FAQ’S on Endometriosis

What is Endometriosis?

Endometriosis is deposits of endometrial tissue (cells from inner lining of uterus) into the surfaces of abdomen. These deposits can occur over the ovaries, tubes, intestines and peritoneal surfaces.

If I have endometriosis what symptoms can I experience?

The following symptoms are common with endometriosis:

Painful periods
Lower abdominal pain &lower back pain
Painful intercourse especially with deep penetration (dyspareunia)
Infertility (inability to conceive)
Nausea, vomiting, dizziness and fainting attacks during period.

 

What happens in Endometriosis?

The female hormone estrogen causes the endometriotic implants to grow causing pain and swelling. These implants outside the uterus have no way to leave the body and become inflamed and swollen. If endometriosis occurs in ovaries it can cause cyst (blood filled sac) formation which is commonly known as chocolate cyst.

What are The causes for Endometriosis?

No one knows for sure what causes endometriosis. One theory is based on the belief that menstrual fluid containing endometrial cells that normally flows out of the vagina, moves backward through the tubes and drips into the abdominal cavity and leads to implants on surrounding organs.

 

How Does Endometriosis cause infertility?

The deposits of endometrial tissue bleed during menstruation and thus enlarge to form cyst or adhere to organs around the pelvic area destroying the relationship between the tube and ovary. In these cases even if the tubes appear patent, there is difficulty in the egg being picked by the tube and transported to the uterus.

Do the symptoms depend upon the severity of the disease?

 Symptoms can start very shortly after your first period or show up years later. Pain is common symptom of endometriosis. The severity of pain does not appear to be linked exclusively to how severe and extensive your endometriosis is.

Where is Endometriosis found?

 Endometriosis can affect the organs and structures of the pelvis. That is:

Ovaries, uterus, fallopian tubes.
Cul-de-sac (extension of the abdominal cavity, like a pouch, that lies between the rectum and back of the uterus)
Endometriosis can also be found in the lungs, diaphragm, brain, small and large bowel but this is very rare.

How is Endometriosis diagnosed?

Endometriotic ovarian cysts can be diagnosed with help of ultrasound. A definite diagnosis of endometriosis requires looking through a laparoscope at the internal organs where it can be treated at the same step.

How does one suspect Endometriosis?

Previously non painful menstruation becomes painful and there could also be pain during intercourse. Endometriosis may also be associated with difficulty in conceiving. Presence of cyst on ultrasound with thick material within, gives rise to suspicion of endometriosis.

What is treatment of Endometriosis?

There are many different treatment modalities available for endometriosis. They range from medical treatment which includes the use of hormonal drugs to surgical treatment which is done by the help of laparoscopy or by open surgery.

Pain Medication: 
Hormones in the form of pills (estrogen & progesterone), Danazol (weak male hormone) & GnRH agonist (Gonadotropin releasing hormone) can be given to suppress endometriosis. 

Surgery:
Laparoscopic surgery is the best form of treatment for endometriotic cyst or to release adhesions. Sometimes open surgery may be required.

Infertility treatment:
Infertility management can be surgical ablation of endometriotic implants immediately followed by medical treatment for ovulation induction with either timed intercourse or IUI (intra uterine insemination). IVF (in-vitro-fertilisation) may be the only option in severe endometriosis or failure to conceive despite the above mentioned treatment.

How can I get rid of Endometriosis?

Endometriosis is a progressive disease and it lasts till you get your menses (menopause). The process of endometriosis can be halted by surgery or medicines mentioned above but it can recur after sometime (1-2 years after surgery and approx 3 months of stopping medical treatment).

Does Endometriosis lead to complications if I get pregnant?

Endometriosis generally remains subsided and symptoms disappear during pregnancy and  lactation as there are no regular menses during this time.