Signs, Symptoms And Treatments Of Endometriosis}

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Submitted by: Dr Kelly Loi

Do you feel a pain in the abdomen (pelvic region), experience painful periods and uneasy sexual intercourse? Maybe these are the symptoms of endometriosis. Endometriosis is a condition in which the endometrial tissue comes out of the uterus and either gets trapped in the pelvic area or the lower abdomen (tummy). The exact cause of endometriosis is not known till now. However, it is mainly found in infertile women.

The question which bothers many is what is the cause of endometriosis? As we know every month, the ovary produces hormones that make the cells lining the uterus swell and get thicker. The uterus sheds these cells along with blood and tissue through the vagina during menstrual cycle. Endometriosis occurs when these cells grow outside the uterus, in other parts of the body and may be attached to ovary, bowel, rectum, bladder or the lining of the pelvic area as well as other body parts. These cells grow and stay in the body and pass off during menstrual cycle.

Over time, the growth of these cells may add more tissue and blood. The buildup of blood and tissue in body leads to pain and other symptoms.

Endometriosis probably starts when a woman begins having periods and it cannot be diagnosed until a lady ages 25-35 years.

A woman is likely to develop endometriosis if:

1. A lady has a someone with endometriosis in her direct bloodline

2. Her periods starts earlier than normal

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3. A lady never bears a child

4. She has frequent periods or if they last 7 or more days

5. She has a closed hymen, which blocks the flow of menstrual blood during the period

Symptoms of Endometriosis:

1. Painful periods: This type of pain begins a few days before the period and lasts till the end of the cycle. It is different than normal period pain which is usually not as severe, and doesn’t last as long.

2. Painful intercourse: The pain is felt deep inside, and may last a few hours after having sex.

3. Pain in lower tummy and pelvic area.

4. Difficulty in becoming pregnant, as the passage of the egg from an ovary to the Fallopian tube may be blocked.

Treatment: There is no perfect way of managing endometriosis. The three basic treatment approaches are:

#1.Watchful waiting:

Women with mild endometriosis or those approaching the age of menopause must delay the treatment. They may, rather, go for lifestyle modifications, such as exercise and relaxation, to cope with pain. Nonsteroidal anti-inflammatory drugs, such as ibuprofen (Advil) and naproxen (Aleve), or acetaminophen (Tylenol) may reduce pain to a great extent.

#2. Hormonal Therapy:

Hormonal therapies are used to mimic states such as pregnancy or menopause or directly blocking ovulation. Hormonal drugs include oral contraceptives, progestins, GnRH agonists, and danazol can be effective in relieving endometriosis symptoms. The downsides of these drugs are that they do not cure the problem and its symptoms may recur within 5 years of treatment.

#3. Surgery:

Surgery is an only option if severe pain persists and does not respond to watchful waiting and medical treatment and in case, a woman wants to become pregnant and endometriosis is hinder her from conceiving. There are two basic surgical approaches:

(A). Conservative Surgery (Laparoscopy or Laparotomy): These surgeries use minimally invasive laparoscopy, or sometimes conventional surgery (laparotomy), to remove the endometriosis implants. Its good for women who wish to become pregnant or who cannot tolerate the hormone therapy. However, endometriosis often recurs after conservative surgery.

(B). Radical Surgery (Hysterectomy): Hysterectomy is used to either cure or control endometriosis. Younger patients can often have only a hysterectomy while leaving one or both of their ovaries intact. However, if endometriosis has developed outside the uterus then even this procedure does work. Removing both ovaries along with the uterus is the only potential cure for endometriosis.

Through these treatments, the symptoms of endometriosis can be controlled providing relief to the patients.

Conclusion: As it is known that causes of endometriosis are not yet known, the way left is to control its symptoms. Thus proper care and effective health measures are the way to keep the pain under control.

About the Author: Dr. Kelly Loi is an Obstetrician and Gynaecologist and medical director of Health and Fertility Centre for Women in Singapore. She has been accredited as a fertility and IVF Specialist by the Ministry of Health, Singapore. She has gained experience in antenatal and obstetrics care, gynecologic and laparoscopic surgeries, treatment of infertility and IVF. To find more information, visit

healthfertility.com.sg/profile.html

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