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Endometriosis Tips

Endometriosis - Symptoms And Treatment!

Dr. Noopur Sharma 88% (10 ratings)
MBBS Bachelor of Medicine and Bachelor of Surgery, MS
Gynaecologist, Ghaziabad
Endometriosis - Symptoms And Treatment!

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.

  1. 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.
  2. 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.
  3. 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.
  4. 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.

1 person found this helpful

Endometriosis & Severe Menstrual Pain

MD - Obstetrics & Gynaecology, DGO, MBBS , FCPS, DNB, FICOG, LLB
Gynaecologist, Mumbai
Endometriosis & Severe Menstrual Pain

The tissue lining the walls of the uterus is known as the endometrium. This tissue is typically contained within the uterus but if it grows outside the uterus, it can cause terrible abdominal pain. This condition is known as Endometriosis. Endometriosis can involve the endometrium tissue spreading into the ovaries, fallopian tubes, and the pelvic area. In rare cases, it may spread to other organs in the pelvic area as well. If the displaced endometrium tissue affects the ovaries, it can also lead to the development of cysts known as endometriomas. 

Typically, the endometrium tissue inside the uterus thickens during the menstrual cycle and breaks down when a woman gets her period. In the case of endometriosis, the tissue growing outside the uterus behaves in the same way as the tissue growing within the uterus. However, when it breaks down, the displaced tissue has no way of exiting the body. Thus it irritates the surrounding tissue and eventually turns in to adhesions and scar tissue which in turn causes the internal organs of the pelvic area to stick to each other. This is the primary cause of pain associated with Endometriosis. It may also cause fertility issues. 

Many women complain of cramps during their menstrual periods but for women suffering from endometriosis, the pain is much more intense. This pain also usually increases with time. Menstrual cramps associated with endometriosis may begin before the period starts and persist even after the woman’s period is over. It may also be accompanied by lower back pain. Let's know its symptoms- 

  1. Painful periods (dysmenorrhea). 
  2. Pain with intercourse. 
  3. Pain with bowel movements or urination. 
  4. Excessive bleeding 

Other symptoms- 

  1. Fatigue 
  2. Diarrhea 
  3. Constipation 
  4. Bloating or nausea, especially during menstrual periods. 

The severity of pain is not always in direct relation to the severity of endometriosis. Some women may suffer from advanced endometriosis but experience slight pain while in other cases; women suffering from a mild form of endometriosis may experience severe pain. Some women may also experience no pain at all. 

Thankfully this pain can be easily managed. In most cases, over-the-counter pain relievers are effective enough. If these medicines are not effective, the patient may be advised to undergo hormone therapy. This slows down the growth of endometrial tissue and keeps new tissue from growing outside the uterus. In cases of severe pain, surgery may be needed to remove the endometrial tissue growing outside the uterus. This procedure may be performed laparoscopically.

643 people found this helpful

Endometriosis - Does Laparoscopic Surgery Help?

MD, MBBS
Gynaecologist, Ahmedabad
Endometriosis - Does Laparoscopic Surgery Help?

Laparoscopy is one of the most common procedures for diagnosing and removing endometriosis. Instead of giving a big incision, this procedure of surgery uses lightweight instrument through a small hole or incision. There could be one or more incisions based on the number of instruments that require access inside the body.

This procedure involves the use of a camera to ascertain endometriosis as well as treat it in the same sitting. This brings drastic improvement in infertility as well as pain associated with the endometriosis. If a cyst is found in the ovary, laparoscopic surgeon removes it very delicately without causing any harm to the normal ovary, as a part of the Laparoscopic Surgery for Endometriosis. 

How does the procedure go? 

Eating and drinking should be suspended before 8 hours of the laparoscopic surgery. The doctor takes a call on whether to give a general or local anesthesia. Mostly, General anaesthesia is given during such procedures. A person specialised in Gynecological Endoscopy ( Gynaec Laparoscopic Surgeon) is the best to perform such a procedure. 

How is the procedure performed? 

The abdomen is first inflated with gas with the help of a needle. It pushes the abdominal wall from the organs to give a clear visibility to a surgeon. The laparoscopic Camera is then pushed through an incision or a set of incisions to examine the internal organ. If the scar tissue or endometriosis needs to be removed, a doctor can use one of the several laparoscopic techniques such as electrocautery, excision etc. Post the surgery, the incision is closed with stitches. The whole procedure usually takes 30-60 minutes depending upon the severity of endometriosis. 

Why is laparoscopy done? 

  1. If the endometriosis pain has returned after a hormone therapy 
  2. If there is a growing endometriotic cyst 
  3. If the scar tissue found on the pelvic wall poses a threat on fertility 
  4. If the endometriosis interferes with other organs such as the bladder etc. 
  5. If the pain during menses ( dysmenorrhoea) refuses to subside 

Duration of hospital stay: 
Operations such as these are usually conducted at the outpatient facility owing to their less risky nature. A patient need not spent more than a day in the hospital. Rarely in severe cases of endometriosis overnight hospitalisation may also be required. One can successfully return to normal work within 1 week of the surgery. 

Post-surgical recovery: Once the laparoscopy is done, the next steps of treatment are decided based on the patient's age and severity of endometriosis. Few hormonal medicines are advised according to the desire for fertility etc. If a patient is over and above 35 years of age, the risk of miscarriages double. Since the quality of egg declines by the year, it makes sense to undergo infertility treatment such as the in vitro fertilization (IVF), intake of fertility drugs, insemination etc.

If, however, the patient is below 35 years of age, makes sense to conceive naturally first and consult a doctor simultaneously. A routine check-up post-laparoscopic surgery on alternate six months for a year will keep any risks at bay.

4302 people found this helpful

Endometriosis - Ways To Manage It Well!

MBBS, MS - Obstetrics & Gynaecology & Fellowship In Fertility ( IVf Specialist ), Dnb - Obstetrics & Gynaecology, MRCOG - Part 1, PGDMLS
Gynaecologist, Thane
Endometriosis - Ways To Manage It Well!

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:

  1. Age of female
  2. Severity of symptoms
  3. Duration of the symptoms
  4. Future plans for children/ fertility
  5. Associated pathologies

Accordingly the doctor might choose any of the treatment options like:

  1. 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)
  2. Hormone Therapy: Hormone therapy is effective, but once you stop them, your symptoms may recur. Some of the hormone therapies include: 
    1. Hormonal Contraceptive pills: Useful in controlling the hormones that are responsible for endometrial tissue growing outside the uterine cavity.
    2. MedroxyprogesteroneThis helps to counter effect estrogen hormone which is responsible for endometrial tissue growth.
    3. 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.
    4. 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.
    5. Dienogest: This newer progesterone molecule, which does not have major side effects and is apporved for use in endometriosis.
    6. Other medications like selective progesterone receptor modulators, immunomodulators, anti angiogenic factors are being evaluated.
  3. 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.
  4. Hysterectomy: In severe endometriosis cases where female has completed her family, hysterectomy is offered wherein the uterus, cervix & if required ovaries can be removed.
3806 people found this helpful

Endometriosis - How Does It Lead To Infertility?

MBBS, MS - Obstetrics and Gynaecology
IVF Specialist, Hyderabad
Endometriosis - How Does It Lead To Infertility?

The uterine cavity has a tissue base that is known as the endometrium. When this endometrium spills over or spreads to the other parts of the reproductive organ, it begins to punch through the uterine lining. Such a condition creates complications and even infertility, and is known as endometriosis.

Read on to know more about endometriosis and how it can cause infertility.

Endometriosis

When the endometrium tissue spreads to areas like the ovaries, and the abdominal cavity, it can lead to numerous complications. Apart from pain, this may also cause infertility. 5 to 10% of the women worldwide suffer from this condition and have trouble conceiving. Additionally, about 30 to 40% of the infertility cases are due to endometriosis, not all cases. These figures are all confirmed by various medical studies.

How does it cause infertility?

Endometriosis can prevent ovulation, which is the process that occurs every month. During the ovulation process, the ovaries release eggs that may be fertilised in order for the woman to conceive. In this condition, the fimbria of the fallopian tubes also has trouble in capturing the egg, which prevents conceptionfrom taking place. This leads to infertility in the long run. Endometriosis also interferes with the proper production of the hormones that are required for normal ovulation and fertilisation of the egg.

Diagnosis: The diagnosis of the condition can be done with the help of lab tests and ultrasounds as well as imaging tests that can create the image of the womb and the endometrium lining. This will help in showing the severity and damage caused by the tissue. A surgical procedure called a laparoscopy may be carried out by the doctor to ascertain whether the patient is suffering from this condition. In this procedure, a small incision will be made and a camera will be inserted to view the insides on a screen, to learn more about the tissue’s spread and the kind of treatment that will be required. The doctor will also diagnose the condition on the basis of various symptoms like irregular and heavy bleeding.

Treatment:

Treatment for endometriosis associated with infertility needs to be individualized for each woman. There are no easy answers, and treatment decisions depend on factors such as the age of the woman, the severity of the disease and its location in the pelvis, the length of infertility, and the presence of pain or other symptoms. Some general issues regarding treatment are discussed below.

Treatment for Mild Endometriosis

Medical (drug) treatment can suppress endometriosis and relieve the associated pain in many women. Surgical removal of lesions by laparoscopy might also reduce the pain temporarily.

However, several well-controlled studies have shown that neither medical or surgical treatment for mild endometriosis improving the pregnancy rates for infertile women as compared to expectant management (no treatment).

For treatment of infertility associated with mild to moderate endometriosis, controlled ovarian hyperstimulation with intrauterine insemination - IUI is often attempted and has a reasonable chance to result in pregnancy if other infertility factors are not present.

Details about IUI success rates with endometriosis

IUI and endometriosis

Success rates with IUI for endometriosis have been variable in studies, showing:

  • A pregnancy rate of 6.5% for women with endometriosis vs. 15.3% per cycle for unexplained infertility
  • A pregnancy rate of 5.6% for women with advanced endometriosis vs. 22.7% per cycle for mild endometriosis vs. 25.7% for no endometriosis
  • Pregnancy chances with insemination for natural cycle IUIs (no drugs) with endometriosis are about 2% per cycle vs. 11% with injectables plus IUI for endometriosis

Treatment for severe endometriosis

Several studies have shown that medical treatment for severe endometriosis does not improve pregnancy rates for infertile women.

Unfortunately, infertility in women with severe endometriosis is usually resistant to treatment with ovarian stimulation plus intrauterine insemination. If the pelvic anatomy is very distorted, artificial insemination is unlikely to be successful. These women often require in vitro fertilization in order to conceive.

Although the studies of in vitro fertilization for women with severe endometriosis do not all show similar results, pregnancy success rates are usually good if the woman is relatively young (under 40) and if she produces enough eggs during the ovarian stimulation.

2868 people found this helpful

Endometriosis - Different Stages Of It!

MD
Gynaecologist, Mumbai
Endometriosis - Different Stages Of It!

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.

  1. 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.
  2. 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.
  3. 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.
  4. 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.

3 people found this helpful

Symptoms, Stages and Treatment of Endometriosis

MBBS, MD - Obstetrtics & Gynaecology
IVF Specialist, Nashik
Symptoms, Stages and Treatment of Endometriosis

Endometriosis is a condition where the endometrial tissue lining the womb, grows outside the uterus 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.

1) Minimal Stage - 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.

2) 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.

3) 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.

4) 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

Gonadotrophin 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 stop 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

2670 people found this helpful

एंडोमेट्रियल मोटाई क्या होता है - Endometrial Motai Kya Hota Hai!

Bachelor of Ayurveda, Medicine and Surgery (BAMS)
Ayurveda, Lakhimpur Kheri
एंडोमेट्रियल मोटाई क्या होता है - Endometrial Motai Kya Hota Hai!

एंडोमेट्रियल मोटाई अंतर्गर्भाशयकला यानि एंडोमेट्रियम की मोटाई है जिससे यह निश्चित किया जाता है कि महिला का गर्भाशय गर्भधारण करने योग्य है या नहीं. अंतर्गर्भाशयकला गर्भाशय का आंतरिक परत है जो रक्त वाहिकाओं में समृद्ध एक म्यूकोसा है. इसका मुख्य कार्य गर्भाशय गुहा में अंडे के निषेचन के लिए अनुकूल परिस्थिति का निर्माण करना है. इसके अलावा यह सभी महिलाओं में मासिक धर्म के समय खून के बहने में मुख्य भूमिका निभाता है.

एंडोमेट्रियम यानि अंतर्गर्भाशयकला में दो परतें होती है – बेसल और कार्यात्मक. ये दोनों परतें हार्मोन्स के कार्रवाई के बाद मासिक चक्रीय परिवर्तन से होकर गुजरती है. कार्यात्मक परत की एक क्रमिक टुकड़ी होती है जो माहवारी के दौरान टूटती है जिसके परिणाम स्वरूप रक्त वाहिकाएँ नष्ट हो जाती हैं और इसी कारण मासिक धर्म के समय रक्तस्राव होता है. मासिक धर्म (माहवारी) के अंत तक एंडोमेट्रियम की मोटाई काफी पतली रहती है. इसके बाद बेसल परत के पुनर्योजी क्षमता के कारण उपकला कोशिकाओं की मात्रा व ऊपरी परत के कोशिकाओं का फिर से बढ़ना शुरू हो जाता है. एंडोमेट्रियल मोटाई यानि एंडोमेट्रियम की मोटाई मासिक से पहले की अवधि में यानि ओव्यूलेशन के तुरत बाद अधिकतम आकार की होती है. इसी मोटाई से पता चलता है कि गर्भाशय गर्भधारण के लिए तैयार है या नहीं. इसी समय गर्भाशय के गुहा तक निषेचित अंडे पहुँचती है. यदि अंडा निषेचित नहीं होती है तो अगली माहवारी के दौरान कार्यात्मक परत फिर से छिलने लगती है और मासिक धर्म के अंत तक एंडोमेट्रियल मोटाई काफी पतली हो जाती है.

चक्र के दिनों की एंडोमेट्रियल मोटाई
मासिक धर्म चक्र के अवधि में एंडोमेट्रियल मोटाई में बदलाव होते रहता है. समान्यतः इसकी मोटाई 0.5 सेमी से 1.5 सेमी तक हो सकती है. मासिक धर्म (महवारी) के दौरान इसकी मोटाई न्यूनतम रहती है. यदि मासिक धर्म के अवधि में इसकी मोटाई अधिक है तो यह एक अप्रिय व गंभीर लक्षण हो सकता है. एंडोमेट्रियम के मोटा होने की घटना को हाइपरप्लासिया कहा जाता है. ऐसी स्थिति होने पर इसका उपचार किया जाता है. आइये जानते हैं कि मासिक धर्म चक्र के किस अवधि में एंडोमेट्रियम की मोटाई समान्यतः कितनी रहती है.

मासिक चक्र के शुरुआत के समय में एंडोमेट्रियल मोटाई: - मासिक चक्र के शुरुआत के समय यानि जब खून बहना शुरू हो रहा होता है उस समय एंडोमेट्रियल मोटाई समान्यतः 0.5 सेमी से 0.9 सेमी तक होती है. 3-4 दिन के मासिक धर्म के बाद एंडोमेट्रियल मोटाई 0.3 सेमी से 0.5 सेमी तक रहता है.

मासिक चक्र के बीच के समय में एंडोमेट्रियम मोटाई: - मासिक धर्म चक्र के 5-7 दिनों में एंडोमेट्रियल मोटाई 0.6 सेमी से 0.9 सेमी तक रहता है. वहीं मासिक धर्म बाद 8-10 दोनों में यह 0.8 सेमी से 1 सेमी तक तथा 11-14 दिनों में 0.9 सेमी से 1.3 सेमी तक रहता है.

मासिक धर्म चक्र के अंत का समय में एंडोमेट्रियम मोटाई: - मासिक धर्म चक्र के 15 से 18 दिनों के समय एंडोमेट्रियल मोटाई 1 सेमी से 1.3 सेमी तक तक मासिक धर्म चक्र के 19 से 23 दिनों के मध्य यह मोटाई 1 सेमी से 2.1 सेमी तक रहती है. फिर मासिक धर्म चक्र के 24 से 27 दिनों के समय में अंतर्गर्भाशयकला आकार में छोटी होती जाती है और इस समय एंडोमेट्रियल मोटाई 1 सेमी से 1.8 सेमी तक हो जाती है.

रजनोवृत्ति के साथ एक महिला के एंडोमेट्रियम की मोटाई
उम्र बढ्ने पर महिला में रजनोवृत्ति के स्थिति में प्रजनन कार्य समाप्त हो जाती है. इस समय सेक्स हर्मोन की कमी देखी जाती है. रजनोवृत्ति के स्थिति में एंडोमेट्रियम की सामान्य मोटाई 0.5 सेमी से अधिक नहीं होनी चाहिए. यदि इस समय यह मोटाई 0.8 सेमी होती है तो महिला को इलाज कराने की जरूरत होती है.

1 person found this helpful

एंडोमेट्रिओसिस क्या है? - Endometriosis Kya Hai?

Bachelor of Ayurveda, Medicine and Surgery (BAMS)
Ayurveda, Lakhimpur Kheri
एंडोमेट्रिओसिस क्या है? - Endometriosis Kya Hai?

एंडोमेट्रिओसिस एक बेहद दर्दनाक विकार है, इस बीमारी से दुनिया भर में करोडो महिलाओं जूझ रही हैं. और सबसे हैरानी की बात यह है की दर्दनाक समस्या होने के बाद भी लोगों को ज्यादा जानकारी नहीं है. एक आकड़े के मुताबिक, हर 10 महिला में 1 महिला एंडोमेट्रिओसिस समस्या से पीड़ित है. ज्यादातर एंडोमेट्रिओसिस से पीड़ित महिलाएं 12 वर्ष से 40 वर्ष की महिलाएं पीड़ित होती है.
एंडोमेट्रिओसिस एक बहुत ही गंभीर समस्या है जिसमें महिलाओं के गर्भाशय के अंदर की ऊतक गर्भ के बाहर फैलने लगता है. यह आमतौर पर श्रोणि, फैलोपियन ट्यूब और हमारे अंडाशय को अस्तर में ऊतक शामिल करता है। एंडोमेट्रोसिस के दौरान, एंडोमेट्रियल ऊतक टूट जाते हैं और ब्लीडिंग होने लगती हैं। यह ऊतक अंडाशय, फैलोपियन ट्यूब या गर्भाशय के बाहरी हिस्सों में और अन्य आंतरिक भागों में फ़ैलता है. एंडोमेट्रिओसिस समस्या के कारण मासिक धर्म के दौरान दर्द होता है. यह आपकी प्रजनन को भी प्रभावित करती है.

एंडोमेट्रिओसिस के चरण
पहला चरण: -
एंडोमेट्रिओसिस के पहले चरण में सतही प्रत्यारोपण होते हैं. ये प्रत्यारोपण गर्भाशय के आसपास के ऊतकों में जलन और सूजन का कारण बनते हैं जिससे चिपकाव होते हैं. यह चिपकाव ऊतकों और अंगों को बांधते हैं जिससे दर्द होता है और उनके कार्य करने की क्षमता में कमी आती है.
दूसरा चरण: - ज्यादातर महिलाओं में हल्के एंडोमेट्रिओसिस का उपचार किया जाता है. इस चरण के लक्षण भी पहलें चरन के सामान ही होते हैं लेकिन वह और भी ज़्यादा गंभीर होते हैं. इसमें गंभीर रेशेदार चिपकावों के ऊपर काले धब्बे दिखाई देते हैं जिससे ओव्यूलेशन के दौरान दर्द या श्रोणि में दर्द होता है. दूसरे चरण के दौरान गर्भाशय और मलाशय के बीच के हिस्से में घाव हो जाते हैं.
तीसरा चरण: - इसके तीसरे चरण में एंडोमेट्रीओमास को देखा जाता हैं. इस स्थिति में रसोली के फटने पर बहुत ज्यादा पेट दर्द और श्रोणि में सूजन हो जाती है. इसके कारण चिपकाव और भी ज़्यादा होते हैं. एंडोमेट्रिओसिस के आकार और संख्या में वृद्धि के आधार पर चिपकाव भी बढ़ जाते हैं.
चौथा चरण: - एंडोमेट्रिओसिस के आखिरी स्टेज में अल्सर और गंभीर चिपकावों की मात्रा में वृद्धि हो जाती है. इस स्टेज में एंडोमेट्रीओमास का अकार अंगूर के आकार जितना बड़ा हो जाता है. यदि एंडोमेट्रीओमास 2 सेमी से ज़्यादा के आकार की होती है तो उसे सर्जरी द्वारा हटाया जाता है. इस चरण में महिलाओं को पाचन समस्याएं, मल त्यागके दौरान दर्द, मतली/उल्टी, कब्ज़ और पेट दर्द होते हैं. इसके अलावा, चौथे चरण में बाँझपन की समस्या भी उत्पन्न हो सकता है.

एंडोमेट्रिओसिस के लक्षण
* मासिक धर्म के दौरान दर्द
* बिना मासिक धर्म के श्रोणि के हिस्से में दर्द होना
* यौन सम्बन्ध बनाते समय दर्द होना
* बाँझपन
* थकान

एंडोमेट्रिओसिस के कोई भी निश्चित कारण नहीं हैं, लकिन कुछ संभावित कारण है जो निम्नलिखित है:
* रेट्रोग्रेड मासिक धर्म-
इस स्थिति में, मासिक धर्म रक्त जिसमें एंडोमेट्रियल कोशिकाएं होती हैं. आमतौर पर शरीर से बाहर निकलने के बजाय फैलोपियन ट्यूबों के माध्यम से श्रोणि गुहा में वापस आती हैं. ये एंडोमेट्रियल कोशिकाएं श्रोणि अंगों और श्रोणि दीवारों से चिपके रहते हैं जहां वे मासिक धर्म चक्र के दौरान मोटा होना शुरू कर देते हैं.
* पेरिटोनियल कोशिकाओं को बदलना - इसे प्रेरण सिद्धांत भी कहा जाता है. पेरोटोनियल कोशिकाओं के परिवर्तन के कारण एंडोमेट्रोसिस का कारण बन सकता है.
* कोशिकाओं के भ्रूण परिवर्तन- एस्ट्रोजेन जैसे हार्मोन शुरुआती चरणों में भ्रूण कोशिकाओं को बदल सकते हैं.
* सर्जिकल निशान इम्प्लांटेशन- सी-सेक्शन या हिस्टरेक्टॉमी जैसी शल्य चिकित्सा के बाद, एंडोमेट्रियल कोशिकाएं खुद को सर्जिकल चीरा से जोड़ सकती हैं.
* एंडोमेट्रियल कोशिका परिवहन- ऊतक तरल पदार्थ (लिम्फैटिक) या रक्त वाहिकाओं एंडोमेट्रियल कोशिकाओं को अन्य शरीर के अंगों में ले जा सकते हैं.
* प्रतिरक्षा प्रणाली विकार- यदि प्रतिरक्षा प्रणाली में कोई समस्या है, तो यह शरीर को गर्भाशय के बाहर बढ़ने वाले एंडोमेट्रियल ऊतक को नष्ट करना और पहचानना असंभव हो सकता है.

एंडोमेट्रोसिस के लक्षण स्थायी रूप से समाप्त हो सकते हैं यदि आप रजोनिवृत्ति का अनुभव करते हैं और अगर आप गर्भवती हो तो अस्थायी रूप से समाप्त हो सकते हैं. एस्ट्रोजन की खुराक लेना कुछ महिलाओं में एंडोमेट्रोसिस को भी ट्रिगर कर सकता है.

Finding The Right Treatment For Your Endometriosis!

MBBS, MS - Obstetrics and Gynaecology, MRCOG
Gynaecologist, Kolkata
Finding The Right Treatment For Your Endometriosis!

Endometriosis is a condition that affects women, where the endometrium or the tissue lining the inside of the uterus, also starts growing on the outside. It is greatly painful and may affect everyday life largely. Here is a look at how the condition is diagnosed and how it can be treated.

Diagnosis of Endometriosis
Diagnosing the disorder can involve a few tests. Patients who visit the doctor, usually complain about the pain experienced during sexual intercourse or urination. The doctor will ask you a few questions regarding the symptoms that you experience and the general area where you feel the pain.

  1. Pelvic Exam- This is the first test that the doctor may perform to determine the cause of the problem. The doctor will manually look for cysts and other abnormalities in the pelvic region. However, this examination is often inconclusive.
  2. Ultrasound- High frequency sound waves are used to detect any abnormalities during this test. However, an ultrasound is only capable of revealing cysts, in the absence of which endometriosis cannot be confirmed through this test.
  3. Laparoscopy- In this slightly invasive procedure, the doctor will use a specialized equipment to look inside the uterus. However, the condition is generally medically managed, before a laparoscopy is ordered, as the procedure involves some risks.

Treating Endometriosis
Endometriosis treatment relies on both medication and surgery. Since the symptoms and intensity of the problem differs from one woman to the next, finding the right drug to use may be challenging. Here is a detailed look at the treatment options for Endometriosis.

  1. Pain medications- Over-the-counter pain medications can help deal with some of the discomfort that accompanies endometriosis. However, since the intensity of pain varies from one patient to the next, the correct dosage for medications may be difficult to determine. Patients will need to report whether the current dosage of medicine is working or whether a higher dosage may be required.
  2. Hormone therapy- Supplementing certain hormones in the body may provide relief from the pain in some cases. Hormonal contraceptives, progestin therapy and hormone altering drugs are used.
  3. Hysterectomy- In case of severe Endometriosis, women who do not want to conceive can consider surgically removing their uterus. This is usually the last resort.

Ensure that you find a doctor whom you trust completely when you are diagnosed with the condition. Treatment becomes much simpler under the care of such a physician.

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