Endometriosis - Enigmatic Disease in Women

Endometriosis is a common disease in women in which tissues found in the inner lining of the uterus are found in other parts of the body. Those tissues can behave in a similar way during the menstrual cycle under the influence of female sex hormones oestrogen and progesterone. These tissues also bleed during menses and become red and later on chocolate coloured. Old endometrial tissue may get fibrosed to form adhesions and which distort the normal structure of the tissue organs. Endometriosis can develop in various places of the body but it usually develops in the vicinity of the reproductive organs of a woman.

Endometriosis is common but problems due to it depend on the size and location of the disease. Minute endometriosis does not cause any problem but bigger endometriosis can cause painful periods, pain discomfort during sex, pelvic pain, low backache, postmenstrual spotting and even sterility. Endometriosis is the most common cause of dysfunctional uterine bleeding. In all women suffering from sterility endometriosis must be suspected and the woman should be investigated for it.

Endometriosis and fertility are related to each other. It can cause sub-fertility or infertility. While in infertile women, due to any other cause, the risk of endometriosis increases two to five fold than in normal woman.

The mechanism by which endometrical-like tissue develops other than the uterus is still a mystery for scientists.

Diagnosis: Diagnosis of endometriosis is also not always easy. Small endometriosis tissues in remote places are difficult to diagnose. The disease can be definitely confirmed by taking out the suspected tissue and examining it. The tissue can be taken out through trans-vaginal laparoscopy. But many times the tissue sample is taken out for examination.

Many other methods are being developed but no other method can confirm the presence or absence of the diseases with certainty.

Management: If women are suffering from endo-metriosis, the treatment depends on the size, problems due to it and the women's need. If women don't have any symptoms due to the disease, no treatment is usually required.

For women having various symptoms due to endometriosis, the aim of treatment should be to relieve the symptoms, stopping its growth and preventing or delaying its recurrence. If women are suffering from infertility, then treatment should aim to restore fertility.

Treatment of endometriosis depends on the need of the woman, her age, the severity of the disease, location of the disease, presence of pain and other problems. Ideal treatment for endometriosis is the removal of endometriosis tissue when lesions are big enough and to restore the normal structure of organs affected, especially Fallopian tubes, ovaries and uterus, as far as possible.

Of course, many effective drugs like Danozol, are also available which can reduce the size of the lesion and prevent its further growth, but these drugs are suitable for women who have completed their family. In these women affected reproductive organs can be removed by surgery.

INFERTILITY

Many women suffering from infertility due to endometriosis to may require surgery and later on control ovarian hyperstimulation (COH) or/and assisted reproductive techniques like intrauterine implantation invitro fertilisation (IVP) to have a baby.

Endometriosis is an enigmatic disease of women and an important cause of dysfunctional uterine bleeding, pelvic pain and infertility. Women suffering from infertility due to endometriosis require early treatment. As the disease becomes older, chances of success decrease. In spite of all the developments and efforts, fully successful treatment for endometriosis is still not possible.