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?

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?

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

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?

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!

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?

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