Debilitating Endometriosis Condition Affecting 1.5 Million Women

What is Endometriosis? How is it different from Menstruation Pain?

Endometriosis is a public health problem affecting approximately 247 million women globally and 42 million women in India.

Endometriosis (et-do-me-tree-O-sis) is an often painful condition in which tissue similar to the tissue that normally lines the inside of the uterus (the endometrium) grows on the outside of the uterus. Endometriosis mainly affects the tissues lining the ovaries, fallopian tubes, and pelvis. Rarely, endometrioid-like tissue may be found outside the pelvic region.

With endometriosis, endometrial tissue behaves like endometrial tissue: It thickens, ruptures, and bleeds with each menstrual cycle. But because this tissue can’t leave your body, it gets trapped. When endometriosis affects the ovaries, cysts called endometriosis can form. The surrounding tissues become irritated, eventually forming scar tissue and adhesions – bands of fibrous tissue that cause pelvic tissues and organs to stick together.

Endometriosis can cause pain – sometimes intense – especially during menstruation.

Fertility problems may also develop. Fortunately, there are effective treatments.

Symptoms

The main symptom of endometriosis is pelvic pain, usually associated with menstruation. Although many people experience cramping during their period, people with endometriosis often describe menstrual pain that is much worse than usual. The pain may also increase over time.

Common signs and symptoms of endometriosis include:

• Dysmenorrhea (dysmenorrhea): Pelvic pain and cramping can start before your period and last for days.
• You may also have lower back pain and abdominal pain.
• Painful intercourse: Endometriosis is common in pain during or after intercourse.
• Painful stools or urination: You may experience these symptoms during your period.
• Excessive bleeding: You may occasionally have heavy periods or spot between periods (breakthrough bleeding).
• Infertility: Sometimes, endometriosis is diagnosed for the first time in people seeking treatment for infertility.

Other signs and symptoms

You may also experience fatigue, diarrhoea, constipation, bloating, or nausea, especially during your period.

Endometriosis is sometimes confused with other conditions that can cause pelvic pain, such as pelvic inflammatory disease (PID) or ovarian cysts. It can be confused with irritable bowel syndrome (IBS), which causes diarrhoea, constipation, and abdominal cramping. IBS can be accompanied by endometriosis, making it difficult to diagnose.

Several factors can make you more likely to get endometriosis, such as

• Never having had children
• Early menstruation
• Advanced age at menopause
• Short menstrual cycles – for example less in the 27 days
• Heavy periods lasting longer than 7 days
• High levels of estrogen in your body, or your body has been exposed to more estrogen in your lifetime
• Low body mass index
• One or more family members (mother, aunt or sister) with endometriosis
• Any condition that prevents blood from leaving the body during menstruation
• Disorders of the reproductive system

Endometriosis usually begins a few days after the onset of menstruation (menarche). Unless you take estrogen, the signs and symptoms of endometriosis may temporarily improve with pregnancy and disappear completely with menopause.

Complications

• Infertility

Egg fertilized and implanted in the uterus

Fertilization and implantation Open pop-up dialog.The main complication of endometriosis is impaired fertility. About one-third to one-half of women with endometriosis have difficulty getting pregnant.

Even so, many women with mild to moderate endometriosis can still conceive at term. Doctors sometimes advise people with endometriosis not to delay childbearing because the condition can get worse over time.

• Cancer

Ovarian cancer occurs more frequently than expected in women with endometriosis. But the overall lifetime risk of ovarian cancer is low to begin with. Some research suggests that endometriosis increases this risk, but it is still relatively low.

Although rare, another type of cancer, endometriosis-associated adenocarcinoma, can develop later in life in people with endometriosis.

When to see the doctor?

Tell your doctor if you have any signs and symptoms that may indicate endometriosis.

Endometriosis can be a difficult condition to manage. Early diagnosis, a multidisciplinary medical team, and knowing your diagnosis can lead to better management of your symptoms.

Treatment

Healthcare providers consider several factors when determining the best treatment for symptoms of endometriosis, including:

• Your age
• The severity of your symptoms
• The severity of the disease
• If you want to have any children

Treatment for endometriosis usually consists of medication or surgery. The method you and your doctor choose will depend on the severity of your signs and symptoms and whether you want to become pregnant.

Doctors generally recommend trying conservative treatment first, followed by surgery if initial treatment fails.