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Endometriosis: Treatment, symptoms, advice and help

About endometriosis

Endometriosis is a gynaecological disorder wherein the tissue which lines the interior of the uterus, also called endometrium, is found over other organs. The most common site for endometriosis is the surface of the ovary followed by the fallopian tubes, the bladder, and scars of previous pelvic surgeries. Rarely, abdominal organs like intestines, appendix and stomach may also get involved.

Endometriosis: Incidence, age and sex

Endometriosis is one of the common gynaecological disorders encountered in the general population. About 1 in every 10 women of the reproductive age may get afflicted. Although it can occur in any age, it mainly afflicts women in the time period between menarche and menopause.

Signs and symptoms of endometriosis: Diagnosis

The clinical features of endometriosis may vary from mild to severe. Some affected women may even remain asymptomatic, thus making it difficult to discover the problem. The prominent symptom of endometriosis is pelvic pain which is severe in intensity and cramping in nature. This pelvic pain is usually associated with the menstrual cycle although it may occur throughout. The affected woman may also experience lower back pain or pain in the abdominal area. The menstrual cycle is characterised by heavy bleeding or passage of blood clots. Some affected individuals have also been documented to experience excruciating pain during sexual intercourse. If the endometrial tissue is found on the surface of the bladder, then the individual may experience urinary symptoms like increased frequency or urgency or even pain during micturition.

Endometriosis is a difficult condition to diagnose. However, detailed history and a comprehensive physical examination may help in diagnosing it. Imaging modalities like ultrasonography or MRI scan may aid in establishing the diagnosis. If in doubt, diagnostic laparoscopy is performed and it is the investigation of choice, in detecting the condition. However, it is an invasive diagnostic tool which needs a small surgical incision through which a flexible tube is passed inside to view the interior of the pelvic or the abdominal cavity.

Causes and prevention of endometriosis

The inner lining of the uterus is called endometrium which may abnormally grow on the surface of other pelvic organs like the ovary, the fallopian tubes or even the bladder. This endometrial tissue proliferates and eventually bleeds like the normal endometrial lining of uterus during periods. It is postulated that increased level of oestrogen may result in this phenomenon. Endometriosis is most commonly seen in women during the reproductive years.

Endometriosis: Complications

Longstanding endometriosis lesions may result in scar tissue or even fibrous bands between organs. Occasionally, endometrial cysts may also be formed in the pelvic cavity. These cysts have a high chance of rupture which may lead to profuse bleeding.

Endometriosis: Treatment

Unfortunately, endometriosis is an incurable condition. However, symptomatic treatment may provide adequate relief to the affected individual. Medications like analgesics may be prescribed to individuals, who experience excruciating pain. Hormonal treatment in form of progesterone or oral contraceptives may be advised to prevent further growth of endometrial tissue on surface of other organs.

Surgical intervention is the last resort which may be required in severe cases. In women, who are planning their family, surgical procedure may be done to remove the endometrial tissue from the surface of pelvic organs but preserving the integrity of ovaries. However, it is advisable to perform total hysterectomy (removal of uterus along with fallopian tubes and ovaries) in women who have completed their family.