Endometriosis treatment: Facts you must know

Endometriosis affects over 7% of women worldwide between 15 to 49 years of age

Hi there!

This is Dr Manu!, Consultant Gynecologist in Chennai. In this short article I am going to share with you quick facts on Endometriosis treatment.

So, first of all…

What is Endometriosis?

Endometriosis is a condition where the tissue that lines inside of the uterus actually tends to grow outside the uterus!. 

The endometrial tissue can technically grow anywhere. This includes the birthing tubes, ovaries and other regions in and around the female reproductive system.

With endometriosis what basically happens is that, the tissue starts to thicken, break down and bleed just as a normal endometrium would inside the uterus with each menstrual period. 

Interestingly, when the ovaries are involved cysts start to form and these ovarian cysts are called endometriomas. 

Endometriosis treatment in chennai

Symptoms of Endometriosis

The cardinal symptom of endometriosis is pelvic pain that is usually associated with periods. The pain is usually severe and intolerable. 

The common signs/symptoms of course include

A. Cramping pain in the lower back and abdomen that lasts several days during the menstrual period

B. Pain during urination and/or bowel movements. Again the pain is aggravated during the monthly cycles

C. Excessive flow of blood or sometimes bleeding in between cycles

D. Infertility, in a small proportion of women seeking fertility treatments, endometriosis is found to co-exist

E. Pain during sexual intercourse 

An interesting point you must bear in mind is that, the degree of pain does not correlate with the extent of disease. 

Patients may have mild pain and severe grades of endometriosis. Some patients may have advances pain yet very mild endometriosis. 

What causes Endometriosis?

Of all the theories that have been suggested as a possible cause of endometriosis, the retrograde menstruation theory has stood the test of time. 

During retrograde menstruation, the menstrual blood containing the cells of the endometrial back-flow out through the Fallopian tubes into the pelvic cavity. 

With repeated back-flow, these cells tend to stick to the walls and continue to thicken, shed and bleed. 

Interestingly, one of the best treatment of endometriosis is getting pregnant and planning your family life early on!

Getting pregnant = No bleeding = No Endometriosis

Most patients tend to develop endometriosis several years after their cycles actually begin. Endometriosis can spontaneously disappear during menopause or during pregnancy

Endometriosis and Infertility   

Over 30% of women with endometriosis tend to have some difficulties with conceiving a child naturally. The exact mechanisms remain unknown. 

Endometriosis Treatment

The diagnosis and treatment of endometriosis is fairly straightforward. 

Diagnosis is done by a combination of 

a. Clinic history taking + Examination

b. Pelvic exam

c. Ultrasound scan

d. Lastly with Laparoscopy

Endometriosis treatment usually proceeds with a combination of 

1. Pain medications

2. Hormone medications: these include medications like oral contraceptive pills, patches, vaginal rings. GnRH drugs are also used. These drugs specifically cause the endometrial tissue to shrink. Short term therapy is sometimes effective

3. Progestins – A variety of progestin based therapies like the Intrauterine devices, progestin injections have also been used in endometriosis treatment. 

Surgical Treatment of Endometriosis

The biggest issue with endometriosis is the risk of recurrence with treatment. However, laparoscopic removal may be helpful with selective patients where there is severe pain. A thorough removal of the endometriosis tissue can help in easing symptoms and sometimes can also help overcome fertility based problems

I hope you enjoyed reading this short article on endometriosis management. Do share this article with all your loved one!. Keep watching this space for more!. 

References

  1. Endometriosis – Diagnosis and management
  2. Giudice LC. Endometriosis. New England Journal of Medicine. 2010 Jun 24;362(25):2389-98.
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