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Vaginal Endometriosis - what is it?

Endometriosis is a disease only found in women and occurs when endometrial tissue, usually found exclusively in the lining of the wall of the uterus (the endometrium), is implanted outside the uterus. Scientists continue to disagree as to how these cells migrate and what causes them to do so. The most common sites for endometrial implants include the ovaries, fallopian tubes, bladder, bowel, the lining of the pelvic cavity and its ligaments. Vaginal endometriosis is often associated with rectal endometriosis.

With endometriosis of the rectum, it can often scars the back of the uterus and can also invade the rear of the vagina. Vaginal endometriosis can be difficult to diagnose; it is not easily visible during laparoscopy as it is often located behind the cervix. When performing an internal exam, the doctor may be able to feel nodules, if they are present, and this area will probably be quite painful, making a vaginal endometriosis diagnosis more precise.

The symptoms of endometriosis of the vagina are similar to the general endometriosis symptoms. These include strong, cramp-like pelvic pain, especially just before and in the first few days of menstruation. Menstrual bleeding can be very heavy or erratic, pain can extend to the lower back and some women with endometriosis have difficulty conceiving. In addition to these general symptoms, vaginal endometriosis sufferers are likely to experience pain during or after sexual intercourse; their pelvic pain will be felt in the lower part of the pelvis and lower back.

Treatment for endometriosis is varied and the treatment plan recommended by your doctor will be determined by several factors. These include your age, your medical and family history, the severity of your symptoms and the extent or stage your endometriosis has reached. The other important factor with determining the most appropriate treatment is whether you want to have children now or in the future. If your child-bearing years are behind you, there are other treatments that could be appropriate.

For mild endometriosis, referred to as Stage I, an observation approach may be adopted, particularly if the patient is not experiencing worrying symptoms. Oral contraceptives are commonly used as a first treatment for endometriosis because they stop ovulation which limits menstrual symptoms. As endometriosis symptoms are often more severe during menstruation, and the tissue responds to hormones, this medication is often all that is needed to reduce the pain and discomfort.

There are other hormone treatments used to treat endometriosis that is more widespread or doesn't respond to oral contraceptives. Some of these medications are taken orally, others are by injection. Surgery is also an option in the treatment of endometriosis; endometrial implants can be surgically removed and in severe Stage IV endometriosis, some gynecologists recommend hysterectomy to remove the uterus, and often the ovaries and fallopian tubes, if the woman does not want to have children.

It should be remembered that these treatments are just that – they treat the symptoms. There is no cure for endometriosis at this time and doctors aim to relieve the severity and frequency of the symptoms with the treatments they use. Some women find they get help with natural or alternative therapies like acupuncture, herbal medicine, lifestyle and dietary changes. Frequently, a combination of different treatments is the most effective.

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