered during investigation of fertility problems or during other surgery. Women may find they have none, some or all of the following list of possible symptoms related to endometriosis however, this list is not exhaustive and it may be found that they have symptoms beyond those included. * Mild/moderate/severe pain before/ during /after     menstruation (periods). * Mild/moderate/severe pain at ovulation time. (Mid cycle). * Pain during/after intercourse. * Pain at any time. * Infertility. * Heavy, prolonged or irregular bleeding. * Loss of dark or old blood before/after periods. * Loss of large clots. * Painful bowel movements. * Pain before or after bowel movements. * Bleeding from the bowel. * Rectal pain/spasm. * Bloating/swollen abdomen. * Symptoms of irritable bowel - diarrhoea, constipation, colic. * Pain when passing urine. * Pain before or after passing urine. * Urgency to pass urine. * Frequency of passing urine. * Pre-menstrual tension. (PMS). * Low energy levels. * Insomnia. (Difficulty sleeping). * Depression/low mood. PLEASE NOTE: The above symptoms can also be indicative of other medical conditions. Therefore although you may suffer from the above, diagnosis is generally considered uncertain until proven by visualization, normally by a small procedure called a Laparoscopy. (See below for more information).

CAUSES OF ENDOMETRIOSIS Although there are a number of theories, the cause of endometriosis remains unknown. THEORIES One well known theory is Sampsons theory of retrograde menstruation - where during menstruation (periods) there is a backflow of menstrual tissue up through the fallopian tubes and into the pelvic cavity. It is now known that retrograde menstruation occurs in most menstruating women however, what remains unclear is why endometriosis developes in some women but not others. Again there are theories but no definate facts as to why this should be, such as dysfunction of immune system and a hormone related response. Another theory suggests that endometrial tissue is spread to other parts of the body via the lymphatic or circulatory systems. The genetic theory - suggests that women have genetic factors predisposing them to developing this disease. This is presently being researched by Oxford University. If other females in your family suffer from this disease you may be able to help further research in this area, or if you ar simply interested in this theory. you will find a link to this site in our links to sites of interest. Environmental toxins / chemical theory, - it has been proven through studies that certain environmental toxins such as dioxin and petrochemicals can exacerbate endometriosis, therefore, it is now being queried that they may actually be involved in the development of this disease. Embryonic theory - here it is suggested that endometriosis is a congenital condition where  tissues remaining from the embryonic stage of development has the ability to develop into e.g. endometrial tissue.

SUGGESTED READING Living with Endometriosis.          Author - Caroline Hawkridge.  Published by - Vermilion. The EndometriosisSourcebook.   Author - Mary Lou Ballweg           Published by - The Endometriosis Association/Contemporary books. Coping with Endometriosis.  Author - Robert H Pillips & Glendaa Motta. Published by Avery. Living with Endometriosis.  Author - Kate Weinstein. Published by - Addison Wesley. Coping with Endometriosis.  Author - Jo Mears. Published by - Sheldon Press. Endometriosis and Fibroids.  Author - Dr Sarah Brewer. Published by - Vermilion. Endometriosis - A Key to Healing Through Nutrition.  Author - Dian Shepperson Mills & Michael Vernon. Published by - Element. Endometriosis a Natural Approach.  Author - Jo Mears. Published by Ulysses Press. Endometriosis - Infertility and Chinese Medicine.  Author - Bob Flaws. Published by - Blue Poppy Press. Taking Charge of Your Fertility - The Definitive Guide to Natural Birth Control and Pregnancy Achievement.  Author - Toni Weschler. Published by - Harper Perennial.

ScotEndo NEWS / UPDATES

DIAGNOSIS FACT - Studies have shown that the average time it takes to be diagnosed as having endometriosis from onset of symptoms is a staggering 7 years.  This delay can effect the management, treatment and severity of this disease, so if you feel you may be a sufferer, please do not delay in seeking the appropriate medical advice. To date endometriosis can only be conclusively diagnosed by laperoscopy. This is a minor procedure carried out under an anaesthetic which involves the insertion of a tiny camera into the abdomen through a small incision near the navel. This allows examinations to be performed with minimal tissue damage. It is obviously advantageous if the surgeon has the ability to deal with any endometrial deposits at this time, however this is not always possible.

ASSESSMENT / CLASSIFICATION During any procedure i.e diagnosis or surgical treatment of endometriosis, the surgeon will use some form of assessment / classification system to record the extent of findings. The most common system used is the one developed by the ASRM where the surgeon looks for lesions, nodules and cysts giving points for each one found in specific areas and for their size. Adhesions are also counted on a rising scale depending on their nature ie whether they are light or dense and whether they press into nearby healthy tissue. Examples of the stages used to describe the extent of endometriosis are recorded below. Minimal (STAGE  I)       : Superficial endometriosis on the lining of the abdominal cavity (Peritoneum) and filmy adhesions on one of the ovaries. Mild (STAGE II )            : Shallow implants on the lining of the abdominal cavity and on one of the ovaries, with filmy adhesions on the other ovary. Moderate (STAGE III)    : Deep deposits on the lining of the abdominal cavity and on one of the ovaries, with dense adhesions on the other ovary. Severe (STAGE IV)       : Deep deposits on both the ovaries, wth dense adhesions on the ovary, fallopian tube and lining of the abdominal cavity.

PUBLICATIONS LIST / INFORMATION AVAILABLE FROM SCOTENDO- 2001

LINKS TO SITES OF INTEREST

Oxford University - are presently researching the possibility of a genetic link to endometriosis. To find out more or perhaps take part in this study please enter the site through the link button. www.medicine.ox.ac.uk/ndog/oxygene/oxygene.htm

Natural Woman - is a site dedicated to chemical free natural products which includes a good selection of Dioxin free feminine hygene products. To visit this site please enter through the link button. www.natural-woman.com/

Amazon - is a leading on-line Book / CD / Toy / Computer software site. To visit this site please enter throough the link button. www.amazon.co.uk

NES - The website of the National Endometriosis Society. To visit this site please enter through the link button. www.endo.org.uk

S.H.E. - The website of Simply Holistic Endometriosis To visit this site please enter through the link button. www.shetrust.org.uk/

W.E.L. - The website for the Womans endoscopic laser foundation. Specialist centre based in Middlesbrough. To visit this site please enter through the link button. www.wel-foundation.org/

Helica - The website for Helica Instruments Ltd. The revolutinary helica thermal coagulator. To visit this site please enter via the link button. www.helica.scot.net

Links to your local and regional Member of Scottish Parliament To visit this site please enter via the link button. www.scottish.parliament.uk/msps/msps.html

Please note - A full reference list of materials used in the compilation of this site is available from - scotendo@hotmail..com The information contained within this web site is by no means meant to replace medical advice

TREATMENT OPTIONS Diagnosis remains the key - following this although there is not cure, treatments and methods of managing this disease can be discussed and employed. There are a few methods available such as medication, surgery and alternative / complimentary treatments. Brief descriptions of the options within each are included below. Which treatment is used depends on a number of factors such as: Age Severity of symptoms Desire to have children Severity of the disease MEDICAL TREATMENT (Hormone Treatments) The aim of medical treatments isto attempt to control oestrogen production, which causes endometrial tissue to grow. Research has shown that both pregnancy and menopause may have this effect, therfore current medications are used to create a pseudo (pretend) pregnancy or menopause to allow deposits to regress and die. For some women hormone treatments can be very successful however, it is now widely recognised that in a large percentage of women these drugs result merely in temporary suppression of this disease which invariably returns. Hormone treatments used include : Gonadatrophin (GnRH) analogues : These treatments control the release of hormones which set the menstrual cycle in action thus causing ovulation and periods to stop resulting in a medically induced meopause. (pseudo-menopause) There are a number of GnRH analogues which may be prescribed such as : *  Prostap      (Leuprorelin) *  Zoladex      (Goserelin) *  Synarel      ( Nafarellin) *  Buserelin   ( Suprecur) Progestogens : Progesterone is the hormone responsible for preparing the uterus for pregnancy. Progestogens basically trick the body into thinking it is pregnant (pseudo-pregnancy), resulting in lower levels of oestrogen in the body and thus helping to relieve endometriosis. Progestogens used include : *  Provera      (Medoxyprogesterone) *  Primolut      (Norethisterone) *  Duphaston  (Dydrogesterone) *  Minera Coil - Intrauterine device *  Combined Oral Contraceptive Pill Testosterone derivatives - (Male type hormones) : These hormones act directly on the ovaries by interfering with the production of oestrogen and progesterone. This results in a change of body chemistry so that it is similar to the menopause with less oestrogen and higher levels of testosterone, therby helping to reduce endometrial deposits. Derivatives used include : *  Danazol      (Danol) *  Dimetriose  (Gestrinone) Please note : Hormone treatments can cause side effects which may vary in type and severity from person to person. SURGICAL TREATMENTS Surgery can be performed either laprascopically as explained above or in some cases a slightly larger incision is required called a laparotomy. Operative techiniques in endometriosis are dependant of the type and extent of the lesions and also on the surgeon preference and equipment availability. The main aim is to remove and destroy endometrial growths and restore anatomy. Techniques include : *  Manual Excision *  Electrocoagualtion *  Laser Vaporization *  Laser excision *  Helium Coagulation (helica) It may be necessary in some women with severe disease to perform radical surgery (Hysterectomy). Note - Once seen as the definitive cure for this disease, it has become apparent that this is not always the case. In order for radical surgery to be effective in the cure of endometriosis it is important that the ovaries and any endometrial growths are removed at the same time. COMPLIMENTARY / ALTERNATIVE TREATMENTS Some women have found certain complimentary / alternative treatments very successful in relieving the symptoms of this disease. There is unfortunately very little research available to demonstrate their effectiveness. If you wish to try any of the below therapies it is advisable to seek treatment from a qualified / registered practitioner. There is a vast amount of complimentary / alternative treatments available some of which include : *  Cinese herbal medicine *  Western herbal medicine *  Acupuncture *  Homeopathy *  Reflexology *  Aromatherapy *  Naturopathy *  Reiki *  Osteopathy *  Nutrition

Link to EndoUK groups resource page. A compilation of useful information discovered by EndoUK group members. To visit this site please enter via the link button. www.endouk.net

KATHIE'S SITE - Endometriosis - A systemic disease? A Biochemical Investigation Please visit this site and complete the questionnaire to help Kathie's studies into this under researched area of endometriosis. To visit this site please enter via the link button. www.kathies-pain.onweb.cx/

Interested in joining our local group or being put in touch with ladies in your own area? Do you have any suggestions to improve this site? or Feel you may be able to help us? For more information please contact us by e-mailing scotendo@hotmail.com

If you wish to join our local group or would like to be put in contact with someone in your own area -  please contact us by clicking the e-mail below

ScotEndo

An Endometriosis Support Group for Scotland

Like this Web site and ScotEndo it'self our publicatons list is a work in progress. So please watch this space!

This page was last updated on: March 7, 2002

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