Endometriosis is a common condition affecting about 20 percent of young women.
It is disease where every month when the menstrual period comes, there is also bleeding inside the pelvis. Because its symptoms can be so varied, it can be hard to pin it down. There are also many myths and misconceptions around the conditions that have been perpetuated over the years.
Here are some basic questions about endometriosis, answered.
What causes endometriosis?
Over a period of time this causes dark thick chocolate coloured blood to accumulate in the ovaries called Chocolate Cyst or Endometriotic Cyst.
This old blood can accumulate anywhere and can cause pelvic organs to get stuck up, distorted and damaged.
Bleeding can even happen within the walls of the womb or uterus and this is called adenomyosis.
Is endometriosis a progressive condition?
Unfortunately, this is a progressive condition and will keep on increasing with time.
What are the common symptoms of endometriosis?
The main complaints that the women has are that of lower abdominal pain before and during the periods or sometimes continuous pelvic pain.
There can also be heavy bleeding during menses. Some women may have problems conceiving (Infertility).
How is endo diagnosed?
The diagnosis is done by clinical examination and a good pelvic sonography, blood tests such as CA125 can be raised in this condition. Sometimes an MRI may be needed for diagnosis.
Is endometriosis treatable?
The treatment depends on the age of the woman, how severe are her symptoms and if she is planning a pregnancy or not.
What are some treatment options available for endometriosis?
As long as the menstrual period continues to come , the disease will keep on increasing due to bleeding inside the pelvis and so periods have to be stopped by some method ,in order to stop the progress of the disease.
In young girls, continuous hormone pills work very well . They stop the menses temporarily , thus giving pain relief as well as preventing progression of disease.
In an older women, once a month injections can produce a temporary menopause and giver relief to the patient.
If the patient does not desire pregnancy, a hormone intrauterine device put inside the womb for five years can give good relief.
What if I still want to get pregnant after getting my endo treated?
If the woman is looking to become pregnant, she can try for pregnancy with medicines for a few months.
Often she requires a laparoscopic surgery if the disease is severe. Through this keyhole surgery the endometriotic cysts can be removed and the pelvic organs can be cleaned up.
After this if the fallopian tubes are open, she can try for pregnancy naturally.
However, if the tubes are damaged, treatments such as test tube baby or IVF may be necessary.
Can endometriosis resurface after it is treated?
Once the woman has finished her family and if her endometriosis or adenomyosis is severe, the final treatment is removal of the uterus and the ovaries. If complete removal is not done, the disease can recur. After menopause, once the periods stop, usually the disease starts to reduce.
The most important thing is for the woman who is suffering from painful periods, to see a gynecologist early, get a proper diagnosis and start treatment soon so as to prevent the disease from progressing.
(The author is a consultant gyanecologist at Lilavati, Jaslok and Hinduja Healthcare Hospitals, Mumbai, and has served as President of the Federation of Obstetrics and Gynaecological Societies of India (FOGSI) in the past.)