Endometriosis: Symptoms, and Treatment



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What is endometriosis?

Endometriosis is a painful gynecological condition, which occurs in women when the tissue that makes up the uterus lining develops elsewhere in the body.
Women with endometriosis often suffer from infertility, lower abdominal pain, pain during menstruation, or pain during sexual intercourse. Some women with endometriosis, however, may not have any symptoms at all.

How does endometriosis occur?

Every month hormonal changes in women cause the lining of the womb to thicken, to prepare itself for pregnancy. When the pregnancy does not occur, the cells break down and bleed out of the body naturally, which is the monthly menstruation cycle.

In endometriosis, the womb cells or the tissue that makes up the uterus lining grows in other parts of the body, such as the ovaries, fallopian tubes, the exterior of the uterus, the bowel, or other internal parts. Now, these cells too go through the same monthly cycle and break down during menstruation. But unlike the cells lining the womb, these cells have no outlet to leave the body once they break down. This can cause inflammation and scar tissue to form.

There are different types of endometriosis:

Peritoneal endometriosis: which occurs when cells which form the uterus lining stray into different parts of the body and accumulate till they become scar tissue.

Endometriosis of ovary: these start as coloured spots and form deposits which can go deeper into the ovary, where they eventually create cysts.

Adenomyosis: which occurs when the endometrial tissue grows into the muscle layer of the uterus damaging the uterine wall. It usually affects women over 30 who have had several births.

Rectovaginal septum endometriosis: affects ligaments between the uterus and pelvic bones causing adhesions.

Who is prone to endometriosis?

Some women are more prone to endometriosis than others. They include women who:

  • have a family history of endometriosis
  • are pregnant for the first time at an older age
  • suffer from heavy bleeding during periods
  • have periods which last longer than five days
  • have their first period before 11 years of age
  • regularly have less than 27 days between periods, or having shorter regular cycles
  • have experienced sudden changes in the immune cells
  • are underweight
  • overindulging in alcohol
  • have retrograde menstruation. Retrograde menstruation occurs in almost all menstruating women (up to 90 %) and therefore is considered a natural process.   Retrograde menstruation occurs when, during menstruation, the blood flows out of the vagina, but also backwards along the fallopian tubes into the pelvis. In majority of the women the blood, which contains endometrial cells is absorbed or broken down and causes no symptoms. However, problems arise when larger volumes of menstrual fluid reach the pelvic cavity. This is when endometriosis occurs.

What are the causes of endometriosis?

The causes endometriosis are not known, however, there can be many risk factors which can vary from person to person such as:

  • a family history of endometriosis
  • being pregnant for the first time at an older age
  • suffering from heavy bleeding during periods
  • having periods which last longer than five days
  • having their first period before 11 years of age
  • having less than 27 days between periods
  • sudden changes in the immune cells
  • being underweight
  • overindulging in alcohol
  • retrograde menstruation

What are the symptoms of endometriosis?

Endometriosis symptoms include:

  • pelvic pain and discomfort
  • painful, heavy and/ or irregular periods
  • pain during or after sex
  • painful bowel movements
  • stomach bloating
  • back pain
  • leg pain
  • depression
  • constipation
  • fatigue
  • fertility issues
  • pain during urination
  • diarrhea

Since some of the symptoms of endometriosis are similar to Irritable Bowel Syndrome (IBS), acute appendicitis, interstitial cystitis, or celiac disease, there are possibilities of misdiagnosis. In fact what is commonly known as bladder and bowel endometriosis can get misdiagnosed easily to be irritable bowel syndrome or appendicitis.

What is bladder endometriosis? What are the symptoms of bladder endometriosis?

Bladder endometriosis occurs when endometrial-like cells grow on or through the walls of the bladder. Symptoms include:

  • frequent urination
  • pain on urination
  • urinary urgency
  • urinary retention
  • bloody urine

What is bowel endometriosis? What are the symptoms of bowel endometriosis?

Bowel endometriosis occurs when endometriosis affects the ileum, (which is part of the small intestine). The symptoms include:

  • pain on the right side of the abdomen that mimics acute appendicitis
  • bowel obstructions
  • constipation which can last for weeks
  • rectal pain and bleeding

How is endometriosis diagnosed?

Endometriosis can be treated by a gynecologist. The doctor will first ask you for your medical history and then ask you to describe your symptoms. He/ she will perform a pelvic exam manually for abnormalities such as cysts. The doctor will ask you to undergo tests such as :

  • Ultrasound
  • Laparoscopy
  • For bladder endometriosis, the doctor may suggest a biopsy, where a portion of the endometrial implant is sampled from inside the bladder. This will rule out other causes of bladder symptoms, such as interstitial cystitis or rarely, bladder cancer.
  • For bowel endometriosis, the doctor may suggest laparoscopy and proctoscopy (a procedure in which a camera is placed in the rectum) or a CT scan of your abdomen. If you suffer from rectal bleeding your consulting gynecologist may also suggest you be evaluated by a gastrointestinal specialist to rule out the possibility of colon cancer.

What are the complications of endometriosis?

The complications of endometriosis if treatment is delayed, include:

  • fertility issues
  • adhesions – 'sticky' areas of endometriosis tissue that can join organs together
  • ovarian cysts that can sometimes become very large and painful
  • bowel obstructions
  • constipation which can last for weeks
  • rectal pain and bleeding
  • frequent urination
  • pain on urination
  • urinary urgency
  • urinary retention

What is the treatment for endometriosis?

Medical Treatment for Endometriosis

Currently, there is no cure for endometriosis. The aim of the treatment for endometriosis is to reduce the severity of the symptoms and the hormones that contribute to the issue.

Based on the severity of your condition the doctor may prescribe medicines which include painkillers, anti-depressants, contraceptive pills. For more severe cases the doctor may suggest laparoscopy, bowel surgery, hysterectomy, or oophorectomy.


Exercise

Endometriosis patients can experience noticeable relief from their symptoms when they include exercise in their daily routine. It is advisable to consult a doctor though before deciding on any form of exercise regimen to find out what exercises will be most suitable, based on the symptoms.

Exercises such as yoga, weight training, pilates, walking or jogging can not only boost up physical energy but also boost one up mentally.


Would you like to consult a doctor for Endometriosis ?

Patient Experiences

Rashmi Joshi
Controlled Endometriosis
The best doctor we ever found. I still remember, our relationship with Dr Leena started as a doctor-patient duo but has turned to a personal bond forever. It was 2009 when Dr Leena helped me to cope with endometriosis and pregnancy together. With her professional skills, expertise and knowledge I was blessed with my first son. She is very humble, her approach makes every patient feel very special. Under her keen interest, guidance and supervision i am blessed with my two sons. Today i am able to control endometriosis well and my hypothyroidism is also under control. I will always be thankful to Dr leena the whole life through. I wish her years of success and glory. I also hope that many more couples are benefitted under her guidance. ...Read Less
Doctor in this story :Dr. Leena Sarkar
Lá Fémmé Çlíníqúé
mrs urmila gandhi
Visited For Painful Periods
Kadambari Bhagwan More
Endometriosis Reduced By 80%
Size of Uterine fibroids, cycts, swelling of endometrium has reduced more than 80% in just three weeks NAP Therapy treatment. Intra Uterine Basti, other panchkarm & medicines are very good. Dr. Sunita is like mother figure & very knowledgeable. Thanks....Read Less
Doctor in this story :Dr. Sunita Jonwal
Dr Jonwal's Niramay Ayush Panchkarm Health Institute & Research Centre

Questions answered by trusted doctors

Verified User
My wife has been suffering from endometriosis for past couple of years and she had gone for laproscopic surgery last year to remove the sist but sists came back after two months and since then se has been taking medication including 3 injections of Zoladex but nothing worked for her. Plz suggest what can be done???
Dr. Venkat Raghav
General Physician, Bangalore
Hey, Treatment for endometriosis is usually with medications or surgery. The approach you and your doctor choose will depend on the severity of your signs and symptoms and whether you hope to become pregnant, harmonal therapy include hormonal contraceptives, Gnrh analogue, medoxyprogesterone, conservative surgery to remove as much endometriosis as possible while preserving your uterus and ovaries (conservative surgery) may increase your chances of success. 
Warm baths and a heating pad can help relax pelvic muscles, reducing cramping and pain.
Take pain killers when its required
Verified User
I have endometriosis and have been operated upon once 2 years ago. My left fallopian tube is blocked. I've been married for 6 years but I am unable to conceive. I am not keen on getting an IVF done. Please suggest the right line of treatment.
Dr. Sarika Dahiphale
Infertility Specialist, Pune
Truely speaking as your age and history of endometriosis you should keen for vigorous treatment see your ovarian reserve if it is less think for IVF only as IUI Have very less chance... As age increase ovarian reserve going to decrease... Show to good infertility specialist
Dr. Geetu Bhatia
Gynecologist, Delhi
If you are not keep on ivf..you can get your gynaecologist to prescribe you medicines for ovulation induction and do follicular monitoring... If right sided egg formation is there you can try naturally or go for IUI.....this treatment will also depend on extent of your endometriosis and your harmonal profile
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Did you know?

Women affected by endometriosis worldwide

Endometriosis is a common medical problem affecting about 89 million young women in the reproductive age group worldwide.

Complications due to endometriosis

Endometriosis is the main reason for stomach pain and inability to conceive in women between 25 to 30 years of age.

Endometriosis and infertility

About 30 and 40 % of women with endometriosis are infertile.

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Home Remedies

Take Ginger

Ginger is a strong anti-inflammatory herb that reduces inflammation, nausea and relieves menstrual cramps.It also plays a role in clearing the liver of excess toxins. You can chew on pieces of ginger to get relief from your symptoms. You can also drink two cups of ginger tea everyday.

Take Chamomile Tea

Chamomile has anti-inflammatory properties that help to reduce inflammation and swelling, conditions often associated with endometriosis. You can take chamomile in the form of capsules or drink two cups of chamomile tea everyday.

Include Turmeric In Your Diet

Turmeric is known to have anti-inflammatory properties and thus can effectively treat endometriosis symptoms. You can add turmeric to your cooking or take two teaspoons of raw turmeric juice in the morning on empty stomach. Please Note: Avoid turmeric if you take blood thinning medicines.

Take Castor Oil Massage

Massage castor oil directly into the abdomen. You can also mix it with a few drops of a relaxing essential oil like lavender to help relax the pelvic muscles, and with a warm compress place it on the abdomen.

Maintain a Healthy Diet

Take foods which include green leafy vegetables, broccoli, celery, blueberries, salmon, chia seeds, and plenty of fruits. Avoid caffeine, alcohol, dairy products, and processed foods.
Book an appointment with a Gynecologist