Endometriosis is a common disorder where tissue similar to the one that lines the inside of the uterus (endometrium), starts to grow outside the uterus. It generally grows on the ovaries, bowel, and tissues lining your pelvis, though it rarely also grows beyond the pelvis region. The tissue on the outside behaves like the endometrium, i.e. it thickens, disintegrates, and bleeds out every menstrual cycle. Endometriosis is generally more common in women who are experiencing infertility but the condition itself does not necessarily cause infertility.
Though pelvic pain is the most significant symptom, you may experience other symptoms such as:-
- Painful periods or dysmenorrhea
- Pain during intercourse
- Excessive bleeding or bleeding in between periods
- Pain during bowel movement or urination
The pain intensity may vary during different months and from woman to woman. It does not necessarily mean that women with only these symptoms are suffering from endometriosis. There have been cases where during laparoscopic examinations for infertility, implants have been found in completely asymptomatic women.
For diagnosis of endometriosis, a doctor may use a physical examination of ultrasound to rule out the possibility of other diseases but the only accurate method for diagnosis is surgical where laparoscopy is the most common procedure.
Though there is no definitive treatment for endometriosis, medications or surgical procedures can be performed to ease the symptoms and avoid any potential future complications. Some of the treatment methods are as follows:-
- Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) can be used with consultation for the doctor to reduce pelvic pain and cramping.
- Often doctors prescribe Gonadotropin-releasing hormone analogues (GnRH analogues) to reduce the size of endometriosis implants.
- Hormonal treatment – Danazol is a common synthetic drug used for this purpose. It creates a high androgen and low estrogen environment but this drug has significant side effects such as weight gain and acne.
- Conservative surgery – This option is for women who experience significant pain or want to get pregnant and for whom hormonal treatments aren’t working. In conservative surgery, the uterus and ovarian tissues are preserved.
- Hysterectomy (removal of the uterus) with or without the removal of the ovaries is also a last resort option.
While surgical treatments can be effective in reducing the pain but rate of recurrence of endometriosis following conservative surgery can be as high as 40%. Therefore most doctors recommend treatment via medication.
Dr. Usha Agarwal | Senior Consultant – Gynaecology | Narayana Multispeciality Hospital, Jaipur