Did you know 1 in 10 Indian women have endometriosis? 

Endometriosis is a condition where tissue similar to the lining of the uterus grows outside of it, leading to inflammation, scarring, and pain. It can affect various parts of the body, especially in the pelvic area. According to a 2023 report by the American Journal of Reproductive Immunology, this condition impacts around 10 per cent of women of reproductive age; about 247 million worldwide and 42 million in India. While it's most common between puberty and menopause, it can also occur in younger girls and even after menopause.

 

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Naturally, not everyone is aware of endometriosis and some might mistake it for something else. So, it is imperative for women to know the signs, causes and treatment available for endometriosis. In an informative YouTube video, Dr. Roma Sinha, Professor & Chief Gynecologist, Laparoscopic & Robotic Surgeon, Apollo Hospitals, Jubilee Hills Hyderabad, explains about endometriosis, its common signs, diagnosis and treatment options. 

 

Related story: The Medical Gaslighting of Endometriosis

 

What is Endometriosis? 

Dr Rooma Sinha explains that endometriosis occurs when tissue similar to the uterine lining grows outside the uterus. It can affect areas like the ovaries, fallopian tubes, and pelvic lining. This misplaced tissue behaves like normal endometrial tissue, thickening, breaking down, and more or less bleeding with each menstrual cycle. However, because it has no way to exit the body, it becomes trapped, leading to inflammation, cysts, scar tissue, and adhesions. This can result in significant pain, especially during menstrual periods, and may lead to fertility issues.

 

Symptoms of Endometriosis

Dr. Sinha says, some women may suffer from endometriosis throughout their life as they might be unaware that they have it because of the nature of the condition. The neglect may happen due to the fact that menstural pain is considered as ‘part of being a woman’, or some may have severe pain, while others experience digestive issues or infertility, making it harder to connect the dots. Dr. Rooma Sinha outlines several symptoms associated with endometriosis:

• Pelvic pain: Persistent discomfort in the lower abdomen and back, often intensifying before and during menstruation. This pain can also occur during or after sexual intercourse, as well as during bowel movements or urination.
• Heavy menstrual bleeding: Watch out for excessive bleeding during periods, which may lead to anaemia and weakness.
• Abdominal bloating: A sensation of fullness or bloating in the abdomen, particularly around the time of menstruation.
• Gastrointestinal symptoms: Feelings of incomplete bowel evacuation, diarrhoea, or rectal pain during menstrual periods.
• Menstrual headaches: Headaches during periods can be a sign that you may have endometriosis. It usually occurs during the onset of periods and may cause discomfort the whole day. 

While the exact cause of endometriosis is not fully understood, factors such as early onset of menstruation, heavy menstrual periods, and a family history of the condition may increase the risk. 

 

Related story: 7 Ways to Improve Irregular Periods

 

Causes of Endometriosis

According to Dr. Rooma Sinha, the exact cause of endometriosis remains uncertain, but several theories exist. 
During menstruation, some blood flows backwards through the fallopian tubes into the pelvic cavity, a process known as retrograde menstruation. This may cause endometrial-like tissue to implant and grow outside the uterus. 
Certain cells outside the uterus transform into endometrial-like cells, possibly due to genetic or environmental factors. Additionally, issues with the immune system might prevent the body from recognising and eliminating these misplaced cells. 

Dr Sinha emphasises that while these theories provide insights, more studies ongoing will determine the exact cause behind endometriosis

 

Related story: Eat, Exercise, and Work in Sync Your Periods

 

Means of Diagnosis

Endometriosis can be tricky to detect. Figuring out if someone has endometriosis isn’t always straightforward since symptoms can vary so much. It often takes multiple doctor visits before getting a clear diagnosis.

• Pelvic examination: Your gynaecologist may start with a physical exam to check for unusual growths, cysts, or scar tissue.
• Imaging tests: Ultrasounds and MRIs can help spot cysts or deep-seated endometriosis, but they don’t always catch everything.
• Laparoscopy: This is the most reliable way to diagnose endometriosis. It’s a minor surgical procedure where a tiny camera is inserted through a small cut in the abdomen to take a closer look inside. If needed, doctors can even collect tissue samples for confirmation.

 

Related story: The Self-Care You Need For Endometriosis Pain

 

What Are Treatment Options?

As a matter of fact, there are various approaches to managing endometriosis, focusing on alleviating pain and enhancing fertility:

1. Medical Treatments

• Pain relief: Over-the-counter medications like paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs) can help reduce discomfort.
• Hormonal therapies: These aim to suppress the menstrual cycle, slowing the growth of endometrial tissue. Options include oral contraceptive pills, intrauterine devices, implants, or injections. Some treatments may cause a menopause-like state, with low-dose hormone replacement provided to manage side effects.

2. Surgical Interventions

• Laparoscopy (keyhole surgery): This minimally invasive procedure allows for the diagnosis and treatment of endometriosis. Surgeons can remove or destroy endometrial lesions, which may improve pain and, in some cases, fertility.
• Hysterectomy: In severe cases unresponsive to other treatments, removing the uterus, cervix, and fallopian tubes and possibly the ovaries might be considered. This is typically done via keyhole surgery but requires a longer recovery period.

3. Alternative and Complementary Therapies
Some women find relief through alternative treatments, though their effectiveness varies. It's essential to discuss these options with a healthcare provider to ensure they complement standard medical approaches.

 

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Endometriosis is affecting millions of women globally, often going undiagnosed for years due to its diverse symptoms. This can be incredibly frustrating and isolating. Understanding its causes and available treatment options is essential for effective management. Early diagnosis and a personalised treatment plan can truly make a difference. 

While there’s no permanent cure, treatments like medication, hormone therapy, and surgery can offer significant relief and improve your quality of life. If you suspect you have endometriosis, please seek help from a medical expert.