Endometriosis is a common health problem in women. Its name comes from the word “endometrium”, which is the tissue lining the uterus. Endometriosis occurs when tissue similar to these starts growing outside your uterus or in other parts of your body where it doesn’t normally exist.
Endometriosis is most commonly found in these organs –
- Ovary
- fallopian tubes
- tissue that holds the uterus in place
- the outer surface of the uterus
Endometriosis can also occur in other organs such as the vagina, cervix, vulva, bowel, bladder, or rectum. In rare cases, it can occur in other parts of the body, such as the lungs, brain, and skin.
Endometriosis in India
More than 10 million women in India suffer from endometriosis every year. In India, it happens to one out of every ten women.
Stages of Endometriosis
There are four stages of endometriosis –
1. First stage
The first stage of endometriosis consists of shallow implants that are sometimes mistaken for cysts or ovarian cancer. They look like small spots on the surface of the pelvis. These implants irritate and swell the surrounding tissue causing “adhesions”. These antigens bind to tissues and organs causing pain and impairing their ability to function.
2. Second stage
Most women are diagnosed with mild endometriosis. The second stage has the same symptoms as the first stage but is more severe. In this, dark spots appear over the severe fibrous growths, which causes pain during ovulation or pelvic pain. During the second stage, there are sores in the area between the uterus and the rectum.
3. Third step
In the third stage, “endometriomas” (sometimes called “chocolate cysts”) begin to appear. If the neoplasm ruptures, it can cause severe abdominal pain and pelvic swelling. Adhesions are also more prone to inflammation and infection. As endometriosis increases in size and number, so does the growth caused by it.
4. Fourth stage
In the late stage of endometriosis, there is an increased number of cysts and severe erosions. In this stage, the endometrioma can be as big as a grapefruit. 2 cm Endometrioma that is larger than this size needs to be surgically removed.
Women in the fourth stage of endometriosis have digestive problems, painful bowel movements, constipation, nausea/vomiting and abdominal pain. In addition, sterility may also occur in the fourth stage.
Symptoms of Endometriosis
The main symptoms of endometriosis are –
- increased pain in periods
- pelvic pain without periods
- pain in sex
- sterility
- Tiredness
Apart from that, endometriosis also has some cyclical symptoms. Cyclic symptoms are symptoms that begin a few days before the period and disappear after a few days or occur only during periods.
These symptoms reappear the next month after the menses have stopped, like –
- bowel problems such as periodic bloating, diarrhea, or constipation
- pain or difficulty in defecation
- blood in urine
- rectal bleeding
- shoulder pain etc.
If you have one or more of these symptoms please consult your doctor immediately.
Causes of Endometriosis
Although the exact cause of endometriosis is not certain, some of the following conditions may be the cause:
Retrograde periods
In this, the endometrial cells containing menstrual blood move out of the body through the fallopian tubes into the pelvic cavity. These displaced endometrial cells stick to the pelvic organs’ surfaces and their walls where they thicken and bleed during each menstrual cycle.
Transformation of peritoneal cells
The transformation of the peritoneal cells that line the interior of the abdomen into endometrial cells during puberty.
Embryonic cell transformation
Hormones such as estrogen can convert embryonic cells (cells with early stages of development) into endometrial cell transplants during puberty.
Coagulation in surgical scars
After a surgery (such as a hysterectomy or C-section) endometrial cells can attach to the surgical incision.
Endometrial cell transport
Our body is a network of tissues, vessels and organs. Sometimes, Blood vessels or our lymphatic system transports endometrial cells to other parts of the body and causes endometriosis.
Immune system disorder
If the immune system is weak or unstable, it may fail to recognize the issue and destroy endometrial tissue due to hyperactivity.
Risk factors
The risk of getting endometriosis depends on a few factors. These factors are –
Age
This disease can affect all ages of women. But the study reveals women between the ages of 25 and 40 are more vulnerable to Endometriosis. In some certain cases, the symptoms can also begin at puberty.
Family History
Consult your doctor if anyone in your family has endometriosis because you are at increased risk if you have a family history of endometriosis.
Pregnancy History
Pregnancy protects women from endometriosis. Women who never gave birth to a child have a higher risk of developing this disease. However, it can also happen in women who have been pregnant before.
History of menstruation
Talk to your doctor if you have problems with your menstrual cycle (such as having shorter or longer periods, having heavy periods, or starting at an early age) as these may increase your risk of developing osteoporosis.
Prevention of Endometriosis
You cannot prevent endometriosis, but you can control the factors responsible for developing the disease. For example, you can reduce minimize its possibility by reducing the level of the hormone estrogen in your body. Estrogen thickens the lining of your uterus during your monthly cycle.
Here’s what you can do to keep estrogen levels low in your body:
- Talk to your doctor about hormonal contraceptive methods such as birth control pills, patches or rings with low doses of estrogen.
- Exercise regularly (more than 4 hours a week). It will also help you to reduce/keep body fat. With the help of regular exercise and less fat in the body, the amount of estrogen is reduced.
- Avoid drinking too much alcohol as it increases the level of estrogen.
- Do not drink excessive amounts of caffeinated drinks. Studies show that consuming more than one caffeinated beverage a day (especially soda and green tea) can increase estrogen levels.
Diagnosis
Following are some of the ways to diagnose endometriosis –
Pelvic test
During a pelvic exam, your doctor feels the area of your pelvis with his hands to detect the presence of disorders such as cysts on your reproductive organs or scars behind your uterus.
Imaging test
Your doctor may do a pelvic ultrasound to check for ovarian cysts caused by endometriosis. The specialist may –
- insert a wand-shaped scanner into your vagina or
- run the scanner over your abdomen
Both types of ultrasound tests use sound waves to take pictures of your reproductive organs.
Magnetic resonance imaging (MRI) is another imaging test that can create a picture of the inside of your body.
Laparoscopy
Your doctor may refer you to a surgeon to look for signs of endometriosis inside your abdomen. This test is called laparoscopy. Laparoscopy helps determine where the implant is and how large it is.
Endometriosis Treatment
There is no cure for endometriosis but treatments are available to improve its symptoms. like –
1. Anti-inflammatory or NSAID drugs
These are used to reduce bleeding and pain, such as ibuprofen.
2. Contraceptive pills
They are often used to treat endometriosis but you cannot use them if you want to become pregnant.
3. Hormone therapy
It stops your period and shrinks the implant. But it can also have side effects and the pain may return after the treatment is over. Like birth control pills, hormone therapy doesn’t let you get pregnant.
4. Laparoscopy
It is used for transplantation and the removal of scar tissue. This can reduce pain and may even help you get pregnant.
5. Hysterectomy and Opherectomy
If the pain is severe and is not remediable through the medications the doctor may advise you to have surgery as a last resort option. In this procedure, the uterus and ovaries (Hysterectomy and Oophorectomy) are removed to give you relief from pain.
If you have had your ovaries removed, your estrogen levels will drop and your symptoms may go away but you may have symptoms of ovulation and will not be able to get pregnant.
Endometriosis Complications
Endometriosis can develop some severe complications if remain untreated for a long time, such as –
Fertility problems
Endometriosis can damage the fallopian tubes or ovaries, and cause infertility in women. Medications and surgery can help remove patches of endometriosis, but there is no guarantee that you will be able to get pregnant.
Ovarian and Ovarian Cysts
Both of these can arise if endometriosis tissue is in or near the ovaries. These can be removed with surgery but may come back in the future.
Bladder and Bowel Problems
Endometriosis affects the bladder or bowel which can be difficult to treat and may require surgery.
What to avoid during this?
Avoiding these things in endometriosis will benefit you –
- Avoid dairy products for three weeks
- Don’t eat foods containing soy if you don’t have them regularly
- Do not drink alcohol
What to eat during this?
Taking care of diet in endometriosis is also beneficial. You should keep in mind –
- eat anti-inflammatory diet
- Eat only hormone-free meats to avoid excess estrogen
- Choose Organic Foods Whenever Possible
- Take omega-3 fatty acid supplements. Start with one gram on the first day and increase the amount gradually (up to three to four grams a day).
- Drink one or two cups of red raspberry leaf tea daily to relieve cramps
- Take a 500 mg calcium supplement and 250 mg magnesium daily
