WHAT IS ENDOMETRIOSIS?

Endometriosis is a medical condition faced by many women during their childbearing years. In this condition, the lining of the uterus, called the endometrium, grows at other places such as the fallopian tubes, ovaries or along the pelvis.  This does not always cause symptoms. And it usually isn't dangerous. But it can cause pain and menstrual irregularities. 

The clumps of tissue that grow outside the uterus are called implants. They usually grow on the ovaries, fallopian tubes, the outer wall of the uterus, the intestines, or other organs in the belly. In rare cases they spread to areas beyond the belly.

WHAT ARE THE SYMPTOMS OF ENDOMETRIOSIS?

The most common symptoms are:

• Pain. Where it hurts depends on where the implants are growing. Pain may happen in lower belly, rectum or vagina, or lower back. Pain may come only before and during the periods or all the time. Some women have more pain during sex, when they have a bowel movement, or during ovulation.
• Abnormal bleeding. Some women have heavy periods, spotting or bleeding between periods, bleeding after sex, or blood in their urine or stool.
• Trouble getting pregnant: Infertility is the only symptom some women have.

Endometriosis varies from woman to woman. Some women don't know that they have it until they go to see a doctor because they can't get pregnant or have a procedure for another problem. Some have mild cramping that they think is normal for them. In other women, the pain and bleeding are so bad that they aren't able to do their day to day work. 

DIAGNOSIS & TREATMENT

Diagnosis: Endometriosis is difficult to diagnose as several different problems can cause painful or heavy periods. To diagnose the doctor will review the symptoms, detailed medical history including family history, enquire about your periods. Will conduct a pelvic exam that includes checking both the vagina and rectum.  

Additional tests may include ultrasound, MRI or a CT. Conclusive diagnosis can be only made through a laparoscopic surgery where, the doctor puts a thin, lighted tube through a small cut in the belly. This lets the doctor see what is inside the belly. If the doctor finds implants, scar tissue, or cysts, he or she can remove them during the same surgery.

Treatment: There is no cure for endometriosis, but there are good treatments, however, there is a chance that the symptoms could come back. Treatment choices will depend on whether the patient wants to control pain or wants to get pregnant. For pain and bleeding, medicines or surgery can be options. For getting pregnant, patient may need surgery to remove the implants.

Treatments for endometriosis include:

• Over-the-counter pain medicines to reduce bleeding and pain.
• Birth control pills are often used to treat endometriosis. Most women can use them safely for years. 
• Hormone therapy. This stops the periods and shrinks implants. But it can cause side effects, and pain may come back after treatment ends. Like birth control pills, hormone therapy will keep you from getting pregnant.
• Laparoscopy to remove implants and scar tissue. This may reduce pain, and it may also help you get pregnant.

As a last resort for severe pain, some women have their uterus and ovaries removed (hysterectomy and oophorectomy). After the ovaries are taken out, the estrogen level drops and symptoms will probably go away. But symptoms of menopause can be experienced, and patient  will not be able to get pregnant.