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Endometriosis

As one of the most common disorders of the female reproductive system, endometriosis is responsible for the growth of tissue that is similar to the lining of the uterus to develop in other areas of the human body, most notably in areas surrounding the vagina, such as the pelvis and the abdominal cavity (Endometriosis, 2013). In some cases, this tissue “may attach itself to the ovaries, the outside of the uterus, the intestines, or other abdominal organs” and has been seen to develop in and around post-surgical scars on pelvic organs (Endometriosis, 2013).

As a case example, in 2010, Mrs. M, a thirty year-old white female in good health, paid a visit to her local women’s health care clinic and upon seeing the attending physician complained that she was experiencing irregular menstrual periods and some severe cramping in the pelvic region. She also noted that the pain associated with the cramping prevented her from doing housework and had forced her to take several weeks off from her job. Mrs. M also added that she and her husband were planning to have children in the very near future and that several weeks ago, her gynecologists told her that she may be suffering from endometriosis which would make it difficult to become pregnant.

At this point in their conversation, the attending physician asked Mrs. M a series of questions in order to arrive at a diagnosis of possible endometriosis–

  1. Have your menstrual cramps become worse over time or is the pain intermittent, meaning if it comes and goes at intervals?
  2. Where exactly is the pain related to the cramping? Does it occur in your lower back or in the front of the pelvis area?
  3. Have you experienced pain during intercourse? If so, was the pain severe or mild as compared with the pain associated with the menstrual cramping?
  4. Have you experienced any sort of pain in the lower intestinal area, specifically in the area of the bladder?
  5. Have you experienced any pain during a bowel movement or when urinating? If so, is the pain worse during menstrual periods or less?
  6. Have you noticed any sort of bleeding either before a menstrual period or immediately after? This bleeding has nothing to do with normal menstrual periods.
  7. Have you found it difficult to become pregnant within the last several months or so? Have you ever experienced infertility problems in the past?
  8. Do you suffer from any of the following disorders–chronic fatigue syndrome, mononucleosis, yeast infections, or any kind of autoimmune diseases? (Endometriosis, 2013).

During the course of asking these questions, Mrs. M replied that her menstrual cramps have become worse over time, especially during the last several weeks; that her pain is generally located in the lower pelvic region; that she has experienced some pain during intercourse and when urinating; that she has noticed spotty bleeding several days after a menstrual period; and that she has found it difficult to become pregnant over the last year or so. Therefore, the attending physician recommended that Mrs. M undergo a  biopsy “of tissue obtained from possible lesions via a culdoscopy, laparoscopy, or a laparotomy” (Glanze, 2000, p. 425). The reason for suggesting these tests is because “one of the most characteristic symptoms of endometriosis is pain, particularly with dysmenorrhea or pain that is associated with menstruation” (Glanze, 2000, p. 398).

References

Endometriosis. (2013). Retrieved from http://www.emedicinehealth.com/

endometriosis/article_em.htm

Glanze, W.D., ed. (2000). Mosby’s medical, nursing, and allied health dictionary.

St. Louis, MO: C.V. Mosby Company, Inc.