Endometriosis is a painful condition where the endometrium tissue lining the walls of the uterus, grows as implants outside the womb of the patient. This can lead to a number of painful conditions and is often considered as a common cause behind severe pelvic pain, as far as women are concerned. Here is all you need to know about endometriosis and pelvic pain.

 Painful menstruation: depending on the stage of the condition, the implants could remain on the surface or go deeper into the ovaries which may cause acute and severe problem during ovulation as well as the menstrual cycles. This is one of the symptoms that one must not ignore. If you are having painful cramps that affect the pelvic area and the abdomen, and if these cramps last throughout the duration of the cycle, then there are strong chances that you are experiencing the pain that comes with endometriosis. 
 Pain during and after intercourse: while there are many reasons why women may face pain during intercourse, it may be noted that vaginal and pelvic pain that come during and after intercourse could point towards the presence of endometriosis, which is causing irritation and discomfort due to the implants. 
 Bowel movements and urination: usually, pelvic pain may trickle down to and also get activated by the bowels when there is a motion as well as urination. This is a common problem that can cause pain, which spreads throughout the region if the patient is suffering from endometriosis. 
 Bloating and other symptoms: when the abdomen and nearby regions face bloating due to the implants and their painful spread, the pelvic region as a whole bears the brunt in terms of severe pelvic pain. The bloating and other symptoms like loose motions and constipation can also create pain in the abdomen and pelvic region on a persistence basis. Sharp pains may also shoot up and down the lower back due to such symptoms which should not be ignored if they do not abate within a few days. 
 Misdiagnosis: many times, the bloating and pelvic pain may be linked with pelvic inflammatory disease, which causes pain in the muscles and joints. But if you are having pain in the abdomen as well as problems during your menstrual cycle, then it may be helpful to have the tests for endometriosis done as well. 

In order to diagnose the condition, the doctor must ensure that proper imaging tests like mri and ct scans as well as an ultrasound with lab tests based on blood samples have been conducted. The pelvic pain that comes with this condition can be treated with the help of pain relievers like ibuprofen and aspirin.

Could Your Pelvic Pain be Endometriosis?

Although most women experience menopause between the age of 45 and 55, but when women experience the menopause before they reach 40, it is termed a premature or early menopause. It is also known as premature ovarian failure.
This may be due to primary ovarian insufficiency in which there is decreased activity in ovaries and the periods spontaneously stops. It may be result of chemotherapy treatment for cancer or it can be surgically induced menopause when the ovaries are removed. Premature menopause can also be caused by treatments for cancer or other conditions that involve chemotherapy or radiation therapy for the pelvis. These treatments can damage the ovaries and result in ovarian failure. The chances of premature menopause depend on the type and amount of chemotherapy as well as the age of the patient

Removal of both ovaries by surgery causes menopause right away. Menstruation stops after this surgery, but the hormones of women facing such condition drop quickly. They experience strong menopausal symptoms such as hot flashes and diminished sexual desire.

Chromosome defects like Turner s syndrome can lead to premature menopause. In this condition, the female is partly or completely missing an X chromosome due to which the ovaries does not form normally leading to early menopause. Women with a family history of premature menopause are more likely to have the same themselves. Autoimmune diseases like Thyroid disease and rheumatoid arthritis that attack the body's immune system may mistakenly effect the ovaries thus preventing them from making hormones.

One should visit agynaecologist, if the period stops or changes before the age of 40. Menopause is confirmed when a woman does not have her period for 12 months in a row. Blood tests for measurement of oestrogen and related hormones, like follicle-stimulating hormone determines if one has reached premature menopause

Women have premature menopause can be observed as physical problems, emotional disturbances or problems associated with sexual functioning. Women experience sudden waves of mild or intense body heat commonly known as hot flashes and can also experience profuse sweating called as night sweats and have difficulty in sleeping. They experience vaginal dryness and the sexual drive or the libido also decreases. The bone density decreases leading to osteoporosis and fractures. In addition to physical symptoms, there are emotional symptoms like anxiety, mood swings, loss of focus and difficulty in concentration. Women who want to conceive and go through premature menopause may feel extremely upset. The sexual symptoms include dryness and thinning of walls of vagina, thus causing pain or discomfort during sexual intercourse.

Premature Menopause - Signs and Causes

Polycystic ovary syndrome (pcos) and infertility are considered synonymous by most. However, the truth is that they are not and there are a lot of treatment options that can lead to pregnancy, even in a lady who is suffering from pcos.

Reasons pcos leads to infertility
Women with pcos have different hormonal pathways than a normal woman without pcos. It changes the system of how your body produces the eggs and prepares your uterus for pregnancy. Three reasons why women with pcos do not get pregnant or why it is difficult for them to maintain pregnancy are:
1. Women who are suffering with pcos do not ovulate normally.
2. They have irregular periods and thus their monthly cycles are not predictable.
3. As they have irregular periods, their endometrium may not be prepared when the egg is released. Thus, it does not help in sustaining the pregnancy.

Symptoms of pcos
There are a lot of symptoms that show the hormonal imbalance due to pcos.
1. Ovarian cysts
2. Excessive amounts of male hormones
3. High levels of insulin
4. Fertility problems
5. Weight gain
6. Ovulation and menstrual problems
7. Excess body and facial hair
8. Acne
9. Anxiety and depression

As there is hormonal imbalance in a woman with pcos, the eggs may not develop properly and at the same time, they may not be ready to get fertilized, thus leading to infertility.

Pcos infertility treatment
The good news is that even if you are one of them with pcos, there are treatments that can help you to get pregnant.

Here are the drugs that help patients with pcos.

Metformin (glucophage)
It helps in reducing the insulin levels and stabilizes the hormones. Thus, doctors often prescribe metformin that will help in making the ovulation cycles regular.

Clomid (clomiphene citrate)
Another fertility drug that helps in conceiving is clomid. It may be prescribed with or without metformin. When women with pcos take these two drugs together, their chances of getting treated for pcos and getting fertile become more. Many women may need a high dose of clomid so that they can retain fertility.

Gonadotropins
This medication is necessary for helping you with ovulation as gonadotropins are hormones that stimulate your ovaries to release eggs. When someone is not responding to clomid then this medication may be tried.
If you too are trying to conceive and yet have not succeeded and can find the symptoms mentioned above, visit your doctor and start the treatment.

How to Get Pregnant Even if You Have Polycystic Ovary Syndrome (PCOS)?

When tissues that usually grow inside the uterus, start growing outside the organ, it is called endometriosis. Painful periods, pain during sex, pain while urinating or bowel movements, extreme bleeding, fatigue, infertility, diarrhea, bloating and nausea are some of the symptoms of endometriosis.

Treating endometriosis usually depends on the following factors

Age
Severity of symptoms
Severity of the disease
Future plans for children
Depending on these the doctor might opt for any of the following treatments

Medication for Pain: If the symptoms are mild, then the doctor will prescribe some pain killers like Nonsteroidal anti-inflammatory drugs. 
Hormone Therapy: Hormone therapy is effective, but once you stop them, your symptoms may come back. Some of the hormone therapies include: 
Hormonal Contraceptives: Birth control pills, vaginal rings and patches are useful in controlling the hormones that are responsible for tissue build-up outside the uterine cavity. 
Medroxyprogesterone: This drug stops menstruation, which in turn stops the tissue build-up and put an end to all the symptoms. But on the other hand, gaining weight, low bone production and depression are some of the common effects of this drug. 
Gonadotropin-releasing hormone (Gn-RH) antagonists and agonists: Hormones that stimulate ovaries are blocked by these. They bring down oestrogen levels and hence prevent menstruation. 
Danazol: This drug prevents menstruation and symptoms of endometriosis by blocking the hormones that stimulate the ovaries. However, Danazol may not be a favourable option because of its side effects. The drug should be avoided during pregnancy.
Conservative Surgery: If you are trying to get pregnant, but you already suffer from endometriosis, then removing endometriosis surgically is a viable solution. Your uterus and ovaries will be preserved, which might increase your chances of becoming pregnant. Even suffering from severe pain might find relief from conservative surgery. 
Hysterectomy: In extreme cases, the only way to deal with the symptoms is to completely remove the uterus, ovaries and cervix. Since a hysterectomy means you cannot have children, it is kept as the last option for women in their reproductive age.

Management of Endometriosis

There are two types of abortion, namely medical and surgical. In case of medical abortion, pills are taken to terminate the pregnancy; whereas, surgical abortion is done if the pregnancy has reached an advanced stage when pills are ineffective. While generally there are no health risks or negative effects of abortion on fertility, there are rare cases of complications, which can give rise to severe symptoms post abortion. Following is the information you need to know about abortion and its effects on fertility:

When to seek medical assistance
It is advisable to seek medical help if you have the following symptoms post abortion:
1. Persistent pain in the lower abdomen, which lingers even after taking medication
2. Excessive bleeding
3. A high temperature

Possible effects of surgical abortion on fertility
1. Infection after abortion: infections post abortion like pelvic inflammatory disease (pid), if left untreated for long can spread and harm your reproductive organs, thereby impacting your fertility. It can cause complications like infertility or ectopic pregnancy.

2. Damage to the cervix during abortion: damage to the cervix during an abortion can cause cervical incompetence and consequently increase the risk of miscarriage.

3. Damage to the womb during abortion: there are chances of damage of the womb (uterus) during abortion, resulting in scarring, which can cause fertility issues if not corrected. This is more likely in case you had multiple abortions.

Apart from the above mentioned complications there are a number of other complications, which can happen due to abortion, preterm birth, vaginal bleeding during pregnancy and low birth rate, etc. Further, infertility can also be a possible side effect of abortion pills, which happens due to scarring of the uterus during the procedure of forcible elimination of the fetus. In all such cases it is advisable to schedule regular check up with your gynaecologist.

Can Abortion Affect Fertility?

Missing out on your periods or irregular periods once in a while is common. However, the problem arises when irregular periods become every month s story. The irregularity can be an amalgamation of a host of factors. Ignoring the same for long will only complicate things further. For women of reproductive age, the problem can give rise to deleterious consequences, including difficulties in conceiving. In this article, we will discuss some of the common triggers that result in irregular periods and when to seek medical help.

What causes Irregular Periods?
The hormonal balance plays a significant role in the proper functioning of the vital organs of the body. More than often, irregular periods are found to be a manifestation of hormonal imbalance. Some of the conditions that trigger the hormonal imbalance include

PCO is a common medical condition that affects women of reproductive age. PCOS is characterized by the formation of cysts in the ovary (one or both) that affects the ovulation process. In PCOS, there is an increased production of Androgen, especially Testosterone that can cause irregular periods, hair fall, facial hair, weight gain etc.

Time and again doctors and health professionals emphasize the importance of leading a stress-free life. Research suggests stress and anxiety often interfere with the functioning of the Hypothalamus. As a result, the pituitary glands that control and regulate the activities of the ovaries, adrenal glands, and thyroid glands may be affected. These can also trigger a hormonal imbalance giving rise to menstrual problems such as Irregular periods. In case of extreme stress, there may be a short-term cessation of periods (Secondary Amenorrhea).

The hormonal imbalance and irregular periods can also be an outcome of other medical conditions such as endometriosis, a cancer affecting the reproductive organs, fibroids, obesity, diabetes, hyperprolactinemia (characterized by elevated level of prolactin) or even thyroid disorders.

Women who indulge in strict dieting can also suffer from irregular periods. Strict dieting (especially the ones that are without a proper nutritional guidance) can rob the body of the essential nutrients disrupting the hormonal balance.

Irregular periods are normal in women who are nearing their menopause.

When to seek medical assistance?
Irregular periods can be indicative of a severe health problem. Consult a gynecologist

If your regular cycles get delayed by more than 7 days.

There is spotting or bleeding in between the periods.

Your periods last for more than ten days or less than two days.

There is excruciating pain during periods.

The gap between two successive menstrual cycles is more than 35 days or less than 21 days.

Your periods are heavy and unmanageable, affecting your daily routine.

Irregular Periods - When To See A Gynaecologist?

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