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Endometriosis - Symptom, Treatment And Causes

Endometriosis is an extremely painful disorder where the tissues which lines the inside of the uterus (endometrium) starts growing on the outside of the uterus (womb). Endometriosis usually includes the tissues lining the pelvis, fallopian tubes and our ovaries. During Endometriosis, the endometrial tissues breaks down and bleeds as it normally would. This tissue doesn’t have any way to exit from the body so it gets trapped. Endometriosis causes chronic pain during your periods. Sometimes, fertility can also be affected and it might create issues during conceiving a baby.

What causes Endometriosis?

The exact cause of Endometriosis is not yet known but studies suggest that it can be caused due to some factors such as:

  • Retrograde menstruation- In this condition, menstrual blood that contains endometrial cells usually flow back into the pelvic cavity through the fallopian tubes instead of passing out from the body. These endometrial cells stick to the pelvic organs and pelvic walls where they thicken and start bleeding over the course of the menstrual cycle.
  • Changing of the peritoneal cells- This is also called induction theory. Endometriosis can be caused due to the transformation of peritoneal cells.
  • Embryonic transformation of cells- Hormones like estrogen can transform embryonic cells in the early stages.
  • Surgical scar implantation- After a surgery like C-section or hysterectomy, the endometrial cells can attach itself to a surgical incision.
  • Endometrial cells transport- The tissue fluid (lymphatic) or blood vessels can transport the endometrial cells to other body parts.
  • Immune system disorder- If there is a problem with the immune system, it may make the body impossible to destroy and recognize the endometrial tissue which grows outside the uterus.

Risk factors that make you more susceptible in developing Endometriosis is:

  • Not giving birth.
  • Starting your period very early in life.
  • Having your menopause at a very old age.
  • Menstrual cycle less than 27 days.
  • High levels of estrogen in your body or exposure to a high level of estrogen produced by your body.
  • Low body mass
  • Excessive Alcohol consumption
  • One or more family members having Endometriosis.
  • A medical condition which avoids the passage of menstrual blood out of the body.
  • Abnormalities in the uterus (womb).

The symptoms of Endometriosis can end permanently if you experience menopause and can end temporarily if you get pregnant. Taking estrogen supplements can also trigger Endometriosis in some women.

Treatable by medical professional Require medical diagnosis Lab test always required Chronic: can last for years or be lifelong
Pain in lower abdomen. Lower abdomenal cramps. Menstrual irregularities.

Popular Health Tips

Endometriosis - Signs & Symptoms That Indicate It!

Dr. Priyanka Singh 94% (50 ratings)
MBBS, MS - Obs and Gynae, MRCOG(London), DNB, Fellowship In Uro Gynaecology
Gynaecologist, Mumbai
Endometriosis - Signs & Symptoms That Indicate 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.
1344 people found this helpful

Lady Finger (Okra) for Sexual Health

Gautam Clinic Pvt Ltd 85% (246 ratings)
Sexologist Clinic
Sexologist, Faridabad
Lady Finger (Okra) for Sexual Health
Lady finger Okra is another great natural vegetable that can help your sexual health. It is high in a number of vitamins and also a great source of zinc. As you know zinc deficiency is one of the major sources of erectile problems. Its high vitamin content also helps counter exhaustion and revitalizes sexual vigor. Mens sexual health As mentioned above lady finger (okra) is great for improving sexual health. You can stir fry some okra in butter or you can have the root powder of it with a glass of milk and honey. This will help you with your erections as well as give you sexual stamina. Women s Sexual heath Lady finger is also great for female sexual health. Women who suffer from excessive bleedings during their menstrual cycles or endometriosis can use it for their benefit. Poke holes in two to three okras and put them in a glass of water. Keep them overnight at room temperature and drink the liquid first thing in the morning. Drinking this for a few weeks will help reduce the bleeding during the cycle and also help in other matters of sexual health. Okra is a great vegetable for sexual health and should be included in the diet on a regular basis.
7 people found this helpful

Quality of Life with Endometriosis!

Dr. Hardik Shah 94% (64 ratings)
MBBS, MS - Obstetrics & Gynaecology
Gynaecologist, Ahmedabad
Quality of Life with 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.
4 people found this helpful

Ovarian Cysts And Pregnancy - Understanding The Connection!

Dr. G.K. Bedi 84% (26 ratings)
Gynaecologist, Chandigarh
Ovarian Cysts And Pregnancy - Understanding The Connection!
Are you aware of the connection between ovarian cysts and pregnancy? A woman s ovaries produce eggs and sex hormones, namely estrogen and progesterone. Sometimes, a sac filled with fluid may develop on one of your ovaries. Ovarian cysts are common and are experienced by all women in their lifetime. Commonly, these cysts are painless, accompanied by no specific symptoms. As the cysts grow, symptoms such as swelling or bloating, painful bowel movements, painful sexual intercourse, and pelvic pain during menstrual periods are indicated. Other symptoms like breast tenderness, lower back and thigh pain, nausea and vomiting are also likely. Link between ovarian cysts and pregnancy Ovarian cysts are connected to pregnancy as they are associated with a woman s fertility. Some ovarian cysts which can affect your fertility and hence pregnancy include the following: Endometriomas These are ovarian cysts, which are associated with complications in fertility and occur on account of endometriosis. This is a health condition in which the normal tissue lining around your uterus or the endometrium starts growing outside your uterus. Ovarian cysts occurring because of polycystic ovary syndrome Polycystic ovary syndrome (PCOS) is featured by the development of several small cysts on the surface of your ovaries. Irregular menstrual periods and the increase in levels of certain hormones are indicated. This condition is associated with fertility. It results in irregular ovulation that causes complications in fertility in many women. Ovarian cysts which only affect fertility after becoming large There are some types of ovarian cysts, which do not affect fertility unless they become very large. They are as follows: Functional cysts These cysts include corpus luteum cysts and follicular cysts. These are the most common forms of ovarian cysts. Functional cysts from a usual menstrual cycle do not contribute to infertility in any way. Instead, they indicate the functions, which lead to fertility. Cystadenomas These are developments or growths in your ovaries. They usually occur from the surface of your ovaries. These cysts require treatment, but do not affect fertility in any negative way. Dermoid cysts These are solid cysts containing tissues similar to skin, teeth and hair instead of fluid content. These cysts too are not related to infertility problems during pregnancy. If you are diagnosed with ovarian cysts and are concerned whether they will affect your pregnancy, it is important for you to consult your doctor. You will be able to discuss the various treatment measures, which revive your pregnancy chances.
4145 people found this helpful

Endometriosis and Infertility

Dr. Sujoy Dasgupta 88% (10433 ratings)
MBBS (Gold Medalist, Hons), MS (Obst and Gynae- Gold Medalist), DNB (Obst and Gynae), Fellow- Reproductive Endocrinology and Infertility (ACOG, USA), FIAOG, MRCOG (London, UK)
Gynaecologist, Kolkata
Endometriosis and Infertility
When couples start their family, they have many dreams. Subsequently many of them, if not all, plan to extend their family to give a sense of accomplishment. That is a journey from being couples to being parents. But unfortunately, in some couples the journey is not smooth and some of them have to struggle a lot for it. Yes, you are right. We are talking about difficulty to conceive, popularly known as Infertility . To achieve successful pregnancy, there must be production of sperms, transport of them and proper deposition of them into the vagina by the male partner. In female partner, the deposited perms must travel through vagina and uterus to reach the Fallopian tubes (the tubes that are attached to the both sides of the uterus) where the sperms must meet the egg (ovum). The ovum is produced by the ovary and released into the abdomen at the time of ovulation (rupture of the surface of ovary to release the ovum). That ovum must be taken by the tube and thus inside the tube an embryo (earliest form of the baby) is formed, which then travels through the tube into the uterus and the uterus attaches the embryo firmly with it and thus the pregnancy starts. So, if there is defect in any one of them there will be difficulty in achieving pregnancy. Perhaps you have heard that infertility may be due to problems in male (defect in production, transport or deposition of sperms) or female (defect in ovaries or ovulation, bock in the tubes and defects in the uterus). But sometimes there may be more than one problems in either of the couples or apparently no reason is found (everything is normal, so pregnancy depends on chance factor). To clarify the latter, in normal healthy couples with regular unprotected timely intercourse, the chance of pregnancy in one menstrual cycle is only 15%, so it may be matter of time for some couples to conceive. But another important reason for infertility in female is endometriosis. What is endometriosis? Endometrium is the inner lining of the uterus. It responds to hormones secreted by the ovaries during normal menstrual cycle. It tends to thicken from the time of ovulation (as described above) and if pregnancy occurs, it continues to grow and supports the embryo to help in continuing pregnancy. If pregnancy does not occur, it is shed off outside the body and is seen as menstrual Bleeding or Period . Unfortunately, in some women, the endometrium may be present outside the normal position. That condition is called endometriosis. It is commonly present around the ovaries, tubes, surrounding the uterus (outside normal lining) but may be present anywhere in the body (even in lungs, urinary system and rectum). As this endometrium (outside the uterus lining) also responds to the hormones in the same way as normal endometrium (that lines the uterus), there will be bleeding around this abnormal endometrium at the time of menstruation. But this bleeding, unlike normal menstrual bleeding cannot come outside the body and so the blood accumulates and forms a chocolate coloured material (old blood is chocolate coloured) and leads to adhesion between organs. Adhesion is a condition where different organs of our body attaches abnormally with each other leading to various problems. Sometimes this chocolate coloured blood may be surrounded by a membrane formed by body tissue and is then called Chocolate Cyst that is found around the ovaries. What is the reason for endometriosis? Unfortunately, despite extensive research throughout the world, the reason for endometriosis is not known. It is said to be due to some genetic factors or some environmental factors. Sometimes, delaying pregnancy is stated as the reason. In some women, however, it is caused by backward flow of menstrual blood (that enters into the tubes during menstruation). Usually these women have abnormal development of uterus (problems in uterus since birth), so that all the menstrual blood cannot come outside the body) What is the problem with endometriosis? Endometriosis usually causes pain. The pain may be long standing and usually occurs at the time of periods (dysmenorrhoea) or sometimes even between periods. The nature and site of pain depends on where it is located. If it is located very deep inside abdomen, it can cause pain during sexual intercourse (dysparaeunia). In some cases there may be pain during passing urine or stool or bleeding during urination or with stool. In around 50% cases, it can cause infertility. The cause of infertility is not always properly understood. But it has been seen that endometriosis can cause adhesion and thus can makes it difficult for the Fallopian tubes to pick up the ovum from the ovaries. Apart from this pain during intercourse often makes the woman avoid intercourse. In addition, it can interfere with ovulation, sperm transport, meeting between sperms and eggs and also the process of attachment of uterus with the embryo. However, endometriosis does not always cause pain or infertility. In some women, there may be both pain and infertility, some women only one symptom and in some women no symptom is found but endometriosis is discovered accidentally during treatment for other purpose (like during laparoscopy for appendicitis or during Caesarean Section). How endometriosis is diagnosed? Endometriosis is suspected by history of pain or infertility and examination findings. Like some women may have pain during examination of abdomen or vagina by doctors, even sometimes vaginal ultrasound causes pain. In ultrasonography (or sometimes CT scan is done) there may be presence of cysts or adhesion can be detected. But the Gold standard of diagnosis is laparoscopy. It is an operation where ( Microsurgery ), making a small opening in the abdomen under anaesthesia, a telescope is introduced and the area is seen through camera in a television monitor. At that time the chocolate cysts, adhesions and condition of the organs can be seen and diagnosed and if there is any doubt, biopsy can be taken. But in all cases, laparoscopy is not needed and treatment is started after the doctors presume the diagnosis by history from the patients, examination and the ultrasonography reports. Endometriosis is a peculiar condition in the sense that women with severe endometriosis may not have any symptoms, while women with very mild disease may have severe pain or infertility. How endometriosis is treated, in general? As mentioned earlier, endometriosis does not always cause symptoms and so, it does not always need treatment. The common reason for treatment is presence of pain and infertility. Endometriosis-related pain is usually treated by medicines or sometimes by surgery. Before surgery, usually medicines are given to reduce the size and to reduce the blood loss during surgery. All these medicines can cause hormonal imbalance and thus deprives the endometriosis tissues of hormonal stimulation and thus reduces pain. As a result, during the treatment, patients usually cannot conceive because of this intentional hormonal deprivation. Unfortunately after stoppage of medicines, often the symptoms of pain come back. Surgery for endometriosis is usually done under laparoscopy but it needs properly trained and skilled surgeons to do these operations. Operations can range from minor (like separating the adhesions, draining the chocolate coloured fluid) and major (like removing the cyst or removing major organs). The surgery has the advantage over medicines is that it confirms the diagnosis and removes the diseased tissues. But there are problems with risks related to anaesthesia and surgery. In particular, there is risk of injury to intestine and urinary tracts, even with the best hands, that may increase patient s sufferings. Apart from this, even after surgery, the disease can come back again after few months or years. What is the cure for endometriosis? Only cure for endometriosis is total deprivation of hormones. That is possible if the woman attains menopause (permanent cessation of menses). This is possible by natural way (around 45-50 years of age when menses cease permanently) or by operations to remove the ovaries and uterus. Another simpler way is achieving pregnancy, as usually after pregnancy most endometriosis patients feel better in relation to pain. What happens if it is not treated? Endometriosis is not like cancer. It is not life threatening usually. That means it will make you suffer in the worst way by causing severe pain and infertility but cannot endanger your life. So, you can have the options of not treating it, even if you have the symptoms. And of course, if you do not have symptoms, endometriosis may not require any treatment. What is the treatment for endometriosis with infertility? First of all, you have to make sure that you have difficulty in conception (that means you have given sufficient time to attempt but failed). Then we have to see whether there is any pain or other problems and what the condition of the disease by examination or ultrasonography is. We also have to look for any additional problems like problems in male partner, problems in uterus or ovaries or the hormones (like FSH, LH, prolactin, thyroid etc). Then we have to plan the treatment. As there is no hard and fast rule, your doctor will explain you the options for you and you can decide what suits you the most, after judging merits and demerits of every option. You may choose directly for surgery. In that case, you may be offered medicines for 2-3 months before surgery to make surgery safer for you and easier for the surgeon. The extent of surgery varies, depending on the disease status and your opinion. Remember, your opinion is important. You can choose for extensive operation (that may mean removal of both the tubes, that may be needed in advanced disease, leaving only option for IVF for pregnancy in future) or only diagnosis (just introducing the telescope and see) or minor operations (like separation of adhesions or removal of the cysts), after judging the merits and demerits of each options. But remember, you should not have any medicines for endometriosis after operation as most of the medicines (with some exceptions) interfere with pregnancy. This is, because, after operation is the best time to conceive and that time gives you the highest chance for pregnancy. If natural conception (or 1. ovulation induction- giving medicines to stimulate growth of your eggs, or 2. IUI- inserting your husband s sperms by special process inside your uterus) does not occur within 12 months after operation, that s probably the best time to consider IVF ( Test tube baby ). Of course, if you had extensive surgery or have advanced age (more than 35 usually), your doctor may advise you to go for IVF directly after operation without wasting the time. You can opt for trial of treatment by medicines. You must know why I have used the word Trial . This is because, during medicine treatment, you cannot conceive. But you will be seen after 2-3 months to see if the disease has disappeared or decreased in size significantly. If this is the case, you can start infertility treatment (Ovulation Induction or IUI or IVF in some cases) directly. But if the disease did not respond to medicines by this time, you may need surgery, the extent of which has been described above. You also have the options of not treating endometriosis at all. In that case, you can request your doctor to start infertility treatment directly. But remember, endometriosis (even treated endometriosis- after medicines or surgery) can interfere with any form of infertility treatment. It can lead to decreased response to medicines used for ovulation induction, thus reducing success rate(normal success rate is 20-25% in a menstrual cycle- that is without endometriosis). It can lead to low success rate after IUI (normal success rate is 25-30% in a menstrual cycle). Even with IVF (where normal success rate is 40-50% per cycle of IVF), the effectiveness of IVF may be reduced in presence of endometriosis. What if I do not go for any treatment at all? Infertility is a peculiar thing. Very few men or women are absolutely infertile. That means they do not have ability to achieve pregnancy naturally. Majority of them are subfertile. That means most of them have lower than normal chance (compared to healthy couples) to achieve pregnancy in a normal menstrual cycle. Often we find that patients planning for treatment and in the meantime, they conceive naturally. That means even without treatment, there is some chance of pregnancy. But that chance decreases in presence of any disease (like endometriosis) or increased age. And of course, nobody usually relies on chance. But the important message is that do not forget to have regular sexual intercourse eve if you are awaiting any test or endometriosis treatment. Of course, it s stressful situation for both the partners. Stress affects conjugal relationships and lead to many couples avoiding conjugal life. Indeed, stress can affect the hormone levels in females and affects sexual performances in males. It s easier for us to advise you to stay stress-free but is difficult to practice. Nevertheless, try relaxation as much as possible. Think that majority of the couples ultimately conceive by some form of treatment. Have faith in yourself and have faith in your doctor.
5 people found this helpful

Popular Questions & Answers

My endometrial thickness is developing 7.5 at day 19 and zone 2 level is also not developed. I wants that my endometrial thickness will going on 9 at day 14. For this what can I do?

Dr. Girish Dani 90% (2843 ratings)
MD - Obstetrtics & Gynaecology, FCPS, DGO, Diploma of the Faculty of Family Planning (DFFP)
Gynaecologist, Mumbai
There are different options and which option to utilise depends on medical history, examination findings, other reports and goal to achieve. Best is let treating Gynecologist or infertility specialist decide that.

I want to ask that is impression of histopathology shows nonseceretory endometrium with evidence of shedding what it mean?Please help me for that.

Dr. Surbhi Agrawal 89% (19078 ratings)
General Physician, Nashik
Non secretory endometrium refers to a phase of the menstrual cycle before ovulation. The endometrium becomes secretory after ovulation under the influence of progesterone.

I am 66 years old . Suffered Ca cervix in 2001. Took cobalt therapy in 2001. Now Ct scan shows metastasis in endometrial and inguinal lymph nodes. Chemotherapy suggested 1st cycle complete. Suggest how many cycles .weather radiation will also be required.

Dr. Deepak P Kumar 91% (60 ratings)
MD - Radiothrapy
Oncologist, Mumbai
Chemotherapy is the treatment of choice. If there is good response to chemotherapy and there is limited local and regional disease after chemotherapy then reirradation should be considered.

I have polyps in fundic endometrium I am 26 years married women trying for baby since 6 years I am on homeopathic treatment I want to know what is polyps.

Dr. Sarika Dahiphale 90% (781 ratings)
Mbbs,, MS OBGY
Gynaecologist, Pune
Please go for hysterscopic removal of polyp. Conception will not be possible without it. Meet a good fertility expert at your place.
1 person found this helpful

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What Is Endometriosis - How To Manage It?

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