Houston Gynecologist-What Every Woman Needs To Know About Endometriosis

Experimental harvest of provitamin A-enriched orange maize, Zambia
woman health
Image by CIMMYT
Ears of orange maize lines following harvesting, on experimental plots at the Zambia Agriculture Research Institute (ZARI). This maize is orange because it contains high levels of beta-carotene, the same substance that give carrots their color. Beta-carotene is a provitamin, and is converted to vitamin A within the human body.

Maize is the staple food for more than one billion people in sub-Saharan Africa and Latin America, but it is generally poor in provitamin A. It is estimated that between one third and half of all Zambian children suffer from vitamin A deficiency, which weakens their vision and immune systems, retards their growth, makes them more vulnerable to various diseases, and reduces their quality of life. In all, night blindness and other health problems caused by vitamin A deficiency affect more than 5 million children and nearly 10 million pregnant women, according to the World Health Organization (WHO).

CIMMYT works with ZARI as part of HarvestPlus, a CGIAR challenge program that uses biofortification to improve the nutritional value of staple foods. The HarvestPlus maize team uses conventional breeding to create maize hybrids and open-pollinated varieties rich in provitamin A. In the research shown here, ZARI is evaluating advanced experimental varieties for yield and agronomic characteristics; the best of these will be tested for provitamin A content. Furthermore, scientists in CIMMYT and other organizations are now producing a new generation of varieties with more provitamin A than ever before. Alleles that can boost beta-carotene levels in grain, rare and previously found only in temperate maize, are being bred into tropical maize for developing countries.

For more about CIMMYT’s work in breeding biofortified maize rich in provitamin A, see the following e-news stories:
– "Rare genetic variant in maize gives grain more pro-vitamin A", 2010, available online at: www.cimmyt.org/newsletter/231-2010/617-rare-genetic-varia….
– "Formula for success", 2007, available online at: www.cimmyt.org/newsletter/63-2007/203-formula-for-success.

For more on the HarvestPlus’s Maize Team meeting, hosted in 2010 by ZARI, see CIMMYT’s blog story "Benefits of biofortification explored during meeting in Zambia" at: blog.cimmyt.org/?p=3468.

For more on HarvestPlus, see: www.harvestplus.org/.

Photo credit: CIMMYT.

Endometrium

The type of tissue that is found in the inner lining of the uterus is known as the endometrium tissue. This tissue can develop outside of the uterus, in such cases it causes a condition known as endometriosis.

The average menstrual cycle for a woman is 28 days, and during those twenty eight days the inner lining of the uterus goes through a few changes. In order to prepare for pregnancy, the endometrium thickens as it develops. Should there not be a pregnancy; the tissue is then shed via bleeding. This bleeding is caused by the hormones progesterone and estrogen and it happened monthly.

Endometriosis

The endometrium that develops outside of the uterus still behaves as though it was growing inside the uterus. If the tissue is growing outside the uterus it may also develop in other areas:

Fallopian Tubes

Rectal portion of the colon

Ovary

Surface of the uterus

Ureters and bladder

Bowel

The cul-de-sac

Inside lining of the abdomen

Pelvis and abdomen

There are rare cases where the endometrium has/will grow in unrelated areas of the body. Should the endometrium develop in the ovaries it can cause a cysts, this cyst like condition is called endometrioma.

Endometrial tissue, whether inside or outside of the uterus, is affected by the woman’s menstrual cycle, especially the hormones progesterone and estrogen. The reaction of the endometrium comes in the form of monthly bleeding. If the monthly bleeding happens outside of the uterus it can cause scar tissue to develop, this scar tissue is also known as adhesions. Adhesions or scarring can cause discomfort and pain. There are times that the adhesions can bind organs together. The symptoms will worsen if not treated.

Cause

Unfortunately, there isn’t a clear cause of endometriosis. There are a couple of theories, during the menstrual period, there is a small amount of blood cells that flow from the fallopian tubes into the abdomen. If a woman has endometriosis, these blood cells stick to the pathway and start to develop there instead of flowing out as they should. There is another theory that endometrial cells are carried to other areas of the body by the lymph and the blood vessels.

Women at Risk

The majority of women that are dealing with endometriosis are between the ages of 30 and 40. This doesn’t mean that women of other ages are not affected. Endometriosis can affect anyone female that menstruates. Those that menstruate but do not procreate are commonly affected by this condition. Family history may also play a role in whether a woman suffers from endometriosis. It has been noted that women who have a sister, mother or daughter with endometriosis increases the likelihood that she will have endometriosis. It has also been found that 75% of all women suffering from chronic pelvic pain also have endometriosis.

Symptoms

Difficulty conceiving

Pelvic Pain

Frequent menstrual bleeding more than every month

Pain during bowel movements, during sex, just prior to or during menstruation, or during urination.

These symptoms can also be indicative of other health issues as well. It is important that if any of these symptoms are noticed you consult your Houston Gynecologist.

Note the severity of the condition is not necessarily one and the same with the level of pain felt. The pain can be mild to moderate and the severity of the condition can be quite severe. Conversely, the pain can be intense and the severity of the condition very mild. There may be no pain felt at all, unfortunately this makes it difficult for a woman to know she has a condition that requires medical attention. The only way she finds out is that she attempts to get pregnant. One third of all infertile women also have endometriosis.

Diagnosis

You should contact your Houston Gynecologist if you notice any of the signs or symptoms of endometriosis. They may want to do a pelvic exam. If all other causes of pelvic pain can be ruled out, endometriosis can be treated without surgery or further examinations.

Endometriosis can be severe, moderate or mild. The best way to determine the severity if the case is via laparoscopy procedure. This will allow the doctor to look inside the body. Should they find any endometrial tissue upon exam they may opt to remove the tissue right away. This is all done under general anesthesia.

Treatment

The severity of your endometriosis will determine the treatment option your Houston Gynecologist will recommend. Treatment will also be impacted by your decision on future pregnancies. Treatment for endometriosis generally consists of medication or surgery or the combination of both. Treatment will alleviate infertility and pain, but these symptoms can reoccur after treatment.

Learn more about endometriosis. Stop by Lisa P. Otey, MD’s site where you can find out all about thisHouston Gynecologist and what she can do for you.

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