Endometriosis: Facts, Symptoms, Diagnosis, & Treatment

Women’s reproductive health doesn’t only require a watchful eye, but periodical checkups conducted by a gynecologist or a fertility doctor. It is quite common to ascertain underlying reproductive issues in the late stages probably with the fact that various female reproductive problems have no clear signs and symptoms and in case there, they can also be contributed by another factor.

Endometriosis is one of the commonest female reproductive issues affecting almost 75% of the women in the reproductive age. Unless diagnosed, endometriosis may remain a myth with popular signs and symptoms such as lower abdominal pain attributed to other factors such as menstrual periods

What is Endometriosis?

The abnormal growth of the endometrial tissue outside the uterus is termed as endometriosis. The endometrial tissue develops during every menstrual cycle in the uterus and if at all no fertilization occurs, it is shed during your period.

When this tissue grows outside your uterus, most especially in the pelvic region, ovaries, and the Fallopian Tubes, this medical condition is called endometriosis.

Its signs and symptoms may differ from one woman to another, but definitely, there may be no pain in the abdominal region until the late stages.

Endometriosis may become a permanent condition in some women

Facts About Endometriosis

One of the commonest reproductive health disorder among childbearing women. It is like polyps, both characterized by abnormal growths
The exact cause of endometriosis remains a myth
It is associated with various signs and symptoms identified if at all, a woman is keen or after a checkup
The problem can lead to infertility
It has no cure
Treatments vary from one woman to another and as some may be helped through medications, others may require surgery
The endometrial tissue, usually grows on the Fallopian tubes, ovaries, and in the pelvic region increasing infertility chances

Common Signs & Symptoms of Endometriosis

During the early stage, the abnormal growth of the uterine lining (endometrium) may indicate no symptoms. However, pain is commonly the initial sign of endometriosis. Generally, endometriosis signs and symptoms include;

Lower abdominal pain
Pain during sexual intercourse
Pain during bowel movement
Excessive pain during menstrual periods
Heavy bleeding during menstrual periods
Pain during pelvic examinations
Trouble conceiving

Abdominal Pain

There are various forms of abdominal pains and cramping that women need to watch out for. Normally, since women differ, some may experience pain prior to the period, during and after their period. In case these suddenly show up, it is necessary to have periodical pelvic examinations followed by an extensive examination of the reproductive system

In case aware of these pains, excessive pain and cramping in the pelvic region, excessive pain during the menstrual period and sexual intercourse could point to the fact that you have endometriosis. In this case, the increased Prostaglandins, which are hormone-like substances increase your sensitivity to pain. Women with endometriosis have increased amounts of Prostaglandins and that is the major reason for the excessive pain

On the other hand, Prostaglandins are produced in the endometrium to facilitate contraction during your periods and labour

Pain during sexual intercourse is commonly triggered by the trapped endometrial tissue in the pelvic cavity, Fallopian Tubes, and vaginal walls.

Pain during bowel movements or urination may be due to bowel or bladder endometriosis.

Menorrhagia (Excessive bleeding during Menstrual Periods)

Studies indicate that women with heavy bleeding during their periods have higher chances of developing endometriosis than other women. Though heavy bleeding may be normal in some women, this may come as an indication of endometriosis in others

Other possible symptoms include

Lower back pain
Constipation
Diarrhea
Chronic fatigue

Diagnosis

Apart from the prevailing signs and symptoms, clinical approaches to diagnosing endometriosis at our IVF Centre in India “Eva Hospital” include;

A Pelvic Examination

Many of the routine gynecology checkups involve pelvic examinations. During this procedure, the gynecologist will extend his or her hand into your reproductive system to feel various organs such as the ovaries, cervix, vulva, uterus, the Fallopian Tubes, bladder, rectum, and the vagina. In this case, the doctor will diagnose you with endometriosis in case cysts have already developed

An Ultrasound

This technique utilizes high-frequency sound waves and a transducer that is normally inserted into your vagina or passed on your abdomen to create clear images of the various reproductive organs. This procedure helps the doctor check for cysts

A Laparoscopy

This is a surgical procedure conducted under anesthesia. This procedure involves removing a sample tissue (biopsy) to ascertain the size, and extent of the endometrial growth outside your uterus

Possible Causes of Endometriosis

The actual causes of endometriosis are unknown, but fertility experts associate the factor to the availability of cells in the pelvic regions that can develop into other tissues.

Another case that can trigger endometriosis is Retrograde Menstruation, where there is a backward flow of the menstrual blood that can leave behind the uterine lining in other organs such as the Fallopian Tubes, cervix and the pelvic cavity. Other cases of endometriosis are the immune system and abdominal surgeries that may cause the implant of the endometrial tissue in other regions

Treatment for Endometriosis

Endometriosis can be treated with oral medications and surgery, unfortunately, there is no cure for it. Treatment is selected depending on the severity, age, and symptoms

Medications these include;

GnRH analogs (Gonadotropin-releasing hormone analogs) – These relieve pain and aid in reducing the size of the endometrial implants
Nonsteroidal Anti-inflammatory Drugs (NSAIDs) – They include ibuprofen and naproxen prescribed to relieve pelvic and menstrual pain
Contraceptive Pills- these include Estrogen and progesterone used in the case of severe menstrual pain

Other medications include;

Progestins
Aromatase inhibitors
Danazol

Surgery

Surgical approaches to remove the endometrial lining with an aim of facilitating pregnancy is the final solution to endometriosis. Conservative surgical approaches, such as Hysterectomy or the latest laparoscopic surgery are used.

Endometriosis & Infertility

Endometriosis is one of the common barriers to pregnancy in women. At least 75% of all childbearing women have certain types of endometriosis that in the long run causes infertility. In case surgeries fail to facilitate natural conception, ART treatments (Assisted Reproductive Technology) such as IUI, ICSI, and IVF can be used to attain pregnancy.

However, the couple must plan extensively to afford the IVF Cost in India depending on the best treatment approach

Endometriosis & Cancer

Certain types of cancers such as Ovarian cancer have been associated with endometriosis, however, many studies indicate no or an insignificant correlation. Certain treatments such as the contraception pills are believed to lower the chances of ovarian cancer.

The genuine answer remains that there is a less risk factor for ovarian cancer in women with endometriosis.