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Article / Health / Gynecology | Post Comments |
Endometriosis - challenges in women's health |
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By : Dr. Duru Shah , Mumbai, India 9.4.2018 Phone: 022 2380 2584 Mail Now | |
Director, Gynaecworld, Kwality house, Kemp's corner. Mumbai 400 026 | |
The most severe painful periods in women occur due to a
condition called “Endometriosis”. Though it is a benign condition, it can behave
like a cancer! It spreads its tentacles from the ovaries to the pelvis and can
go further to invade the bowel, the bladder, the uterus, scars in the abdomen
wall and sometimes travels even beyond the pelvis and the abdomen into the
chest! It is simply the invasion of the endometrium (inner lining of the uterus) into spaces where endometrium is normally not found. It responds to the hormones in the body in a similar way as the endometrium responds. Every month, the endometrium within the uterus grows thicker in response to the rising hormones in the blood of a menstruating woman, and prepares itself to receive an embryo. If a woman has been sexually active and has conceived, then this thick lining helps in nourishing the growing embryo. But if a woman is not pregnant the endometrium is shed off through the vagina during a menstrual period and the cycle starts all over again in the next month. Just as the endometrium within the uterus responds, so also does the
endometrium outside the uterus responds to the circulating reproductive
hormones. It grows thicker and sheds every month, and when it sheds, the blood
which accompanies it, has no outlet. This collection of blood into spaces which
have no outlet causes the extreme pain which accompanies this condition. The
pain in the early stages maybe mild, but as the disease progresses, the pain
gets excruciating and unbearable, leaving a woman in agony which is difficult to
be control with routine pain killers. Endometriosis is more commonly seen in career women or those who have “Type A” personalities and in women who delay childbirth. Approximately 40% of infertile women have endometriosis which may be mild, moderate or severe. In infertile women, the disease may be so mild that it may not show on sonography. But if we suspect that it may be present, then to prove the diagnosis we have to proceed with a laparoscopy ie. check the interior of the abdomen with a telescope. Besides the pain which it causes in the lower abdomen and back, endometriosis can also be the cause of extreme pain during sexual intercourse which is termed as dyspareunia. Treatment There is unfortunately no cure for this disease as of today, only because we still do not know the cause of this disease. Fortunately we do have potent drugs which can help to keep it under control, but these drugs do have side effects thus limiting their use. Surgery is the preferred choice of treatment for relief of pain especially if excessive. The surgery can be performed laparoscopically or as open surgery, depending on the severity of the condition. The ideal option for infertility management in a woman having moderate or severe endometriosis is Assisted Reproduction (IVF) after removing as much of the disease as possible surgically. Endometriosis is truly a condition which may make a woman dread the approach of her period and also her sexual partner. |