All you need to know about: endometriosis

In women with endometriosis, tissue that is similar to the endometrium, grows on or around other organs, commonly reproductive organs in the pelvis or abdomen. Photograph used for representational purposes only
| Photo Credit: Getty Images

Not many people talk about menstruation. Even fewer people talk about the pain associated with it, though almost every young girl and woman has experienced some form of menstrual cramps. It is no wonder then that endometriosis, a condition that can cause extremely painful menstrual cramps, continues to be talked about only minimally and diagnosed late, despite affecting roughly 10% of reproductive age women and girls globally.

March being Endometriosis Awareness Month, here is what you need to know about this condition.

What is endometriosis?

Endometriosis is a condition in which tissue that is similar to the lining of your uterus, grows outside your uterus. All women’s uteruses are lined with a tissue known as the endometrium. During a menstrual cycle, this tissue lining thickens in response to hormones, in order to prepare for a fertilised egg. If the egg is not fertilised, then the tissue breaks down, and is released along with blood, during the menstrual cycle.

In women with endometriosis, tissue that is similar to the endometrium, grows on or around other organs, commonly reproductive organs in the pelvis or abdomen. This tissue can grow on the ovaries, fallopian tubes, behind the uterus, in the lining of the pelvic cavity and less commonly on the bladder, intestines, rectum or elsewhere in the body.

The endometrial tissue that grows outside the uterus responds to hormones, particularly estrogen, just like the uterine lining does, causing it to thicken and bleed. However, it does not shed like the regular uterine lining does during a menstrual cycle, meaning it does not leave the body. This buildup of tissue in places where it is not supposed to be, can lead to inflammation, scarring, formation of cysts, and sometimes, fibrous tissue can form, causing organs to stick to each other.

Also Read:Will endometriosis be exempt from the gender pass over?

What are the signs and symptoms of endometriosis?

Endometriosis can start at a person’s first menstrual period and last until menopause, says the World Health Organization. The cause is unknown and there is no way to prevent it.

Some women have no symptoms. In those who do, symptoms can range from mild to severe and generally include very intense pain during the menstrual cycle, back pain and abdominal pain, pain during sex or while using the bathroom, heavy bleeding during periods, spotting or bleeding between periods, fatigue, bloating, diarrhoea or constipation and difficulty conceiving.

How is endometriosis diagnosed?

As per the WHO, a careful history of menstrual symptoms and chronic pelvic pain provides the basis for suspecting endometriosis. Although several screening tools and tests have been proposed and tested, none are currently validated to accurately identify or predict individuals or populations that are most likely to have the disease, it says.

Doctors may perform a pelvic exam and run imaging tests such as ultrasounds if they suspect endometriosis. A laproscopy may be performed, where a thin tube with a light and camera goes into abdomen to check for signs of endometrial tissue growth, and a small sample may be removed for a biopsy.

Endometriosis can often have often have symptoms that are similar to those of other conditions, which can lead to a diagnostic delay. The condition can go undiagnosed or misdiagnosed for years.

What is the treatment for endometriosis?

There are currently no treatments that can cure endometriosis. However, treatment can help manage symptoms. Treatment may be based on age and severity of the condition.

Medication such as painkillers may be prescribed. Hormone therapy using contraceptives (such as birth control pills) or other hormone medications may also be prescribed. Surgery options could include laprascopic surgeries for removal of the endometrial tissue, or in what may be considered a last resort, hysterectomy or removal of the uterus.

There need to be more conversations around endometriosis. As the WHO points out, “in many countries, the general public and most front-line healthcare providers are not aware that distressing and life-altering pelvic pain is not normal, leading to a normalisation and stigmatisation of symptoms and significant diagnostic delay. Patients who could benefit from medical symptomatic management are not always provided with treatments due to limited awareness of endometriosis among primary healthcare providers.”