Endometriosis commonly involves the ovaries (female reproductive organs that produce the female eggs and female sex hormones), fallopian tubes (tubes connecting the ovaries to the uterus), and tissues lining the pelvis.
The endometrial-like tissue will act like the endometrial tissue and will thicken, break down, and bleed with each menstrual cycle. Since this tissue has no way to exit the body, it gets trapped in the body and may lead to pain and fertility problems.
Causes:
The precise cause of endometriosis is not known. However, it is thought to occur due to the following reasons:
Risk factors:
Some factors may increase the risk of developing endometriosis and may include the following:
Stages:
Endometriosis can be divided into the following stages depending on its severity:
Stage 1: Minimal
This stage involves the presence of isolated endometrial implants with no significant adhesions (sticky endometrial tissue areas that join the organs together).
Stage 2: Mild
This stage involves the presence of superficial endometrial implants on the ovaries and peritoneum (a thin film that lines the pelvic cavity) with no significant adhesions.
Stage 3: Moderate
This stage involves the presence of multiple endometrial implants, both superficial and deeply invasive. Adhesions could be present.
Stage 4: Severe
This stage involves the presence of multiple superficial and deep endometrial implants along with large ovarian cysts or endometriomas. Dense adhesions are seen in most cases.
The following symptoms may be associated with endometriosis:
Depending on the severity of the condition and the overall health of the patient, the various treatment modalities for endometriosis may include:
1. Pain medicines:
Pain-relieving medications like ibuprofen may be recommended to ease the painful menstrual cramps.
2. Hormone therapy:
This type of treatment is recommended in the case of patients who are not trying to get pregnant.
Hormonal medicines help in slowing the growth of the endometrial tissue and preventing the formation of new endometrial tissue implants.
The different hormone therapies that may be used to treat endometriosis include:
Hormonal contraceptives: Birth control pills, vaginal rings, and patches help in decreasing or eliminating the heavy bleeding and pain during menstruation.
Progestin therapy: The use of an intrauterine device (IUD), contraceptive implant, contraceptive injection, or progestin pill help in stopping the menses and the also growth of the endometrial implants.
Gonadotropin-releasing agonists and antagonists: These medicines help to reduce estrogen levels, block ovarian-stimulating hormone production, and stop menstruation creating artificial menopause. The menses resume once the patient stops taking these medicines.
Aromatase inhibitors: These medicines decrease the estrogen levels in the body.
3. Conservative surgery:
This type of surgery is performed to remove the endometriosis implants while preserving the uterus and the ovaries.
This type of procedure is preferred in women who are trying to get pregnant but have endometriosis.
This type of surgery can be performed in the following ways:
Laparoscopic surgery: A laparoscope (a tube with a light and camera on one end) is inserted through a small incision (cut) near the belly button area. Small surgical instruments are then inserted inside to remove the endometrial tissue through the incision.
Traditional open-cut abdominal surgery: This type of surgery is performed in more extensive cases. The surgeon makes a large incision in the abdominal region to remove the endometrial tissue.
4. Fertility treatment:
Endometriosis could cause difficulty in conceiving.
Fertility treatments, such as the stimulation of the ovaries in order to produce more eggs or in vitro fertilization may be performed.
5. Hysterectomy along with the removal of the ovaries:
Hysterectomy is a surgical procedure performed to remove a woman’s uterus. Oophorectomy is the surgical removal of a woman’s ovaries.
Hysterectomy can treat symptoms of endometriosis such as painful menstruation and heavy bleeding.
Removal of the ovaries causes early menopause. Early menopause may increase the risk of developing cardiovascular diseases, and metabolic disorders, and may even cause early death.
This procedure is performed only if all other treatment options have failed.
The complications associated with untreated endometriosis are:
The following home remedies are helpful in relieving the symptoms of endometriosis:
Endometriosis cannot be prevented. However, lowering the levels of estrogen in the body can reduce the risk of developing endometriosis. This can be done in the following ways:
Cost of Endometriosis treatment in India-
The cost of endometriosis treatment using medications in India is between INR 2,000 to INR 3,000.
The cost of endometriosis treatment in Mumbai is between INR 60,000 to INR 2,75,000.
The cost of endometriosis treatment in Delhi is between INR 55,000 to INR 2,50,000.
The cost of endometriosis treatment in Bangalore is between INR 55,000 to INR 2,50,000.
The cost of endometriosis treatment in Chennai is between INR 50,000 to INR 2,25,000.
MBBS, DGO - Gynecologist