Endometriosis is a painful disease affecting women which was mentioned in medical literature more than 300 years ago. For centuries the symptoms of this disease have been dismissed as a normal consequence of womanhood and not only the general population but even the medicos believe that painful periods are normal.
Endometriosis is one of the top 3 causes which make a woman infertile. 30-40% of women with endometriosis experience infertility related issues. This disease has been ranked recently as one of the top 10 most painful medical conditions.
This disease commonly goes undiagnosed or misdiagnosed with women experiencing about 6-10 years of delay before correct diagnosis is made. Often women consult multiple doctors before finally someone suspects this condition as a cause.
Despite centuries of research the cause of this disease is still unknown.
In this disease the tissue (called as Endometrium) which normally lines the inside of the womb or uterus and which is normally shed off with blood during periods, grows outside the uterus and is seen involving ovaries, intestines, urinary bladder, the lining of your pelvis and may even spread to distant sites like lungs etc.
Now, this tissue which is abnormally placed continues to act as it would that is, it becomes thick and then breaks and bleeds like the uterine lining during each period.
Now this bleeding and abnormal tissue has no way to leave out from the body as normal periods are flushed out. So this tissue and bleeding in each cycle gets trapped inside the body and this irritates the other surrounding tissues and forms collections and hard areas(nodules) and gets attached and adherent to surrounding organs and causes pain and functional problems related to the organ gets involved. For eg. If urinary bladder is involved it can cause bleeding in urine or pain during urination etc.
The body also recognizes that this growth should not occur outside the womb and so it tries to destroy these areas by setting an inflammatory reaction against these tissues and this leads to severe pain and scarring and destruction of tissues and surrounding organs inside
You are more likely to get Endometriosis if
- Your period started at a young age.
- You never had children
- Have some other associated disease conditions like fibroids, abnormal shaped uterus etc
- Have sister or mother with endometriosis.
Pelvic pain may begin before and may extent several days after periods and may have increased over time. Pain may extent to lower back, thighs, legs etc.
Pain with intercourse
Pain during or after intercourse is common in this disease.
Pain with bowel movements or urination
This might be present especially during menses. Some patients might have bleeding in stools or urine during periods.
Patients may get occasionally heavy bleeding in between periods.
Inability to achieve pregnancy
This condition can make a women infertile and is diagnosed first when this women seek treatment for achieving pregnancy.
Other rare symptoms
Because this disease can involve the far away areas and organs outside the pelvis this can cause rarely odd symptoms like
- Chronic pelvic pain unrelated to periods
- Hip pain/groin pain
- Rarely pain in chest or shoulders or near kidney areas during periods
- Review of your medical history and symptoms by a specialist
- Pelvic exam by a specialist
- Investigations like ultrasound or MRI
- Special blood tests
- Laparoscopy with biopsy in some cases.
All these investigations are to be decided at the judgment of the specialist doctor.
Now treatment depends on
- Extent of disease
- Severity of symptoms like pain.
- Desire for child bearing
For severe symptoms, the options can be
- Medicines to control pain
- Hormones to stop Endometriosis from getting worse.
- Surgery to remove cysts due to Endometriosis, nodules, adhesions and to free the surrounding organs which are stuck up.
- Surgery to remove the entire uterus, tubes and ovaries.