ENDOMETRIOSIS MANAGEMENT

The presence of endometrial tissue (the inner layer of the uterus) outside the uterus is known as endometriosis.The tissue of endometriosis can be observed in the ovaries, fallopian tubes, and intestines.Pain and menstruation abnormalities are the most prevalent symptoms.

Symptoms of Endometriosis

  • Pain- Lower abdomen, lower back, pelvis, vagina, rectum, Pain during sexual intercourse (Dyspareunia), Pain during defecating (Dyschezia)
  • Menstrual
    • Abnormal menstruation, Heavy Irregular Spotting
  • Gastrointestinal- Nausea, Abdominal cramps, Constipation, Irritable bowel syndrome
  • Generalized symptoms- Chronic Fatigue, Poor quality of life, Emotional distress
  • Commonly presents as infertility

Causes of Endometriosis

  • Retrograde Menstruation – The backward flow of menstrual blood and uterine lining through the fallopian tubes, which subsequently embeds itself in other organs, is known as retrograde menstruation.
  • Genetic Cause – Endometriosis is considered to be five to seven times more likely to be inherited by women who have a close relative with the disease.
  • Autoimmune issue – A problem with the immune system and the body’s inflammatory response may lead to endometriosis

Course of the disease

When a woman menstruates, there will be bleeding in the extra uterine tissue as well, causing acute discomfort and heavy bleeding during periods. If it gets inside the ovary, it forms a chocolate cyst, which decreases egg quality and eventually damages the egg. When these heal, they will cause adhesions between two organs, which will limit tube movement. All of this will lead to infertility issues. Depending upon the severity of the disease symptoms will be visualized and accordingly the treatment will be decided.
The treatment of endometriosis will depend upon the age, severity and symptoms of the patient.

Endometriosis Treatment

  • Surgical treatment: Laparoscopy can be done in some cases. Adhesions can be separated. Chocolate cyst and other endometriotic lesions can be removed. The tubal status at the time of operation is recorded.
  • Hormone injections once a month can be given following the surgery or when the doctor believes the condition is still in its early stages. There is also a hormonal tablet that must be taken on a daily basis. These pills suppress the menstrual cycle and keep the condition and symptoms under control. The treatment will also include medications to prevent inflammation of the pelvis and to relieve pain.
  • Fertility treatment: It is preferable for a woman with endometriosis to conceive as soon as feasible. The six-month period following surgery is the golden period, when fertility is at its peak. Your doctor will determine which method is best for you to conceive faster based on the surgery findings. Pregnancy will also be a cure for the condition. Depending upon the tubal status doctor will advice IUI or IVF

Frequently asked questions

Q1. What is Endometriosis?Ans:- Endometriosis is the presence of endometrial tissue (the inner layer of the uterus) outside the uterus.

Q2. How does Endometriosis affect fertility?Ans- Inflammation due to endometriosis may have a negative impact on egg quality hence will reflect the embryo quality and further pregnancy. Due to the adhesions the fallopian tube may be blocked which will affect the pickup and transport of egg.

Q3. How common is endometriosis?Ans:- 1 in 10 women of reproductive age

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