Endometriosis: The Effects on Menstruation

Posted by Chantel Martiromo, Research article by Kyle J. Norton

During the last stage of the menstrual cycle, normally a layer of endometriosis lining on the inside of the uterus is expelled, known as menstruation blood, instead some of the endometriosis tissues grow somewhere in the body to cause endometriosis. Endometriosis also react to hormone signals of the monthly menstrual cycle, by building and breaking up tissues and eliminating them through menstrual period.

The Effects on Menstruation)44)(45)
1. Variable amounts of bleeding either heavy or scanty
Variable amounts of bleeding either heavy or scanty is normal for menarche and perimenopause as the menstrual cycle is initiated and during a woman 's forties until menopause accordingly because of imbalance of estrogen and progesterone. In endometriosis, heavy and scanty bleeding are caused by over-production of certain hormones in the prostaglandins hormonal family that controls the aggregation or disaggregation of platelets(46)(50).

2. Menstrual spotting
Menstrual spotting in the middle of the menstrual cycle may be caused by polyp growth in the uterus. Polyps within the uterus may prevent pregnancy or interfere with implantation of embryo as well as miscarriage. Polyps also cause heavy bleeding as a resulting of rupture of polyps in the uterus during menstruation. Luckily most polyps exit in uterus tend to be benign growth(47).

3. Prolong bleeding
Prolong bleeding may be caused by endometriosis cysts or fibroid located in the uterus wall as a result of imbalanced hormones of the prostaglandins family caused by excessive estrogen in the body if one type of prostaglandins hormone that helps to stop platelets from clumping together(48)(49).

4. Long menstrual cycle
An irregular menstrual pattern of long menstrual cycles may be an indication of ovulation problems and can be a major factor in infertility caused by endometriosis ovulation problems resulting in ovulation delay or immature eggs in the follicular phase. Sometimes, the follicle develops but the egg is not expelled from the ovary, caused by low levels of progesterone(49)(50).

5. Blood clots
Because of irregular menstruation causing imbalance hormone, blood clots usually happen during menstruation if one of the hormones of the prostaglandins family that helps to regulate blood clots is over-produced. In this case over-production of such hormones cause more platelets clumping together and fails to dilate blood vessels resulting in blood clots(51).

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References
(44)Predictors of hysterectomy as a treatment for menstrual symptoms by Graham M¹, James EL, Keleher H.(PubMed)
(45)Referral for menstrual problems: cross sectional survey of symptoms, reasons for referral, and management by Warner P¹, Critchley HO, Lumsden MA, Campbell-Brown M, Douglas A, Murray G.(PubMed)
(46) Menstrual suppression for adolescents by Altshuler AL¹, Hillard PJ.(PubMed)
(47) Premenstrual spotting of ≥2 days is strongly associated with histologically confirmed endometriosis in women with infertility. by Heitmann RJ¹, Langan KL¹, Huang RR², Chow GE¹, Burney RO³.(PubMed)
(48)Migraine is associated with menorrhagia and endometriosis by Tietjen GE¹, Conway A, Utley C, Gunning WT, Herial NA.(PubMed)
(49) Endometriosis: associations with menorrhagia, infertility and oral contraceptives by Sensky TE, Liu DT.(PubMed)
(50) Hemostatic disorders in women by Kadir RA¹, Davies J.(PubMed)
(51) Prostaglandin synthesis inhibitors in menorrhagia, intrauterine contraceptive device-induced side effects and endometriosis by Ylikorkala O. (PubMed)