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

What is Endometrium?

The uterus is where the fetus grows and develops. It has three linings- the outermost lining, the middle layer and the innermost lining. The innermost layer is called Endometrium. The endometrium is made of mucosal tissues.

How the endometrium changes and what is its function?

Before ovulation, when an egg is released, the functional layer of the endometrium undergoes a change. Vascularization takes place i.e. a buildup of blood vessels and tissues that thickens the endometrium in anticipation of implantation of a fertilized egg. If conception does not take place, the tissues and cells are shed from the endometrium lining. This is when a woman gets her period.

When conception does take place, the fertilized egg attaches itself to the endometrium. The endometrium also supports the placenta, which provides the fetus with oxygen and nutrition.

What is the ideal thickness of the endometrium?

In pre-menopausal women, the thickness of the endometrium should be-

  Between 2-4 millimetres during menstruation,
  5-7 millimetres at the onset of the early proliferative phase
  Around 11 millimetres during the late proliferative phase
  16 millimetres during the secretory phase



What is a poor/thin endometrium?

If the endometrium lining does not meet standard thickness and is not conducive to implantation, it is called a poor endometrium.

Causes behind thin endometrium

There could be many reasons that can lead to a poor endometrial layer-

  Inadequate secretion of estrogen
  Insufficient blood flow
  Prolonged use of birth control pills
  Substandard quality of endometrial tissues
  Presence of fibroids (small uterine tumours)
  Amenorrhea (unnatural periods/ excess bleeding or too little bleeding)
  Intrauterine adhesions (scar tissues form between the layers of the uterus and glue them together)
  Pelvic inflammatory disease
  Use of clomiphene

What are the symptoms of poor endometrium?

  Infertility (inability to conceive)
  miscarriage
  Irregular menstruation
  Painful periods
  Inadequate bleeding during menstruation

Treatment for poor endometrium

  Since the most common cause of poor endometrium is insufficient estrogen, doctors prescribe estrogen pills that can raise estrogen levels.
  If poor endometrium is the result of poor blood flow, an Ultrasonography Test will reveal that. Then doctors prescribe Vitamin E pills and L-arginine amino acid pills to thicken the endometrium layer.
  Regular exercising increases blood flow to the uterus
  Acupuncture is a very effective stress buster. Chronic stress could lead to a shrunk uterine wall. Acupuncture can allay the stress and promote the health of the uterus.
  Intrauterine adhesions can be extracted through surgery.
  Natural remedy (through natural therapy) includes asparagus, royal jelly, cover and they help in thickening the endometrium layer.
  Granulocyte Colony Stimulating Factor if injected into the body raises endometrial thickness and combats infertility.

Only an endometrium of normal thickness can support a pregnancy. If the lining is not thick enough medical intervention may be necessary.

Poor Endometrium - Can It Be Treated?

Being able to conceive and give birth to a new life is something that most women dream about. The natural instincts of motherhood give a lot of joy to women after they reach a certain age and this is something that is hormone driven so that they are inspired to get pregnant and give birth, keeping the life cycle of humans regular and growing.

A lot of women may be able to easily conceive and go through a natural pregnancy without any major glitches or problems, but everyone may not be as lucky and there may be those women who may be suffering from health issues that make it difficult for them to conceive.

One problem in women that may lead to difficult in conceiving or infertility may be the problem of endometriosis. This is a health issue that affects the uterus and it is defined as a problem in which the lining of the uterus grows outside of it, disturbing menstrual cycles as well as the ability to conceive and carry a foetus in the uterus.

Is it possible to get pregnant?
There is widespread misconception that women who suffer from endometriosis may never be able to conceive because the uterus lining that is needed for the inception of the embryo in early pregnancy may be missing. However, the truth is that the problem is a treatable one and with the right medical help and guidance, it may be possible to make sure that the problem is brought under control or reversed and that a successful pregnancy may be achieved.

While it is possible to reverse the problem, it is also important for aspiring couples to choose the right gynaecologist for the treatment, because it is a complex issue that can be resolved only with expert and experienced interference. The medical professionals may put you under medication that works on the hormones and creates ways to reverse endometriosis. However, in patients who suffer from severe endometriosis, a surgery may be one of the alternative treatments.

The relation with pregnancy:
As it is suggested by experts in the field of gynaecology, finding difficulty in conceiving may be a real possibility. However, with the help of modern medical practices such as in vitro fertility, it may be possible to conceive when all other forms of treatment fail and in order to achieve such a feat it may be important to trust a doctor that has a perfect backing of knowledge and experience in the field.
The modern world of medicine is no shorter than a marvellous miracle, however, the success or failure of any treatment depends a lot on the kind of medical aide and specialist that you decide to opt for.

Endometriosis - How it Affects Pregnancy?

When endometrial tissue that usually grows inside the uterus, starts growing outside uterus, it is called Endometriosis. Pain during or before periods, pain during intercourse, pain while urinating or bowel movements, heavy bleeding, infertility are some of the symptoms of endometriosis.

Treatment of endometriosis usually depends on the following factors:

Age of female
Severity of symptoms
Duration of the symptoms
Future plans for children/ fertility
Associated pathologies
Accordingly the doctor might choose any of the treatment options like:

Medication for Pain: If the symptoms are mild, then the doctor will prescribe some pain  relieving medications like Nonsteroidal anti-inflammatory drugs (e.g. Diclofenac) or anti-spasmodics(e.g.drotaverine)
Hormone Therapy: Hormone therapy is effective, but once you stop them, your symptoms may recur. Some of the hormone therapies include: 
Hormonal Contraceptive pills: Useful in controlling the hormones that are responsible for endometrial tissue growing outside the uterine cavity.
Medroxyprogesterone: This helps to counter effect estrogen hormone which is responsible for endometrial tissue growth.
Gonadotropin-releasing hormone (GnRH) agonists: Gonadotropin hormones that stimulate ovaries are blocked by these. They bring down oestrogen levels and hence symptoms. It can cause absence of menstruation in some females which is reversible.
Danazol: It is synthetic androgen, suppresses growth of endometrial tissue temporarily.  However, Danazol may not be a favourable option because of its side effects. Females should avoid pregnancy while on this drug.
Dienogest: This newer progesterone molecule, which does not have major side effects and is apporved for use in endometriosis.
Other medications like selective progesterone receptor modulators, immunomodulators, anti angiogenic factors are being evaluated.
Conservative surgery: If you are trying to conceive, then surgical excision or ablation of endometrial tissue is one treatment option.Suboptimal surgery with conservation of maximum ovarian tissue is considered suitable in such cases.
Hysterectomy: In severe endometriosis cases where female has completed her family, hysterectomy is offered wherein the uterus, cervix & if required ovaries can be removed.

Endometriosis - Ways To Manage It Well!

The abnormal growth of the endometrium tissue outside the uterus is known as endometriosis. Ideally, the abnormal tissue is supposed to break down and exit the body. However, in this condition, the tissue is unable to pass out of the body. As a result, the surrounding tissue tends to get irritated and leads to the formation of scar tissues.

The various causes of endometriosis include:

Immune system disorder: Complications in the immune system might render it incapable of destroying the endometrial tissue that grows outside the uterus.
Surgical scar implantation: Certain surgeries such as a C-section may result in the attachment of endometrial cells to the incision area.
Embryonic cell transport: These cells may be transported to other parts of the body by the blood vessels which may lead to endometriosis.
Retrograde menstruation: Instead of passing out of the body, under this condition, the blood flows back into the pelvic region via the fallopian tubes. When these cells attach themselves to the pelvic cavity, it causes endometriosis.
Symptoms
1. Pain during sexual intercourse
2. Pain during periods including pelvic pain, especially during periods, lower back pain and abdominal pain.
3. Excessive bleeding during periods
4. Fatigue
5. Constipation
6. Bloating

The major complication that results is fertility problems. Endometriosis may prevent the combination of the egg and the sperm and thus, impairs your ability to conceive. It is recommended not to delay pregnancy if you have endometriosis. This disorder also tends to increase the risk of ovarian cancer in some women.

How can it be treated?

Endometriosis is usually done using surgery or medications. 

Medication: It usually involves painkillers.
Hormone therapy: Some of the hormonal therapies include:
Hormonal contraceptives
Progestin therapy
Gonadotropin-releasing hormone (Gn-RH) agonists and antagonists
Conservative surgery: If a patient wants to become pregnant, surgery is done as much as possible without harming the uterus and ovaries. Suggested procedures include laparoscopy and traditional abdominal surgery.
Assisted reproductive technologies: An example of this form of treatment is In Vitro Fertilization.
Hysterectomy: Under severe circumstances, total hysterectomy is conducted in order to facilitate the removal of cervix and uterus. If you wish to discuss about any specific problem, you can consult a gynaecologist and ask a free question.

Endometriosis - 4 Reasons Behind it!

Endometriosis is a condition in which the endometrial cells lining the inside wall of the uterus begin to grow outside the uterus. In a majority of the cases, the growth is on the ovaries, the Fallopian tubes, or the tissues around the uterus. In rare cases, it occurs in other body parts. Normally, women in the age group of 30 to 40 years are prone to developing this condition and genetics is believed to be the reason behind this disorder. It is a serious medical condition if it causes discomfort to the woman.

Signs and Symptoms:  The signs and symptoms of endometriosis include chronic pelvic pain, pain during menstruation, urination, and intercourse, longer periods, bleeding between menstrual cycle, bloody urine or stool, and urinary and bowel problems.

Treatment methods:  In many cases, endometriosis goes undiagnosed and it can only be diagnosed through biopsy. If the biopsy confirms endometriosis, then it can be treated in the following ways:

Hormonal treatment: Hormonal treatment includes birth control pills, placement of the intrauterine device, Gonadotropin-releasing hormone, and Danazol or Medroxyprogesterone (Depo-Provera).
Pain medication: Pain killers with anti-inflammatory properties are prescribed to those who suffer from painful menstruation.
Surgery: This is the last treatment option and only advised to those who did not find relief from medicines and hormonal treatment. Surgeons try to remove the areas affected by endometriosis but in severe cases, the ovaries might need to be removed completely.
Complications: It is important to treat endometriosis on time as delay can lead to complications. The complications arising out of endometriosis include the following:

Infertility: The scarring and distortions caused in the reproductive organs due to endometriosis and the endometriotic cysts can make a woman infertile.
Scarring: The bleeding and the inflammation caused by endometriosis leads to scarring of the tissues of ovaries.
Ovarian cysts: Sometimes, the abnormal growth of endometrial cells outside the uterus spreads to the ovaries and starts growing over there, leading to cysts.
Prevention: As it been mentioned before, in many cases, endometriosis goes undiagnosed but it can be prevented or its symptoms managed effectively if one is cautious. One should do the following:

Exercise regularly: Exercise increases immunity and also reduces the level of estrogens, which slows down the progression of endometriosis. It also provides relief from pain.
Eat nutritious diet: A diet rich in vitamin and minerals ensures good health of the reproductive organs and a fine immune system. This helps to fight the symptom of endometriosis and keeps the disorder in check.
Endometriosis is known to affect a large number of women and since the early symptoms are mild or confusing, most of the time they go undetected. Nevertheless, a woman can avoid it and the complications arising out of it by being mindful of the symptoms. They should also undergo a regular pelvic exam and follow the instructions of their gynecologist. This would ensure timely detection of the disorder and if this is ensured, the management also becomes easy.

Suffering From Endometriosis - What Are Its Treatment Options?

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