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?

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?

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?

There can be a number of reasons that lead to infertility in women. Endometriosis is one of them. It is a benign condition where the endometrium, which includes the tissues that form the lining inside the uterus, grows outside the uterus. Apart from infertility, it may also cause pelvic pain in women.

There are no such symptoms of endometriosis apart from pelvic pain and it cannot be detected without surgery. Thus, it is very difficult to diagnose this disease and state how common it is. However, research says that the prevalence of this disease in women in their reproductive age is between 3 to 10 per cent.
It is found that endometriosis sometimes leads to infertility. Here is how:

Abdominal Adhesions and Infertility
Normally, the endometriosis implants develop in the abdomen. Then the body surrounds them with connective tissues. The reason for doing so is isolating the implants, so that they cannot harm your body.
Now, sometimes these adhesions can create a blockage in the opening of the fallopian tube or may also pinch off the fallopian tube. This will result in obstruction in the fertilisation of egg and the sperm and thus fertilization will not take place; so there are no chances of conceiving. These obstructions when diagnosed can be treated with surgery.

Secretions from implants
Endometrium plays a vital role in conception where the tissues secrete a wide variety of hormones and nutrients. Now, the endometrial implant also functions in the same way and secretes those hormones. The difference is that it does not deposit them in the lumen of the womb, and it is released in the abdominal cavity. In these substances, there may be some hormones that are responsible for infertility.

Prostaglandins
Prostaglandins are other hormones that are secreted by the endometrium normally. It helps in a lot of body processes that include various stages of menstrual cycle and pregnancy. This hormone is required for a lot of functions such as ovulation, sperm mobility, and regression of corpus luteum, immune interaction, menstrual cramps and contraction of the uterus at birth.

Just like the endometrium, the implants also secrete these hormones. And, the problem that is caused by the implant secreted prostaglandin hormone is that they are released in the abdomen and not in the womb. Moreover, they are not secreted at the right time, thus sending a wrong message to the brain.

A woman with a few days of pregnancy may face a miscarriage because the ovary will get a signal to start the menstrual cycle, and the womb lining where the egg is implanted will be expelled.

How Endometriosis Leads to Infertility and Miscarriages?

Cancer that originates in the uterus is termed as Endometrial Cancers. The cancer is known to originate in the endometrium i.e. lining as well as the cells of the uterus. Abnormal vaginal bleeding causes the cancer to be detected early and a consultation with the doctor should be done immediately. When other cancers originating from the uterus are considered, endometrial cancer is found to be the most common.

Causes
The exact cause for endometrial cancer is not known clearly. The cells in the endometrium tend to become abnormal due to the occurrence of a genetic mutation, which causes rapid multiplication of cells that ultimately lead to the formation of a tumour like mass. They begin to spread to other parts and proceed to affect the tissues in the surrounding areas.

Symptoms
The typical symptoms of endometrial cancer include:
1. Irregular bleeding in between periods
2. A watery discharge from the vagina
3. Bleeding from the vagina postmenopausal
4. Pain in the pelvic floor muscles

Risk factors that might increase the chances of being affected by endometrial cancer include:
1. Aging increases the chances of this disease, especially post menopause.
2. Obesity can cause hormonal imbalance.
3. Certain drugs used in hormone therapy
4. Early onset of menstruation, especially before 12 years of age

Treatment for Endometrial Cancer Includes:
1. Radiation therapy: This treatment procedure involves using radiations, such as X-rays to target and destroy the cancer cells. The two forms of radiation therapy are external radiation therapy (external machine is used to direct radiation on the cancer cells) and internal radiation therapy (radioactive substance enclosed within small and consumable items is placed near to or directly at the spot of cancer).

2. Hormone therapy: Medications are administered to eliminate imbalances in hormone levels and prohibit the growth of cancer cells in the body. This remedy is preferred if the cancer progresses to an advanced stage.

3. Chemotherapy: This form of treatment uses oral administration or injection of chemicals into the veins so that the growth of cancerous cells is curbed, either by elimination of the cells or by prohibiting cell division.

4. Surgery: In this surgery, the areas affected by cancer are surgically removed; i.e. the uterus in this case. The surgical procedures that might be used include total hysterectomy (total removal of uterus), radical hysterectomy (removal of the cervix, uterus and part of the vagina) and Bilateral salpingo-oophorectomy (removal of both the ovaries and the fallopian tubes)

All About Endometrial Cancer

An often painful condition usually involving the bowel, ovaries or the tissue lining the pelvis, endometriosis is characterized by the abnormal growth of the endometrial tissue beyond the premises of your uterus or your pelvic region. The endometrium, in fact, functions perfectly normal with each menstrual cycle, but because of it being displaced, it cannot exit the body and consequently gets trapped.

Besides causing severe pain and distress, endometriosis can also adversely affect fertility. When the ovaries get involved, certain cysts known as endometriomas tend to develop which often result in the formation of scar tissues and adhesions.

Complications associated with it

Infertility: Impaired fertility is the most common kind of complication arising from endometriosis, with approximately one-third to one-half women having problems with pregnancy. During endometriosis, the fallopian tube gets obstructed, thereby restricting the union of the egg and sperm.
Ovarian cancer: Women with endometriosis are more likely to suffer from ovarian cancer. Moreover, they are also more susceptible to acquiring endometriosis related adenocarcinoma, which is another variant of cancer, but a comparatively rarer phenomenon.
How best to treat it?

Depending upon how severe your symptoms are, endometriosis can be treated via the use of medications or through the advent of surgery.

Pain medications: Certain medications, including pain relievers and anti-inflammatory drugs, are particularly useful in providing relief to painful menstrual cramps.
Hormone therapy: Undergoing hormonal therapy can help ward off or reduce the pain of endometriosis, but it should be kept in mind that it is only a temporary fix and that symptoms might reoccur. Hormonal therapies include:
Hormonal contraceptives
Medroxyprogesterone
Gonadotropin-releasing hormone (Gn-RH) agonists and antagonists
Danazol
Conservative surgery: This can either be done through laparoscopy or, in more extensive cases, through traditional abdominal surgery.
Assisted reproductive techniques: These include in-vitro fertilization, and are sometimes more preferable over conservative surgery.
Hysterectomy: This is usually done in more severe cases of endometriosis whereby ovaries are also removed with uterus and cervix

Complications and Treatment of Endometriosis

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