One of the silent diseases in the female population, endometriosis can be symptomless for years and sometimes even decades, but can sometimes manifest itself quickly. The uterus is lined on the inner side by a tissue known as endometrium. When this tissue is found in other parts (fallopian tubes, abdomen, near the ovaries, etc., it is known as endometriosis.

Causes: The exact cause for endometriosis is not clear. There is a possibility that during the regular period, there could be spilling of the tissue back into the fallopian tube, from where it reaches the ovaries or other organs and gets implanted.

There are certain predisposing factors for a woman to develop this condition, including genetic correlation and non-menopausal women. The female hormone estrogen is essential for the development of endometriosis. There are also immunological reasons attributed to the development. It can range from minimal to mild to moderate to severe.

Symptoms: From being completely benign to causing severe pain, endometriosis can present itself in varying ways. The implanted tissue can be minimal like a small lump to large clumps. The symptoms are not dependent on the size of the implanted tissue, however, 

1. Painful menstruation: One of the most common causes of non-menstrual cramps, the pain is different from usual menstrual pain, starts a few days before the period and can last up to after the period.

2. Pelvic pain: One of the most common causes of pelvic pain, this can happen wherever the implanted tissue is. In severe cases, this tissue can also bind different organs, forming what are called adhesions. The bladder or the bowels may adhere to the uterus. These are more painful than individual lumps of tissue outside the uterus.

3. Intermenstrual bleeding: There could be spotting to severe bleeding between the regular cycles.

4. Painful sex: There is a deep pain within the pelvis and it can lead to losing interest in sex.

5. Infertility: The most severe symptom and complication is not being able to become pregnant.

Diagnosis: A detailed patient history, discussion on symptoms followed by ultrasound and laparoscopy can help in diagnosing endometriosis.

Treatment: If there is no symptom and fertility is not an issue, then it is possible that no treatment is required. However, depending on symptoms and complications, the following are done.
- If pain is the only main problem, painkillers are administered
- Surgical treatment may be required if there is severe bleeding and adhesions complicating the situation. 

This will also relieve other symptoms
1. Hormone therapy is also an option for treating endometriosis.
2. If you are having pelvic pain and irregular bleeding, bring it up with your doctor. Even if it is not endometriosis, a thorough check up will put your mind at rest.

Endometriosis and Complications Associated With It

Endometriosis is a painful disorder in which tissue that normally lines the inside of your uterus, the endometrium grows outside (endometrial implant). It commonly involves ovaries, bowel or tissues lining your pelvis. The main symptoms are pelvic pain and infertility. While chronic pain exists throughout, it tends to aggravate during menstruation and / or sex. Though the cause is not entirely clear, women with a family history of the condition need to be extra cautious. Endometriosis is normally detected by its symptoms combined with a medical imaging. Though the growth is not generally cancerous, a biopsy is recommended to eliminate doubts. 

The condition of endometriosis is attached with social and psychological effects as it affects a woman's child bearing ability. Most minds race anxiously as to what the surgeon might find and will your body heal after the procedure. Here are some tips to prepare for your endometriosis laparoscopy

 Before the surgery: read up as much as possible about your condition and note down questions you want to ask your doctor. Get details about the entire procedure and how the doctor is treating your specific case. Having knowledge will help you stay calm and focused. Next, gear your home for the process. Stock your fridge with quick heat home made meals. It's best for you and the family to have healthy food than the store bought preservative laden food. Clean your home, change your sheets and purchase some loose fit clothing for later use. Last but not the least, stock up on some reading material that will come handy during your rest period. 
 On day of surgery: do not eat or drink anything from 12 midnight until the time of your surgery. You may also need the unpleasant enema procedure during your prep. Remove your nail polish and leave your jewellery, watch and valuables at home. Shower and get to the hospital early to get on with the forms you'll need to fill. The procedure requires anesthesia so do discuss your allergies or any concerns you may have with this aspect of the procedure. Once you are set with you iv and anesthesia, the doctor takes over to do what they do best cure you.
 The procedure: a small incision is made near the belly button and the abdomen is filled with co2 gas which lifts it away from other organs. During the laparoscopy, the doctor examines the pelvic organs, looking for obvious and atypical endometriosis lesions as well as endometriomas (endometriosis'filled cysts, adhesions, and scarring. He may then remove the lesions to send to a lab for biopsy
 After surgery: you'll most likely wake up groggy in the recovery room after your surgery. You may feel some pain as you come around but if it's a day procedure, you'll be able to leave as soon as you feel ready. 

Although pregnancy may temporarily suppress the symptoms of endometriosis, it does not eradicate the disease. The symptoms will almost always return after the baby is born. If you are suffering from this painful condition and want to seek help, you can consult here.

How To Prepare For Your Endometriosis Laparoscopy

What is endometriosis?

Endometriosis is a common condition where cells of the lining of the womb (the endometrium) are found elsewhere, usually in the pelvis and around the womb, ovaries and fallopian tubes. It mainly affects women during their reproductive years. Endometriosis is not an infection and it is not contagious.

What are the symptoms?

The main symptoms of endometriosis are pelvic pain, pain during or after sex and painful, sometimes heavy periods. It may cause problems with getting pregnant. It can affect many areas of a woman s life including her general physical health, emotional wellbeing and daily routine. Many women may have no symptoms. It is a long-term condition. Some women with endometriosis become pregnant easily while others have difficulty getting pregnant.

What causes endometriosis?

Endometriosis occurs when the cells of the lining of the womb are found in other parts of the body, usually the pelvis. Each month this tissue outside the womb thickens and breaks down and bleeds in the same way as the lining of the womb. This internal bleeding into the pelvis, unlike a period, has no way of leaving the body. This causes inflammation, pain and damage to the reproductive organs. Less commonly, endometriosis may occur on the bowel and bladder, or deep within the muscle wall of the uterus (adenomyosis). It can also rarely be found in other parts of the body.

The symptoms of endometriosis are common and could be caused by a number of other conditions such as irritable bowel syndrome (IBS) and pelvic inflammatory disease (PID).

There is no simple test for endometriosis.
Your gynaecologist may examine your pelvic area, this will include an internal examination.
You may be offered a scan. This can identify whether there is an endometriosis cyst in the ovaries. A normal scan does not rule out endometriosis.
For most women, having a laparoscopy is the only way to confirm endometriosis; because of this, it is often referred to as the  gold standard  test. This allows the gynaecologist to see the pelvic organs clearly and look for any endometriosis.
Several factors may influence your decision about treatment. These include:

How you feel about your situation
Your age
Whether your main symptom is pain or problems getting pregnant
What treatment can I get?

The options for treatment may be:

Pain relief

Hormone treatments: There is a range of hormone treatments to stop or reduce ovulation (the release of an egg) to allow the endometriosis to shrink or disappear. The hormonal methods below are contraceptives and will prevent you from becoming pregnant:

The combined oral contraceptive (COC) pill or patch. These contain the hormones estrogen and progestogen and work by preventing ovulation and can make your periods lighter, shorter and less painful.
The intrauterine system (IUS): this is a small T-shaped device which releases the hormone progestogen. This helps to reduce the pain and makes periods lighter. Some women get no periods at all.
The hormonal methods below are non-contraceptive, so contraception will be needed if you do not want to become pregnant:
Use of hormonal progestogens or testosterone derivatives
GnRH agonists are drugs that prevent estrogen being produced by the ovaries and cause a temporary and reversible menopause.
Some women find that recreational exercise improves their wellbeing, which may help to improve some symptoms of endometriosis.

Surgery: Surgery can be used to remove areas of endometriosis. There are different types of surgery, depending on where the endometriosis is and how extensive it is. How successful the surgery is can vary and you may need further surgery.

Laparoscopic surgery: The gynaecologist removes patches of endometriosis by destroying them or cutting them out.
Laparotomy: If the endometriosis is severe and extensive, you may be offered a laparotomy. This is major surgery which involves a cut in the abdomen, usually in the bikini line.
Hysterectomy: Some women have surgery to remove their womb (a hysterectomy) with or without the ovaries. Depending upon your own situation, your doctor should discuss hormone replacement therapy (HRT) with you if you have your ovaries removed.
What if I am having difficulty getting pregnant?

Getting pregnant can be a problem for some women with endometriosis. Your doctor should provide you with full information about your options such as assisted conception. If you become pregnant, endometriosis is unlikely to put your pregnancy at risk.

Endometriosis - Signs & Symptoms That Indicate 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?

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 woman s reproductive system is an extremely complex one. The uterus which is the main organ with its appendages helps in conception, pregnancy, and childbirth by undergoing marvellous changes. The uterus measures just about 7.5 x 4.5 in a normal woman and expands to accommodate a full-term baby within her during gestation.

The uterus is lined with smooth muscles, and due to unknown reasons, this lining material could be found in other parts of the pelvic organs. This condition is known as endometriosis and is one of the main causes of pelvic pain. Most women suffer through it, and it mostly gets diagnosed when some other issue is being investigated. 

For women with endometriosis, there are mainly two issues to deal with i.e. pain and depression.

Pain: While the pain per se is one issue, the way it affects daily normal life is another thing to be considered. For the pain to minimally affect routine life, the following are effective ways.

Exercise: Anything that you prefer like swimming, jogging, dancing, aerobics, cycling. This will help in stress management and pain relief.
Rest: Get adequate rest of 8 to 9 hours per night. On severely painful days, go ahead and sleep for a couple of hours extra.
Stress management: Whether through yoga or meditation or music, learn to manage stress better. Nobody is without stress but managing it is the key.
Eat healthy and fresh: Whole grains, fresh fruits and vegetables, increased fibres are definitely useful. Reduce whites including sugar, salt, and dairy products if possible.
Social life: Stay connected with people whose company you enjoy   be it family or friends, or even counsellor if required.
Speak up: Let your close circle of friends at work know your problem, so they can help when you need it the most.
Depression and mood swings can be managed in the following ways.

Do what makes you happy: There are some activities which will definitely make you feel better. A quiet walk to get some fresh air. Watching a dance video. Listening to your favourite soundtrack. Changing body language to one without stopped shoulders and frowning foreheads can make a big difference.
Focus on the good: Writing down or thinking about what went well for the day can cheer you up and overcome the blues that is so common in women with endometriosis.
Positive thinking: Instead of saying, I can not try saying I will try. It makes a BIG difference, and you will be amazed at the results.
Keep happy company near you: Surround yourself with happy, positive people and see your happiness quotient go up!!!
Endometriosis is definitely an enigma that is not well known, understood, or identified. However, the above are definitely useful way to cope with it.

Pain & Depression Due To Endometriosis - How To Deal With It? 

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