Mrs X 28-year old married since 3 yrs consulted for not being able to conceive. She complained of painful periods with heavy bleeding. The pain had worsen with time. After evaluating her medical history and complete physical examination and an ultrasound , she was diagnosed with ovarian endometrioma. This is the story of several women around the world who tend to ignore the symptoms and dismiss serious painful signs as something normal, but they could be an indication of endometriosis. In this article, Dr. Jyoti Tripathi, Fertility Consultant at Nova IVF Fertility, Indore explains how this condition can affect reproductive health of women.
What is Endometriosis?
Endometriosis is a medical condition in which the tissue called endometrium that is usually lining the inside of the uterine cavity starts to grow outside it. It can involve any organs like ovaries, intestines, fallopian tubes, and the peritoneal tissue lining your pelvis but commonly involves the ovaries and tubes. Therefore, women with this disease can also experience many fertility problems due to endometriosis. This condition affects fallopian tubes can affect the transport of egg and subsequent fertilisation of the egg and sperm. Ovarian endometriosis leads to formation of cyst in the ovaries commonly known as chocolate cyst of the ovary.. Although the exact reason for endometriosis is still not completely known, it is believed to be caused by retrograde menstruation, certain transformation of the peritoneal and embryonic cells into endometrial cells.
What are the signs and symptoms of Endometriosis?
The signs and symptoms depend on the stage of the disease. It’s graded from mild, moderate to severe endometriosis.
Common signs and symptoms of Endometriosis include:
Pelvic Pain-The most prominent symptom of endometriosis is pelvic pain. Pelvic or lower abdominal pain may start before the first day of your period and last for an extended time. Some women describe it as their internal organs being stretched and pulled.
Painful periods- Women with Endometriosis describe their period pain as a sharp and throbbing feeling, and medication often fails to work. Period cramps are often accompanied by lower back and abdominal pain. Although many women experience period pain, those with endometriosis suffer from far worse pain than usual. Most women with endometriosis the menstrual pain steadily increases over time. The pain in endometriosis is far more severe from the usual menstrual cramps which mostly settle by themselves or simple pain medication.
- Pain during intercourse- Endometriosis can be associated with pain during or after sexual intercourse.
- Excessive bleeding- women with the condition may experience heavy bleeding during their menstrual periods.
- Infertility- It is a common presenting symptom as endometriosis can affect fertility in multiple ways.
- Painful bowel movements or urination is also seen in few patients
How Endometriosis Affects Pregnancy
Endometriosis causes various fertility problems and negatively impacts a woman’s reproductive health. It can damage fallopian tubes, inflammation of the pelvic structures,pelvic adhesions,, altered immune system, hormonal imbalance, impaired implantation of a pregnancy, ovarian endometriosis affect egg quality and egg number.While some women have successfully achieved pregnancy but many women with endometriosis suffer difficulty in getting pregnant and need help.
Treatment options for Endometriosis
Unfortunately, there are no natural ways to get a quick relief from pain and other symptoms of endometriosis. Although endometriosis has no cure,symptomatic treatment are available.. Some treatment options for endometriosis include;
Pain medications such as ibuprofen might help reduce the pain of endometriosis, but they aren’t effective in all cases.
Hormone therapy in the form of hormonal contraceptive pill, progesterone therapy or Gonadotropin releasing hormones agonist injection can help balance the body’s hormonal changes and relieve pain by stopping the progression of endometriosis. When the patient is on the hormone medication she cannot conceive as it changes the body hormone milieu and prevents ovulation.
Conservative surgery (laparoscopic) refers to a procedure of removing the endometrial implants without harming the reproductive organs. This surgery is recommended to those who wish to get pregnant or experience extreme pain.
Infertility treatment: Since endometriosis cause infertility, there are different type of fertility treatment options. It varies according the evaluation of reports of both partners. Your fertility expert will advise you the best treatment options as per your reports.
A woman suffering from endometriosis mostly face challenges in getting pregnant. It’s advisable to consult a fertility expert to better understand and evaluate the stage of the condition and their treatment options. As the symptoms of endometriosis worsen over time, it is recommended that you should plan your family on time.Doctors may also recommend joining a support group or using other supportive resources to help with your mental health.
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