Endometriosis is a condition where the endometrial tissue lining the womb, grows outside the urethral lining. This can cause severe pelvic pain and a host of other complications, if it is not treated on time. 

Here is everything you need to know about this ailment.


- symptoms: owing to the location of this tissue and its painful protrusion through the lining or walls of the womb, one of the earliest and most painful symptoms experienced may include severe cramps and pain during the menstrual cycle. Also, the patient will experience pain in the lower abdomen region about a week before the onset of the cycle. Heavy bleeding as well as infertility may be experienced in such cases too. Sexual intercourse will also give rise to pain in the region, while discomfort will be felt during the bowel movements. Pain in the lower back will also be experienced throughout the menstruation period. 


- stages: there are several stages of this disease and its progression, each of which will require a different form of treatment. These four stages usually depend on the location, size, depth and number of the endometrial implants within the body of the patient.


- minimal stages: in this stage, usually there will be small wounds and lesions as well as shallow implants on the ovaries. Inflammation in the pelvic cavity can also be felt in this stage.


- mild stage: in this stage, there will also be light lesions and shallow implants which will spread over the ovaries as well as the pelvic lining.


- moderate stage: in this stage, the implants will dig deeper into the ovaries and the pelvic lining, which will result in the growth of even more lesions.


- severe stage: as the name suggests, in this stage the patient will experience deep implants along with lesions in the bowels and the fallopian tubes.


- treatment: there are varied forms of this treatment including pain relief medication for minimal to mild stage patients. Also, hormonal therapy with the help of supplements may be prescribed. Hormonal contraceptives may also be used. In such cases, medication like danazol, medroxyprogesterone, 

Gonadotripin releasing hormone agonists, and other such elements may be prescribed. Conservative surgery and radical surgery may follow, depending on the severity of the condition. Laparoscopy is the preferred form of treatment in such cases. A hysterectomy can be conducted as a final resort where the surgeon will remove the cervix as well as the uterus of the patient. This will make pregnancy impossible for the patient, thereafter. To stem estrogen production, the ovaries will also be removed. 


One must discuss all risks and complications before going in for a certain form of treatment for this ailment.

Symptoms, Stages and Treatment of Endometriosis

The uterine cavity has a tissue base that is known as the endometrium. When this endometrium spills over or spreads to the other parts of the reproductive organ, it begins to punch through the uterine lining. Such a condition creates complications and even infertility, and is known as endometriosis.

Read on to know more about endometriosis and how it can cause infertility.

Endometriosis

When the endometrium tissue spreads to areas like the ovaries, and the abdominal cavity, it can lead to numerous complications. Apart from pain, this may also cause infertility. 5 to 10% of the women worldwide suffer from this condition and have trouble conceiving. Additionally, about 30 to 40% of the infertility cases are due to endometriosis, not all cases. These figures are all confirmed by various medical studies.

How does it cause infertility?

Endometriosis can prevent ovulation, which is the process that occurs every month. During the ovulation process, the ovaries release eggs that may be fertilised in order for the woman to conceive. In this condition, the fimbria of the fallopian tubes also has trouble in capturing the egg, which prevents conception from taking place. This leads to infertility in the long run. Endometriosis also interferes with the proper production of the hormones that are required for normal ovulation and fertilisation of the egg.

Diagnosis: The diagnosis of the condition can be done with the help of lab tests and ultrasounds as well as imaging tests that can create the image of the womb and the endometrium lining. This will help in showing the severity and damage caused by the tissue. A surgical procedure called a laparoscopy may be carried out by the doctor to ascertain whether the patient is suffering from this condition. In this procedure, a small incision will be made and a camera will be inserted to view the insides on a screen, to learn more about the tissue s spread and the kind of treatment that will be required. The doctor will also diagnose the condition on the basis of various symptoms like irregular and heavy bleeding.

Treatment:

Treatment for endometriosis associated with infertility needs to be individualized for each woman. There are no easy answers, and treatment decisions depend on factors such as the age of the woman, the severity of the disease and its location in the pelvis, the length of infertility, and the presence of pain or other symptoms. Some general issues regarding treatment are discussed below.

Treatment for Mild Endometriosis

Medical (drug) treatment can suppress endometriosis and relieve the associated pain in many women. Surgical removal of lesions by laparoscopy might also reduce the pain temporarily.

However, several well-controlled studies have shown that neither medical or surgical treatment for mild endometriosis improve the pregnancy rates for infertile women as compared to expectant management (no treatment).

For treatment of infertility associated with mild to moderate endometriosis, controlled ovarian hyperstimulation with intrauterine insemination - IUI is often attempted and has a reasonable chance to result in pregnancy if other infertility factors are not present.

Details about IUI success rates with endometriosis

IUI and endometriosis

Success rates with IUI for endometriosis have been variable in studies, showing:

A pregnancy rate of 6.5% for women with endometriosis vs. 15.3% per cycle for unexplained infertility
A pregnancy rate of 5.6% for women with advanced endometriosis vs. 22.7% per cycle for mild endometriosis vs. 25.7% for no endometriosis
Pregnancy chances with insemination for natural cycle IUIs (no drugs) with endometriosis are about 2% per cycle vs. 11% with injectables plus IUI for endometriosis
Treatment for severe endometriosis

Several studies have shown that medical treatment for severe endometriosis does not improve pregnancy rates for infertile women.

Unfortunately, the infertility in women with severe endometriosis is usually resistant to treatment with ovarian stimulation plus intrauterine insemination. If the pelvic anatomy is very distorted, artificial insemination is unlikely to be successful. These women often require in vitro fertilization in order to conceive.

Although the studies of in vitro fertilization for women with severe endometriosis do not all show similar results, pregnancy success rates are usually good if the woman is relatively young (under 40) and if she produces enough eggs during the ovarian stimulation.

Endometriosis - How It Results in Infertility?

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!

The tissue that lines the uterus is known as the endometrium. In some cases, it can grow outside the uterus. This is known as endometriosis. Endometriosis usually involves organs in the pelvic cavity such as the ovaries, fallopian tubes, bowel and lining of the pelvic cavity. In rare cases, it may involve the vagina, cervix and bladder as well.

Depending on the location and extent of endometrial tissue, it can be classified into four stages ranging from minimal to severe. Most cases of endometriosis fall into the minimal or mild category which involves mild scarring and superficial tissue implants. Moderate or severe endometriosis can cause cysts and severe scarring. Infertility is also commonly associated with severe endometriosis.

Pain in the pelvic area just before and during menstruation is one of the most characteristic symptoms of this disorder. This is because the overgrown endometrial tissue acts like normal endometrial tissue and is shed during menstruation. The only difference is that since there is no exit for this overgrown tissue, it is trapped in the pelvic cavity. The location of the implantation of endometrial tissue also plays a role in the amount of pain experienced. The deeper the implant, more the pain. Implants near areas with high nerve density are also more likely to be painful than implants in areas with low nerve density.  These implants may also release substances into the blood stream that can cause pain.

Other symptoms associated with this disorder are:
  Painful intercourse
  Painful urination
  Pain during bowel movements
  Infertility

These symptoms especially the pelvic pain can vary from month to month in terms of duration and intensity.

A few simple changes in your diet can help manage the symptoms associated with this disorder and in some cases, prevent it as well. Avoid processed food and foods that are high in sodium content. You should also avoid high-fat dairy and food that is rich in arachidonic acid. Instead, increase your consumption of carbs and green leafy vegetables. You could also add two tablespoons of walnut oil a day to your diet to help combat inflammation and the other effects of arachidonic acid.

Early stages of this disease can be treated with hormone therapy, but if it has progressed to the later stages, surgery may be needed. This surgery is performed laparoscopically and aims at removing all the implanted tissue from outside the uterus. However, in cases where the anatomy of the pelvic organs has been distorted by the implants, a hysterectomy may be required. This option, however, it usually considered only in cases where a woman does not have any plans of conceiving more children. 

Endometriosis - How It Is Affecting Your Life?

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

A woman s body goes through a number of changes during her lifetime and therefore, it is always better to undergo regular health check-ups at proper intervals to ensure that all organs of her body function well.

Endometriosis is something, which every woman is likely to have heard about. However, not many women are aware of what it exactly is. Even fewer know about what they should look out for when it comes to having endometriosis or understanding what it means to be suffering from it. Is it not a lot better to be informed about all of this?


The condition of endometriosis is when the tissue that is supposed to be inside the uterus also known as the womb and lining starts existing outside it. What effectively happens is that the lining of the uterus, known as the endometrium, finds itself to be trapped in the pelvic area.


Some amount of discomfort is usually experienced by women who are menstruating. However, when a woman has endometriosis, the amount of pain is pretty persistent, sometimes extending to a month-long duration. Some women also suffer from excess bleeding.


Unfortunately the symptoms are not only limited to this. Women who are adversely affected by endometriosis usually find having sex painful as well, ironic as it is supposed to provide pleasure.

Also fertility is the primary function affected by it. There are so many complications in this regard. It is said that about 50 percent of women who have endometriosis have trouble getting pregnant and carrying a baby. Effectively, as sad as it is, endometriosis has the potential to take away the entire prospect of motherhood from a woman.


In addition to this, a fair number of cases, show that the symptoms, which are experienced worsen over the course of time. So, what this means is that the lifestyle of the woman may be severely affected as the symptoms get progressively worse; which is just one of the reasons why treatment is something, which should be resorted to sooner than later.


One of the lifestyle changes which may be beneficial in reducing the severity of endometriosis includes a change in your diet. Increased intake of green vegetables and fresh fruits along with a reduced consumption of red meat is definitely worth a try. Regular exercising is also helpful in treating the condition.


Endometriosis - What are the Symptoms and Consequences of it?

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