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? 

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?

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

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!

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!

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!

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