Endometriosis

ENDOMETRIOSIS pain

Last Updated December 20th, 2021

Overview

Endometriosis is a common gynecological problem and it is one of the major causes of infertility in women. In fact, it is reported in as many as 40% of women with fertility problems. Typically, it involves the abnormal growth of inner uterine lining or endometrium in locations outside of the uterus. Patients describe this as a very painful condition.

It can affect women of any age, although it is seen to occur more frequently in those of reproductive age. Symptoms can appear at any time following the onset of menses and last until menopause. Symptoms have been known to persist even after menopause particularly if there is significant scarring of pelvic tissues and organs.

 

What Is Endometriosis?

ENDOMETRIOSIS uterusEndometriosis is a gynecological disorder in which the endometrium or tissue forming the inner lining of the uterus begins to encroach into other locations outside of or around the uterus. Typically, this involves the ovaries, fallopian tubes, the cavity behind the uterus and the inner lining of the pelvic cavity. In severe cases, this condition may extend to the bowels or bladder as well. It is also possible, although extremely rare, for other parts of the body such as the diaphragm or skin to be affected. These growths (known as endometrial implants) are not malignant. Instead, they behave exactly as the inner lining of the uterus normally does.

In other words, they undergo changes associated with the menstrual cycle. As the cycle progresses, the implants thicken with blood and then break down. The discarded inner lining of the uterus is normally expelled through the vagina. This is what causes menstruation. However, ectopic endometrial tissue has no outlet and hence cannot be expelled. It accumulates and irritates the surrounding tissues and organs, causing inflammation and swelling accompanied by severe pain. Eventually, cysts appear on the ovaries and lesions can develop in the pelvic lining. The formation of scar tissue can even cause organs to become stuck to each other.

 

How Does It Develop?

It is not as yet known why endometriosis occurs. A number of theories have been put forward as to what causes endometrial tissue to grow outside of the uterus.

  • One possible explanation is that endometrial cells might get introduced into the fallopian tubes or pelvic cavity by means of a backward flow of menstrual blood. The reverse flow of menstrual blood is not uncommon but the presence of other factors such as impaired immunity can increase the risk of displaced endometrial cells becoming firmly implanted.
  • It is also believed that under certain conditions, particularly under the influence of hormones such as estrogen, other types of cells such as those of the pelvic lining may become transformed into endometrial cells.
  • Having an impaired immune response which is unable to recognize and destroy ectopic endometrial growths, allowing them to persist and develop into implants.
  • Following a surgical procedure such as a Caesarean section or a hysterectomy, it may be possible for endometrial cells to become implanted in the incision.

ENDOMETRIOSIS uterus painCertain risk factors are recognized in connection with endometriosis:

  • Having a close female relative with this disease can increase one’s own chances fivefold.
  • Irregular menstruation raises the probability of developing endometriosis.
  • Having a late first pregnancy or having no history of pregnancy at all.
  • Early onset of menses and delayed onset of menopause.
  • Having a low body mass index.
  • Consuming alcohol.
  • Pre-existing gynecological disorders affecting the uterus or causing obstruction in the normal elimination of menstrual blood.
  • Having an excess of the hormone estrogen.
  • A history of having undergone surgical procedures such as hysterectomy or Caesarean section.
  • A previous ectopic pregnancy.

 

How Do I Recognise The Signs?

The first signs of endometriosis may be felt some years after menarche (onset of menses). Some women experience no symptoms. Otherwise, the main complaint associated with endometriosis is extreme pain. Patients often report a pain far exceeding that of menstrual cramps in severity. Symptoms are particularly intense around the time of menstruation and intensity can vary from one month to the next. Symptoms can also subside temporarily during pregnancy. The following is a list of possible clinical indications:

  • Severe pain in the pelvic region around the time of menstruation.
  • Pain may also be experienced during or post vaginal intercourse.
  • Excessive menstrual bleeding.
  • Menstrual period lasting longer than 7 days.
  • Spotting or minor bleeding between periods.
  • Pain during urination or during bowel movements. This is more likely to occur around the time of menstruation.
  • Blood may appear in the urine during menstruation.
  • Lowered fertility.
  • Fatigue.
  • Constipation or diarrhea.
  • Bloating.
  • Nausea.

 

Are There Different Stages of Endometriosis?

The American Society for Reproductive Medicine has developed a scheme for identifying four stages of endometriosis. This scheme is based on diagnostic findings. Severity is graded based on the location, extent, and depth of endometrial implants, the extent of adhesions and cysts on the ovaries. Grading does not correlate with the intensity of symptoms that the patient may experience. Nor does it correlate with the extent to which the patient’s fertility may be affected. For instance, women with only mild endometriosis may actually experience severe pain. The four grades are:

  • Minimal: Endometrial implants are fairly shallow, generally located on the ovary, and the resultant lesions are small.
  • Mild: Slight lesions associated with shallow implants on the ovary and pelvic lining.
  • Moderate: Deep implants on the ovary and pelvic lining. The resultant lesions are larger and more in number.
  • Severe: Deep implants on the ovary and pelvic lining, accompanied by severe lesions on the fallopian tubes and bowels.

 

What Are The Complications That Could Arise?

This disorder is known to be one of the top causes of infertility in women. It can physically hamper the movement of sperm or ova through the reproductive tract or even damage them. In less severe cases, however, the patient may be able to conceive and successfully carry a baby to term.
The formation of scar tissue can cause adhesions when one section of injured tissue comes into contact with another and binds together. For instance, an ovary might become stuck to the pelvic wall. Women with endometriosis are at a higher risk of developing certain forms of cancer, particularly endometriosis-associated adenocarcinoma.

 

What Tests Help To Diagnose Endometriosis?

ENDOMETRIOSIS painEndometriosis is often diagnosed when a patient seeks medical help for infertility. Alternatively, the symptoms may be mistaken for those of primary dysmenorrhoea, pelvic inflammatory disease or irritable bowel syndrome. The patient’s family history may provide an indication of a possible case of endometriosis.

The first stage of diagnosis involves a pelvic examination. The physician may be able to feel lesions during a vaginal examination. This may be followed by a transvaginal ultrasound which helps detect abnormalities like cysts on the ovaries. This technique cannot, however, detect peritoneal lesions or scar tissue. Hence, a minimally invasive procedure known as laparoscopy in order to obtain visuals of the inside of the pelvic cavity. This procedure allows the collection of tissue samples for a biopsy which will help confirm a diagnosis of endometriosis.

 

Treatment and prevention

Treatment – depending on the severity of the symptoms that the doctor will decide if medication will be provided or a surgery would be done.

  • Pain medications – the doctor may suggest taking over-the-counter pain medications to help ease period cramp pains.
  • Hormone therapy – supplemental hormones are effective in reducing or eliminating the pain of endometriosis at times. The rise and fall of hormones during the menstrual cycle cause endometrial implants to thicken, break down and bleed.
  • Constructive surgery – in case you are trying to get pregnant, surgery to remove as much endometriosis as possible while preserving the ovaries and uterus can increase chances.
  • Hysterectomy – in severe cases of endometriosis, surgery to remove the uterus, cervix and both the ovaries is the best treatment.

Prevention – since there is no sure shot cure for this condition. There are certain risk factors that can help you understand if you have or will develop endometriosis –

  • Starting your period at a young age.
  • Short menstrual cycle.
  • Low body mass index (BMI)
  • Uterine abnormalities.
  • Any medical condition that prevents the normal passage of menstrual flow out of the body.

 

Dos and Don'ts

Dos
  • Eat well to make sure that there is sufficient nutrition in the body.
  • Consider eating an endo diet (a special diet for those diagnosed with endometriosis)
  • Join an endometriosis support group to help cope with the treatment.
Don'ts
  • Indulge in smoking as nicotine can worsening the pain and delay healing
  • Ignore the signs of depression. Depression and anxiety are common among patients of endometriosis.
  • Ignore the pain and symptoms. Maintain a record of the symptoms and explain it to the doctor.

 

 

 

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shoulder pain
Arthroscopy Arthroscopy is a minimally-invasive surgery to treat joint problems. Know about its benefits, preparation, procedure technique, and recovery.
Hydrocele
Hydrocele Hydroceles occur when fluids accumulate in the male scrotum. They may not be a major health problem but…
Low fat diets
A complete list of low-fat diets and how to follow them Low-fat diets help you lose weight in a healthy way, but it works only with regular exercise and…
Muscle relaxers: Think twice before popping prescription drugs for muscle pain The market is brimming with OTC muscle relaxers. But these come with a host side-effects. Find out the…
colposcopy
Colposcopy Colposcopy is a simple, quick and non- invasive diagnostic tool to look closely inside the vulva, vagina, and…
free testosterone test
Free testosterone Free Testosterone Test measures and monitors the level of the free testosterone in the blood. Less than 4%…
Find all the instant ways to get rid of blackheads Blackheads - Not only are they aesthetically unappealing but if left untreated these can cause bacterial overgrowth on…
Crossfit with rope
CrossFit: Now get the perfectly sculpted body with this explosive gym routine CrossFit is a fitness regimen that makes use of high-intensity exercises in a shorter period to achieve muscle…
Is it possible to achieve full body detox with Master Cleanse? Master cleanse is a diet consisting of a lemonade based beverage, a salt water drink and a herbal…
Astaxanthin: Why experts believe it could be 550x more potent than vitamin E! What is astaxanthin and why is this new supplement on the block touted as the most powerful antioxidant…
smelling-salts-benefits
The actual science behind smelling salts and how it helps in injury recovery Most smelling salts are a mixture of ammonium carbonate and some perfumes which are sniffed by an individual…
reflexology massage
Top reasons why you should go for a reflexology massage today Reflexology involves the application of pressure to your feet and hands to encourage self-healing. Could this be beneficial…
myelogram
Myelography Myelography is an important diagnostic tool that is used to investigate and identify abnormalities in the spine and…
waterchestnut
Water Chestnuts: The tastiest ways to include this healthy tuber in your diet Water chestnut is not a nut after all. It is a tuber (much like the potatoes) growing close…
dandelion weight loss
Caralluma Fimbriata: How to eat this cactus to lose weight Caralluma fimbriata is a miracle cactus that can be safely consumed by most for losing weight and boosting…
woman with abdominal pain holding ovulation calendar
Ovulation – facts to know about ovulation Learn how and when ovulation occurs, demystify common misconceptions, identify symptoms, methods of detection and right period for…
folate test
Folate test The Folate test measures and monitors the levels of folic acid in the blood. This test is also…
maltodextrin sugar
Maltodextrin: What are the hidden health benefits of this food additive? Maltodextrin is one of the few food additives that has been relatively deemed safe. Many experts now have…
Juice Plus: Can you really replace actual fruits with pills?  Juice Plus supplements intend to fill nutritional gaps present in our daily diet. But how successful have they…
shakeology woman
Meal replacement or protein drink? Learn all about Shakeology and its claims Shakeology from Beachbody claims to be the most suitable shake that can aid in weight loss, regulate blood…
Miracle extract from the root of maca: 10 ways it can help you! Maca root has been used for years in herbal medicine. Today scientific research is unearthing fresh evidence in…
Lauric Acid: 8 health benefits you can derive from coconuts Appropriate use of saturated fats containing lauric acid can provide you numerous health benefits. This is the main…
kshar sutra
Kshar sutra treatment for piles, fissures and fistula Read to know the benefits and side effects of kshar sutra to treat anal piles, fissures, and fistula…
Tamarind: The top health benefits of this staple Asian ingredient Did you know this sweet and sour pulpy fruit does more than just add a tangy flavor to…
shiitake mushrooms healthy
What are Shiitake Mushrooms and why should you eat them? Shiitake Mushrooms are well known for their smoky and robust taste. However, did you know they are replete…
SIBO Diet: The important dos and don’ts of this gut-healing diet A SIBO diet is a diet that works by eliminating certain sugars from your diet and adding fibers…
CEA_test
Carcinoembryonic antigen (CEA) test CEA or carcinoembryonic test detects the presence of CEA antigen in your blood mainly & determines the effectiveness…
Ear pain model
Easy and safe tips for ear wax removal you can do at home Cerumen impaction generally occurs when an external object like cotton swabs are used to remove the ear wax.…
Propolis: Yet another amazing gift by the bees to the humans Bee propolis is yet another generous gift by the bees bestowed on the human race. They utilize substances…
blood elements analysis
Blood Element Analysis Test A blood element analysis is a blood test performed to measure the level of toxic elements such as…
How to scrub away stress and fatigue with an Epsom salt bath? Epsom salt is a popular home remedy for many skin ailments. Though there is a lack of scientific…
leptospira Igm test
Leptospira-IgM Test A Leptospira-IgM test is a blood test which is carried out to detect anti-Leptospira IgM antibody. Leptospirosis is…
Hymenoplasty
Hymenoplasty Read on to find out all about hymenoplasty, the procedure, post-surgery care, the risks, and the benefits.
chloride test
Chloride Test A chloride test of the blood checks the level of chloride in body, an important factor governing the…
Rheumatoid Arthritis xray
Arthritis Profile Arthritis profile is a panel of primarily blood tests used to detect the presence of arthritis or check…
Turner syndrome and infertility
Infertility profile (women) The infertility profile tests in women are conducted to form a complete picture of the hormonal balance and…

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