The word Endometriosis is often associated with female infertility treatment. The lining of the uterus wall is known as the endometrium. The tissues attached to this lining inside the uterus are known as endometrial tissues. In normal cases, this tissue thickens during the menstrual period, the ovulation process starts and the uterus gets ready for the possible implant of the embryo. But in some cases, these endometrial tissues grow outside the uterus, commonly in pelvic area and peritoneum and occasionally in other organs like kidney, bladder, lungs. . During ovulation, it reacts the same way as it does while being inside the uterus. It thickens, breaks and bleeds leading to inflammation and irritation of local tissues causing pain sometimes disturbing the normal day to day activity of a woman. This problem is known as Endometriosis.
- Chronic pelvic pain. The most prominent symptom is pain and heavy bleeding during the menstrual cycle. Pelvic pain and cramps become intense and severe and continue with the progress of the cycle.
- Infertility can be a symptom of endometriosis and get diagnosed only during infertility treatment. Women suffering from Endometriosis have difficulty in conceiving as this condition leads to inflammation and scarring causing difficulty in egg transport, endometriotic cyst, blockage of tube, low ovarian reserve, poor egg quality, and poor endometrium receptivity.
- Pain during and after the intercourse
- Intermittent bleeding or spotting in between the cycles
- Pain or difficulty in passing stool or urine as it generally grows in the pelvic area and might disturb the bowel or urination process during menstruation
- Cyclical pain affecting other organs, hemoptysis, acute abdomen.
- Sometimes Endometriosis can exist without any symptoms
However, similar symptoms might occur for other problems like PID( Pelvic Inflammatory Disease ), IBS( Irritable Bowel Syndrome ) and ovarian cysts. If the symptoms persist then a doctor should be seen.
Exact cause of Endometriosis is not known. Some of the probable causes are:
- The menstrual bleeding flows backward into the fallopian tubes and pelvis and cannot go anywhere resulting in Endometriotic implants.
- Estrogen is the driving force making it prominent in the reproductive age group.
- It can occur in the surgical area of c section or hysterectomy scar.
- Transformation of extrauterine cells into endometrial cells and abnormal multiplication of cells of abdominal and visceral peritoneum can lead to endometriotic implants.
- A genetic connection has also been linked as in the first-degree relative
- Immunological factors
- Hormonal factors
- General physical and psychological disturbances in day to day life.
- Endometriosis can cause infertility in women. Although some women with a low or moderate level of endometriosis are able to carry the pregnancy till term. Generally, women of menstrual age suffer from this problem
- Laproscopy is the gold standard to know the severity of endometriosis. Pregnancy should be planned following first few months of surgery as it has a high recurrence rate.
- The Treatment is effective if treated early through medications to ease the pain and symptomatic treatment is given through anti-inflammatory pain killers
- Hormone treatment like birth control pills, Lupron or Progesterone is advised for women who are not planning to be pregnant and are unable to carry on daily chores due to severe pain. The growth of endometrial tissue may slow down as a result of this therapy. But due to the side effects of such therapy it cannot be continued for long and once the therapy stops the problems might come back. Conservative surgery to remove the tissues without damaging the ovary and uterus is sometimes undertaken
- Hysterectomy or removal of the uterus and ovaries can be considered in very severe cases
- Female infertility will have to be treated by IVF Specialist to make pregnancy successful
Women with Endometriosis are advised not to delay their childbirth as the condition might worsen with age. Although this is not curable but very much treatable and controlled if timely medical advice is take