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The inner lining of the uterus is known as the endometrium. The female body grows a new endometrium with each menstrual cycle and prepares for a fertilized egg and when a similar tissue like endometrium grows outside the uterus, it is termed Endometriosis.
Endometriosis affects approximately 11% of women between the ages of 15 to 44 globally. It is a common condition in women in their 30s and 40s but can be seen in the early years of life. Early diagnosis is difficult because symptoms of endometriosis are not conclusive. However, awareness and self-inspection always help.
What Is Endometriosis?
Endometriosis is a disorder that causes endometrial tissue to grow outside of the uterus. This tissue is identical to the uterine lining tissue. This causes significant pelvic pain and makes pregnancy challenging. This tissue's development causes inflammation in the area, causing scarring and adhesion.
Endometriosis can develop in different parts of the body, known as:
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Superifical Endometriosis
In pelvic peritoneum.
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Cystic Ovarian Endometriosis (Endometrioma)
In Ovaries.
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Deep Endometriosis
In recto-vaginal septum, bowel, or bladder.
Endometriosis is also found outside the pelvic area.
Symptoms of Endometriosis
The first alarming symptom you can feel is severe pain in the pelvis during menstrual periods. Some might even feel pain during sexual intercourse or using the bathroom. Women with Endometriosis also face difficulty in conceiving (becoming pregnant).
Endometriosis can also be identified by the symptoms mentioned below:
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Chronic pain in the pelvis.
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Heavy bleeding during periods.
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Fatigue
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Depression
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Anxiety
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Bloating
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Nausea
Consult a gynaecology hospital if you are experiencing symptoms of endometriosis.
How is Endometriosis Diagnosed?
Endometriosis is a broad-range condition, and hence the diagnosis becomes difficult. Even if you have the symptoms, you may be unaware of the condition. Thus, it is often jumbled with other diseases such as IBS- irritable bowel syndrome, pelvic inflammatory diseases, constipation, ovarian cysts, or abdominal cramping.
However, if you visit a gynaecologist due to severe pain and heavy bleeding during periods, he or she may check your possibility for endometriosis by examining the pelvic area and suggesting some imaging tests. Diagnostic imaging exams like ultrasound help to understand the body, thereby correctly diagnosing the disease.
Causes of Endometriosis
The main causes of endometriosis include:
1. Retrograde menstruation
This is when the menstrual blood with endometrial cells flows back through the fallopian tubes into the pelvic cavity. At the same time, blood can also flow out through the cervix and vagina during periods which results in the deposition of endometrial-like cells outside the uterus, where they implant and start growing.
2. Cellular Metaplasia
Here, cells change their form. Cells from outside the uterus change into endometrial cells. The exchanged cells then start growing.
3. Stem Cells
Stem cells can initiate this disease, spreading through the body and lymphatic vessels.
4. Surgical Scar Implantation
Some endometrial cells may attach to a surgical incision after any surgery, like a C-section or hysterectomy where they grow and cause endometriosis.
Treatment for Endometriosis
Endometriosis is a condition that majorly impacts women between the ages of 25 to 40. It can also occur to younger ones during their teenage years. However, after menopause, some women don't have any discomfort or pain.
The treatment options depend upon your body condition, the severity of the disease, your age, and the severity of inflammation and pain. Your doctor will consult you on the treatment to manage pain and improve fertility. The treatment includes medicines, surgery, and therapies.
Some of the common medications include:
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Birth Control Pills
Birth control pills help to suppress the hormonal levels of estrogen and progesterone. It helps to give you lighter and less painful periods. However, this isn’t suitable for those planning for pregnancy.
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GnRH (Gonadotropin-releasing hormone) Medicines
These medicines help to stop the hormone that causes menstruation. It basically holds your reproductive system in place to relieve pain.
Other medicines include general painkillers and non-steroid anti-inflammatory drugs.
If the condition cannot be treated with medicines, the doctor might suggest surgery to relieve pain, improve fertility, and reduce inflammation. The surgical options for endometriosis include:
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Laparoscopy
For laparoscopy, the surgeon makes incisions in your abdomen and inserts tools like a laparoscope (high-definition camera) surgical instruments. With the help of a laparoscope, the surgeon can inspect the organs inside and identify the location of endometriosis. The surgeon then uses other instruments to remove and treat the disease.
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Hysterectomy
A hysterectomy is performed for severe cases of endometriosis. In this process, the surgeon removes some portion of your uterus to relieve the pain.
Both the surgeries (Laparoscopy and Hysterectomy) are performed under anaesthesia. Depending on the body's conditions, the surgeon gives local (general) or regional anaesthesia to put the patient in a state of sleep. After surgery, rest and care must be taken to recover fast and healthy.
Risk Factors of Endometriosis
The following factors can cause or heighten the risk of endometriosis:
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Delayed childbirth or nulliparity.
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Early periods
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Early menopause
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Short menstrual cycles
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Heavy bleeding during menstruation.
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High levels of estrogen
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Low Body Mass Index (BMI)
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Family history (mother, aunt, or sister with endometriosis).
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Any condition that prevents blood from flowing out in menstruation.
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Reproductive tract disorders.
Endometriosis is an idiopathic condition, hence, there are no specific ways to prevent it. However, awareness about the disease helps you to be in a better position to diagnose it early and treat it well. Schedule regular check-ups with the doctor, discuss issues, and be alert for any signs of endometrial tissue. It is always recommended to consult gynecologists in Bangalore if you feel any discomfort or a different feeling during your period.
FAQs
1. What is the main cause of endometriosis?
Endometriosis is most likely to be caused by retrograde menstrual flow - the menstrual blood with endometrial cells flows back through the fallopian tubes into the pelvic cavity.
2. Can endometriosis be cured?
The symptoms can be significantly reduced with adequate medications and treatments.
3. How is endometriosis treated?
There are both surgical and non-surgical options available. Non-surgical means include medications and painkillers. Surgical options include laparoscopy and hysterectomy.
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