Before talking about treating the problem, let’s first talk about what exactly the problem is. This is a very big issue and it affects between 6 and 10 percent of women of reproductive age worldwide.
What is endometriosis?
Endometriosis is a common and sometimes debilitating condition experienced by women in their reproductive age. According to Gynaecologists in Mumbai, It is a painful disorder in which tissue that normally lines the inside of your uterus — the endometrium — grows outside your uterus.
That “outside” is usually in the abdomen but it may also grow in the vagina, cervix, bowel or bladder, and in rare cases, it may spread to other parts of the body, such as the lungs. This misplaced tissue responds to the menstrual cycle in the same way that the tissue lining the uterus does: each month the tissue builds up, breaks down and sheds.
Women with endometriosis may experience symptoms like chronic pelvic pain, pain during sex, painful urination, gastrointestinal issues, abnormal or heavy periods, and infertility.
Causes of Endometriosis
There are several different ideas given by different Gynaecologists in Goregaon West about how and why endometriosis happens but the exact cause is not known-
One idea is that when a woman has her period, some of the blood and tissue from her uterus travels out through the fallopian tubes and into the abdominal cavity. This is called retrograde menstruation.
Another idea is that some cells in the body outside of the uterus can change to become the same kind of cells that line the uterus.
Another possible explanation is that the cells from the lining of the uterus travel through the blood vessels or through the lymphatic system to reach other organs or body areas.
Also, endometriosis can spread at the time of surgery.
Based on what the doctor sees during the laparoscopy, the endometriosis is categorized into four different stages:
Stage 1 or minimal:
There a few small implants or small wounds or lesions. They may be found on your organs or the tissue lining your pelvis or abdomen. There’s little to no scar tissue.
Stage 2 or mild:
There are more implants than in stage 1. They’re also deeper in the tissue, and there may be some scar tissue.
Stage 3 or moderate:
There are many deep implants. You may also have small cysts on one or both ovaries, and thick bands of scar tissue called adhesions.
Stage 4 or severe:
This is the most widespread. You have many deep implants and thick adhesions. There are also large cysts on one or both ovaries.
How can you treat endometriosis?
Treatment for endometriosis usually involves medication or surgery. Sometimes both medicine and surgery are used. Some women also benefit from alternative therapies.
The approach you and your doctor choose will depend on how severe your signs and symptoms are and whether you hope to become pregnant.
Dr. Kazi Trupti says if the ovaries contain cysts of endometriosis these are best treated surgically as they are unlikely to disappear on their own and they can't be treated with medicine.
Treatments for pain from endometriosis
Treatments for endometriosis pain fall into three general categories:
Many women will experience some relief of symptoms with over-the-counter drugs such as paracetamol (Panadol) and non-steroidal anti-inflammatories (Ponstan, Nurofen, Naprogesic, etc).
Hormone treatments are used to suppress the normal menstrual cycle, which in turn stops or slows endometriosis growth. The simplest way to achieve this is with the Pill. Other hormonal therapies that have been shown to be effective in reducing endometriosis-related pain, are also available. Some women will experience side effects with hormonal treatments.
Therapies used to treat endometriosis include:
- Hormonal contraceptives.
Birth control pills, patches, and vaginal rings help control the hormones responsible for the buildup of endometrial tissue each month.
- Gonadotropin-releasing hormone (Gn-RH) agonists and antagonists.
These drugs block the production of ovarian-stimulating hormones, lowering estrogen levels and preventing menstruation. This causes endometrial tissue to shrink.
- Progestin therapy.
A variety of progestin therapies, including an intrauterine device with levonorgestrel (Mirena, Skyla), contraceptive implant (Nexplanon), contraceptive injection (Depo-Provera) or progestin pill (Camila), can halt menstrual periods and the growth of endometrial implants, which may relieve endometriosis signs and symptoms.
- Aromatase inhibitors.
Aromatase inhibitors are a class of medicines that reduce the amount of estrogen in your body.
Different surgeries according to misplaced tissue are:
- Keyhole surgery or laparoscopy
Some women are offered surgery because they don't want to take medicine or because medicines haven't worked. Surgery for endometriosis includes laparoscopy (key-hole surgery), which may be used to make the diagnosis and treat all visible endometriosis. This is done with laser or diathermy, which destroys the endometriosis by burning it. Alternatively, the deposits of endometriosis can be cut away.
In a small group of women who have severe symptoms that are not relieved by medical or other surgical treatment, more extensive surgery such as hysterectomy and removal of the ovaries may be considered.
- Bowel surgery
Sometimes the endometriosis affects the wall of the bowel. When this is causing significant symptoms it may be suggested that the affected piece of bowel is removed. This would require bowel surgery and is uncommon.
Treatments to infertility related to endometriosis
Surgery has been shown to improve fertility for women with mild endometriosis. Treating more severe endometriosis with surgery, especially if there are cysts in the ovaries, also appears to improve fertility, although this hasn't been fully proven. Medication for endometriosis has not been shown to improve fertility.
Other causes of infertility should be looked for and treated.
For many women, the decision about treating endometriosis is often a matter of balancing the risks of the treatment against the effect the endometriosis is having on their life. These kinds of therapies may be helpful to you in conjunction with other therapies. Speak with your health care provider if you are considering incorporating alternative treatments into your lifestyle.