According to the Endometriosis Society of India, about 25 million people suffer from a painful condition called Endometriosis, among which the majority of the women are not properly diagnosed until they are in their late 30s. But, what is endometriosis? Every month, an adult female body in the process of fertilization releases an egg or ovum, and the inner layer of the uterus is lined with a tissue of cells called the endometrium. When the released egg is not fertilized by a sperm, endometrium is shed as menstrual discharge. Onlymyhealth editorial team spoke to Dr. Teena Thomas, MBBS, MRCOG, PGDFM, Consultant - Obstetrics & Gyneacology, Apollo Cradle & Children’s Hospital – Brookefield, Bengaluru, about the symptoms causes and treatment of endometriosis.
But women, who suffer from this condition have microscopic bits of the endometrium tissue grow on other reproductive organs such as the ovaries, the outer wall of the uterus, the fallopian tubes, and the gap between the uterus and the rectum. When the body is ready to menstruate, the endometrial tissue thickens but there is no exit for the discharge as it is growing on the other parts of the body. This causes irritation to the surrounding tissue, which causes cysts, painful periods, and scar tissues.
There can be multiple causes as to why this condition occurs. A few common reasons as listed below:
1. Retrograde menstruation
During retrograde menstruation, the menstrual discharge that has endometrial cells tend to flow back to the pelvic cavity through the fallopian instead of eliminating it out of the body. These undischarged endometrial cells are prone to stick to the uterus outer walls and surfaces of other reproductive organs, where they continue to grow and thicken causing painful periods every month.
2. Immune system disorder
If a woman suffers from Immune System Disorder, the body will fail to recognize and destroy endometrial-like tissue that's growing outside the uterus causing Endometriosis.
Also read: Endometriosis And Stomach Pain During Period: Significant Signs, Causes And Difference Between The Two
3. Family history
Sometimes the genes tend to play a role in developing this condition. In many cases, the conditions worsen from one generation to the future generations.
Most of the times endometriosis is characterized by pelvic pain and is often disregarded as menstrual periods. Some of the other common symptoms of the condition are as follows:
1. Excessive bleeding
Heavy discharge during periods and in between periods along with painful cramps is the most common symptom of endometriosis.
2. Bladder and bowel irregularities
With this condition, there will be an increased urge to urinate more frequently, as compared average female and pain while passing motion
3. Vaginal discomfort
Frequent pelvic muscle spasms and vaginal tightening during sexual intercourse or vigorous physical activity are also characterized as early symptoms of Endometriosis.
According to Dr. Teena, a few recommended treatment options are as follow:
1. Hormone therapy with OCP Supplemental hormones are usually effective in decreasing or eliminating the pain caused because of endometriosis. The fluctuation of hormones caused during the menstrual cycle thickens endometrial tissues and later break down and bleed. Hormone Therapy slows the endometrial tissue growth. Although Hormone Therapy can reduce pain levels, it is not a permanent solution for the condition.
2. Hormonal therapy with progesterone only pills have found to have better results in suppressing the dieses.
Also read: What Is The Connection Between Endometriosis And Infertility? Know From Fertility Specialist Dr Shanujeet Kaur
3. Progesterone IUD (Intra Uterine Device) will help against pain / heavy bleeding and decreased the progress of dieses.
4. Endometrial Ablation is a surgical procedure where the surgeon locates scarred endometrial tissues and can use various methods to remove/destroy the scarred tissue. This procedure can be performed laparoscopically also, where the surgeon makes a very small incision and inserts a laparoscope through it to identify the scar tissues and treat them.
5. Hysterectomy with or without Bilateral Salpingo - oophorectomy although this procedure is the last resort recommended by the doctors when no other treatment options show results. Hysterectomy causes menopause and the ovaries stop producing hormones and improve endometriosis pain in most patients. However, doctors suggest this mode of treatment only as the last option.
Diagnosis is very vital for treating the condition because the symptoms are often dismissed as premenstrual signs or, hormonal imbalance. The treatment for the condition is very patient-specific, but often a combination of surgery and medication is administered depending on the severity of the condition.