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?

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

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 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!

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

Endometriosis is a painful disorder wherein, a tissue that normally belongs to the inside of a woman s uterus, starts to grow out of the uterus. It common involves a woman s ovaries, fallopian tubes and the tissue, which lines the pelvis. In case of endometriosis, the displaced endometrial tissue continues to act like normal, becomes thick, breaks down and leads to bleeding with each menstrual cycle. Endometriosis can lead to pain, which might be severe especially during a woman s period. 

Causes of Endometriosis:

Embryonic Cells Getting Transformed: Hormones like estrogen might transform the cells, which are in the early stage of development, into implantation of endometrial cells at the time of puberty. 
Surgical Scar Implantation: After undergoing a surgery like a hysterectomy or C-section, the endometrial cells might get attached to the incisions done for conducting the surgery. 
Transport of Endometrial Cells: The tissue fluid system or the blood vessels might transport the endometrial cells to different parts of the body. 
Let us take a look at some of the symptoms of endometriosis: 

Periods which become painful 
Pain suffered during or after the intercourse. 
Feeling of pain during bowel movements 
Excess bleeding 
Infertility 
Possible location of endometriosis: 

Ovaries(the most common site) 
Fallopian tubes 
Back of the uterus 
Front of the uterus 
Uterine ligaments such as the broad or round ligament of the uterus 
Pelvic walls 
Intestines 
Urinary bladder and ureters 
Investigations Required in Endometriosis 
The investigations required in endometriosis are as follows: 

Pelvic Exam   In this exam, a doctor manually tends to feel certain areas in pelvis for any kind of abnormality like cysts or the reproductive organs or scars behind the uterus. 
Ultrasound   High-frequency sound waves are used to create certain images inside the body, through capturing them via a device known as transducer and getting it pressed against a woman s abdomen.
MRI   MRI by way of magnetic field and radio waves help to get detailed images of the tissues and organs in the body. 
Laparoscopy Endometriosis through the eyes of ayurveda: The signs and symptoms mentioned in endometriosis are described in ayurveda under the heading of vataja yonivyapadh and udavartha. 
Apana Vata is considered as the main functioning agent to maintain normal menstruation. 
This is vitiated due to sedentary life style, lack of exercise, sleep, irregular sleep, stressful professional atmosphere, mental tensions and unhealthy food habits. 
The deranged apana vata causes retrograde menstruation leading to endometriosis. Along with this, the other two doshas-pitta and kapha are vitiated leading to hormonal imbalance and abnormal growth of endometrium respectively. Hence, the first and foremost step is to restore the physiology of these doshas. 
What are shodhanas? 
Shodhanas are detoxifying procedures like snehana, svedana, vamana, virechana and basti. Benefits of shodhana in female reproductive system: 

Biological systems return to normalcy. 
Revitalizes body tissues 
Potentiates pharmacological actions of internal medicines 
Removes toxins 
Improves physiological functions and gut absorption. 
Also, improper metabolism is corrected 

Mental faculties, strength and vitality are enhanced 
Fine tunes the endocrine system (hormonal balance correcting hypothalamus-pituitary-ovarian axis). 
Promotive-promotes fertility, preventive-prevents recurrence and curative- cures from the root and rehabilitative too. 
Ayurvedic Treatment for Endometriosis 
Endometriosis s treatment in Ayurveda requires an anti-Pitta diet and regimen, where there would be complete avoidance of all spices, except coriander, turmeric and saffron. One must also refrain from having 

Salt 
Alcohol 
Refined sugar 
Good herbs might get included in the form of: 

Shatavari 
Kumari Saar 
Kanchanar 
Ashoka 
Lodhra 
Pradranta Churna 
As per Ayurveda, Endometriosis happens as a result of more Kapha due to increased growth of the uterine membrane. Anti-kapha, anti-tumor and general detoxification can be helpful along with some typical herbs like Guggul, Myrrh, Turmeric and Dandelion. 

How can Diet and Yoga help to improve Endometriosis? 
Modifications in diet by switching to the intake of healthy foods and Yoga can help to a great extent in improving Endometeriosis. Some of the diet tips include: 

Avoiding foods like cakes, donuts and fries that contain trans fats. 
Cut down on consumption of red meat. 
Have lots of fruit, vegetables and whole grains 
Put a check on consumption of caffeine and alcohol 
Reduce the intake of processed foods. 
Impact of Yoga 
Yoga s positive impact in treating endometriosis includes: 

Yoga, with its structured approach towards the body help reduce the symptoms of emdometriosis, while improving the general functioning of the body & oxygenation to the organs. 
Women, who have tried out Yoga in order to decrease pain, also observed that there has been an improvement in their condition through healing. 
Control in the breathing exercises decrease anxiety and a general sense of well-being is promoted. 
Yoga helps to ease out menstrual pain, improves fertility and helps in bringing about hormonal balance.

Endometriosis - A Possible Therapy In Ayruveda!

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