What do endometrial implants look like

Superficial endometriosis can be destroyed using any of several techniques. These include electrosurgery, laser, ultrasonic scalpel, or surgical scissors.

Surgery is most often needed to remove deep endometriosis from an affected organ, such as the ovary. Several medical treatments are often effective for endometriosis. Non-steroidal anti-inflammatory agents such as ibuprofen are often used and can help with pain.

Narcotic medications are sometimes used for severe pain, but these should be used sparingly as they can be addictive. Hormone therapy is often helpful for endometriosis pain, but should only be used by women who do not want to become pregnant.

Birth control pills work by decreasing the thickness of the endometrial lining and the amount of menstrual flow. Most birth control pills contain two hormones, estrogen and progestin. Progestin-only hormones also reduce the thickness of the endometrial lining. Progestins can be given as a pill, by injection, or through an intrauterine device IUD. Symptoms of endometriosis usually return after stopping birth control pills and progestins.

GnRH analogs are another type of therapy. These drugs work by decreasing the amount of estrogen in a woman's body, which stops the menstrual cycle and ovulation. Leuprolide acetate is an example of a GnRH analog given by injection. Side effects of these drugs are similar to those of menopause and include hot flashes and bone loss. Many women find that lifestyle changes help them manage many of the discomforts of endometriosis.

Regular exercise and weight control can reduce body fat to help keep the amount of estrogen low. Chronic pelvic pain may have many different causes and more than one cause is often present in the same woman. Pain can come from the bladder, intestinal area or muscles. All other possible causes of pelvic and abdominal pain should be investigated and treated. For women who want to become pregnant, particularly those with moderate and severe endometriosis, surgery is a treatment option.

Scar tissue is removed as much as possible to allow free movement of the internal organs. Ovarian endometriomas may be surgically removed. This will improve fertility in some women. Medical treatment with hormones that suppress the ovaries has not been found to improve fertility in women with endometriosis.

However, pain medications may relieve discomfort. The ovaries can be stimulated with a pill called clomiphene citrate, or injections of the hormone FSH to increase hormone levels. These drugs cause release of multiple eggs during each cycle, but also increase the risk of multiple pregnancies. This increases the number of sperm coming into contact with the egg s , and increases the chance for pregnancy.

In vitro fertilization IVF is the most effective, but also the most expensive treatment for infertility associated with endometriosis.

IVF is recommended when other treatments are not successful. For IVF, the ovaries are stimulated with injectable hormones and the growth of the eggs is carefully monitored with ultrasound and blood hormone levels. If they see signs of endometriosis, like implanted endometrial tissue or scar tissue, they can both diagnose the condition and remove things like cysts and scar tissue. Being able to see endometriosis implants and scarring is what enables doctors to classify the disease into four different stages.

To determine the stage of endometriosis, doctors assign points to what they see as they perform the laparoscopy. A score of 15 or less means that the disease, visually, is either Stage 1 minimal or Stage 2 mild. A score of 16 to 40 means the disease is Stage 3 moderate , and 40 or more puts the disease at Stage 4 severe.

Based on what the doctor sees during the laparoscopy, the endometriosis is categorized into four different stages. Not only are there many deep endometrial implants, but there may be endometrial cysts on at least one ovary. These endometrial cysts form when the tissue attaches to an ovary and begins to shed blood and tissue.

Doctors may also find thin bands of tissue, called filmy adhesions, that bind organs together. These adhesions are the scar tissue that form when the body tries to heal from the inflammation caused by endometriosis.

In addition to many deep endometriosis implants, there are large cysts on at least one ovary and many dense adhesions throughout the pelvic region. The escalating severity of these stages might give the impression that endometriosis, like cancer, first starts off in one part of the body before spreading to more distant organs. Taylor says about the stages. Taylor says. Because of the difficulty in describing endometriosis in a way that is meaningful for treatment, others have tried to propose different ways to classify the disease.

The body responds to this inflammation by forming scar tissue during the healing process. Adhesions can cause serious complications, particularly when they are very large.

For example, an endometrial adhesion can attach to the ovaries, cutting off the blood supply. It may also trap blood in the ovaries, causing ovarian cysts. Adhesions can also affect fertility, making it more difficult for an egg to travel to or implant in the uterus. Endometriosis is not the only condition that causes adhesions, however.

A person may develop adhesions in the pelvic region due to:. Having endometriosis surgery can increase the risk of adhesions.

Even surgery to remove adhesions can cause new adhesions. Although many people with endometriosis adhesions report having pelvic pain, few studies have assessed the relationship between adhesions and pain. For example, there are experts who believe that the pain from endometriosis is different than the pain from adhesions.

Harry Reich, an endometriosis specialist, states:. Adhesions, when they bind the bowels, can cause their own pain, which is separate and different from endometriosis pain. A study looked directly at the role of adhesions in endometriosis pain. The researchers identified an association between pain symptoms and the location and extent of the adhesions.

In fact, the group of participants with the lowest reported pain scores included the highest proportion of people with adhesions. Physical, social, and emotional scoring showed that these individuals were best able to cope with their pelvic pain. Some doctors classify endometriosis into stages from 1 to 4 to reflect the amount and severity of the implants.

People with stage 3 or 4 endometriosis are more likely to have adhesions. There is no consensus on what symptoms endometriosis adhesions cause, however, and research is ongoing.

Surgery can remove endometriosis adhesions, which may help preserve fertility, reduce bleeding and pain, and prevent injuries to the ovaries. Endometriosis can cause additional adhesions to form even after surgery. Moreover, the surgery itself is a risk factor for endometrial adhesions. The reason for this is that inflammation and scar tissue are normal parts of the healing process.

Surgery creates a wound that must heal, increasing the risk of scar tissue and adhesions forming.