Watch Out for Key Signs and Symptoms of Endometriosis

Endometriosis is when the endometrium lining starts to grow in areas outside the uterine lining

leading to an inflammatory reaction. The surrounding tissue tends to become inflamed and scar tissue and adhesions can form.  The pelvic organs can stick to each other (adhesion formation) and fail to function normally. It is estimated ten percent of women have endometriosis.

In an interview with HT Lifestyle, Dr Sulbha Arora, Clinical Director at Nova IVF Fertility in Mumbai, stated, “The endometrium bleeds or sheds during a menstrual period. Nature has given a passage in the form of the vagina for the endometrium to flow out however, there is no such passage available in these other regions, so the blood shed here tends to accumulate. When this occurs inside one’s ovaries it collects and forms a cyst. With the passage of time, the color of blood in these ovarian cysts changes and goes from red to chocolate brown hence, endometriotic cysts in the ovaries are also often called chocolate cysts. Due to these adhesions and cysts, endometriosis is often associated with severe period pain and infertility. Fortunately, effective treatments are available.”

What is Endometriosis?

The endometrium is the inner lining of the uterus and it is composed of endometrial glands and stroma. After a menses ends, the endometrium begins to thicken in response to ovarian hormones and the lining sheds during the next period if a pregnancy has not occurred.

With endometriosis, the same lining starts to grow in areas outside the uterus. Common sites for endometriosis are the ovary, behind the uterus, on supporting uterine ligaments, the fallopian tubes, uterine surface, bowel and bladder, most commonly. Rarely, endometriosis is located outside of the pelvis or in surgical incision. Endometriosis is estrogen dependent and endometriosis lesions contain fibrous tissue, old blood, and inflammatory cells. Lesions can be superficial, deep, or contained in the ovary (endometriomas).

Endometriosis can cause scar tissue, pain, and infertility.

The exact cause of endometriosis is not known. During menses, the endometrial lining is shed as a menstrual period. Though most tissue exits via the cervix and vagina, some tissue exits out of the fallopian tubes and ends up in the pelvis, called retrograde menstruation. The cause of endometriosis is felt to have many factors including retrograde menstruation, alterations in immunity and genetic factors.

Signs and Symptoms to Watch

The signs and symptoms of endometriosis are:

• Painful periods (dysmenorrhea): Pelvic pain and cramping are commonly seen before and during menses. You may also have lower back and abdominal pain.
• Painful sexual intercourse: Pain during or after sex is common because of this condition.
• Pain with bowel movements or urination: One can experience this particularly during menstrual cycles
• Infertility: Endometriosis is often first diagnosed only when a couple undergoes tests for infertility as there may at times be no other symptoms. Up to 50 % of women presenting with infertility have endometriosis.

Endometriosis may cause irregular menstrual bleeding and pain or other symptoms with urination or bowel movements. Some patients experience nausea with menses, bloating and fatigue. Approximately 1-7 % of women with endometriosis do not have symptoms.

Dr. Sulbha Arora adds, “Women with mild endometriosis may have severe pain and people with more advanced disease may have no symptoms at all. Endometriosis may also be mistaken for various other conditions such as pelvic inflammatory disease (PID) or other types of ovarian cysts. It can also overlap with irritable bowel syndrome (IBS), making one prone to diarrhea, constipation, and abdominal cramping. If you have any of the symptoms of endometriosis and have trouble conceiving, please consult a fertility specialist who can guide you with the right fertility treatment options.”

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