What Is Peritoneal Endometriosis?

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Peritoneal endometriosis occurs when endometrial-like tissue develops along the lining of your abdominal cavity.
Endometriosis is a condition in which uterine-like cells are found in other areas of your body. This causes scar tissue and inflammation in your pelvic area and, less commonly, in other areas of your body.
Endometriosis is divided into three subtypes. Superficial peritoneal endometriosis makes up 80% of cases.
The peritoneum is the membrane that lines your abdominal cavity. It supports your pelvic floor and abdominal organs. The peritoneum also supports the surrounding blood vessels, nerves, and lymphatics.
According to the World Health Organization, endometriosis affects roughly 190 million women and girls of reproductive age. There is currently no cure for endometriosis. The goal of treatment is to manage the condition and its symptoms.

How does peritoneal endometriosis present?

How does peritoneal endometriosis present?
The peritoneum is thin and contains two layers (the superficial parietal layer and the deep visceral layer) with potential space in between. It’s composed of mesothelial cells that are supported by a layer of fibrous tissue.
The intensity of symptoms can be directly connected to the depth and location of the lesions and the tendency of some scar tissue to invade nerve structures.
Endometriosis does not always cause symptoms, although pain in the lower abdomen and pelvis is common.
Pain may intensify during or after penetrative sex, during menstruation, or when urinating or defecating.
Other possible symptoms include:
fatigue
heavy bleeding during and between periods
bloating
nausea
difficulty getting pregnant

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What causes peritoneal endometriosis, and who’s at risk?

What causes peritoneal endometriosis, and who’s at risk?
The cause of peritoneal endometriosis is still unknown.
There are three popular theories on the development of endometriosis:
Cellular metaplasia is when cells change from one form to another. During endometriosis, cells outside your uterus may change into endometrial-like cells and multiply.
Retrograde menstruation is when menstrual blood flows backward through your fallopian tubes and into your pelvic cavity while also flowing out of your cervix through your vagina. This phenomenon can help endometrial-like cells travel outside your uterus and deposit endometrial-like tissue in other places where it can implant and grow.
Stem cells can also generate endometriosis, spreading through your body via your blood and lymphatic system.
Some research highlights the relationship between estrogen and the persistence of ectopic endometrial tissue. Estrogen can increase the tissue growth, inflammation, and pain associated with endometriosis.

How is peritoneal endometriosis diagnosed?

How is peritoneal endometriosis diagnosed?
A healthcare professional may suspect that you have endometriosis if you have chronic pelvic pain and a documented history of menstrual symptoms.
The symptoms can often mimic those of other conditions. This can cause a delay in diagnosis, which can affect your quality of life.
Diagnosis may require a laparoscopy, an MRI, ultrasonography, and histologic verification to confirm the presence of endometriosis.

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How is peritoneal endometriosis treated?

How is peritoneal endometriosis treated?
There is no cure for peritoneal endometriosis. The best approach to managing your symptoms may depend on how severe your symptoms are and whether you want to become pregnant.
Nonsteroidal anti-inflammatory drugs can help manage the pain and other symptoms associated with endometriosis.
Hormonal treatments, including birth control methods and medications that trigger the release of the hormone GnRH, are also used to manage pain. These methods can include:
implants
injections
patches
vaginal rings
intrauterine devices
pills
Laparoscopic surgery can be performed to remove scar tissue, adhesions, and pelvic lesions.

What complications are possible with peritoneal endometriosis?

What complications are possible with peritoneal endometriosis?
Since there is no cure for endometriosis, some symptoms can reappear if hormone therapy stops. Lesions could reappear even after successful surgery.
Most hormonal treatments can affect your ability to get pregnant since they affect ovulation. Be sure to discuss with your doctor any potential or future pregnancy plans.
Many healthcare professionals still do not understand that life-altering pelvic pain is not normal. This can lead to the stigmatization and normalization of pain, which can contribute to a delay in diagnosis.
Some countries’ healthcare systems do not provide adequate healthcare, and specialized surgery may not be available to those who need it.
The three hallmarks of endometriosis are peritoneal endometrial implants, endometriotic cysts, and adhesions of the ligaments and organs.
The appearance of nodules and lesions in the peritoneum cannot be significantly associated with other forms of the disease.

What’s the outlook for people with peritoneal endometriosis?

What’s the outlook for people with peritoneal endometriosis?
Early diagnosis gives your care team the best treatment options and an increased success rate for fertility and side effects.
Fertility is a significant consideration in developing your treatment plan since some medications may affect your menstrual cycle.
The degree of success of surgery in reducing pain symptoms and increasing pregnancy rates often depends on the extent of the disease.
In addition, lesions may recur even after successful surgical removal of the endometrial-like cells, and pelvic floor muscle abnormalities can contribute to chronic pelvic pain even after successful treatment.

The bottom line

The bottom line
Peritoneal endometriosis may include a range of symptoms, including deep pain in your genitals, pain when defecating, chronic pelvic pain, and pain during your menstrual periods. Symptoms can be severe and affect your ability to work or maintain your daily schedule.
Pelvic pain and pain during sexual arousal may deter you from engaging in sex, and this may affect your mental and sexual health. Multiple treatment options, including hormone therapy and surgery, are available and can be adjusted to fit your specific needs and future plans for your body.
Catasha Gordon is a sexuality educator from Spencer, Oklahoma. She’s the owner and founder of Expression Over Repression, a company built around sexual expression and knowledge. You can typically find her creating sex education materials or building some kinky hardware in a fresh set of coffin nails. She enjoys catfish (tail on), gardening, eating off her husband’s plate, and Beyoncé. Follow her everywhere.

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