Endometriosis is one of the most mysterious gynaecological disease. Endometriosis is a disease of women of child bearing age. One should be aware of the symptoms of endometriosis because early diagnosis promises good prognosis.
In endometriosis, there is occurrence of ectopic endometrial tissue outside the cavity of the uterus. Endometriosis is further graded as minimal, mild, moderate, and severe depending on the extent of endometrial tissue present outside the uterus. Symptoms of endometriosis are dysmenorrhoea, dyspareunia, menorrhagia and infertility. However 30 % women are asymptomatic. So every woman should go for regular check-ups after a certain age.
Dysmenorrhoea or painful menstruation is the most common symptom. It is moderate to severe in intensity and aggravated before menses. Pain can be dull aching, crushing, cramping or colicky in nature. Backache is also associated with it. In severe cases, dysmenorrhoea persists for few days even after menstruation. In endometriosis, abdominal pain can occur anytime not in relation with menses and can be very severe. Menorrhagia is common in endometriosis when adhesions are formed. Irregular bleeding may also occur.
The endometrial tissue causes adhesions between the ligaments of uterus and fixes the uterus in adhesions. So movements of cervix cause pain. Hence there is dyspareunia which means pain during sexual intercourse. Endometriosis can also cause infertility.
Endometriosis interferes with motility of the tube and may inhibit ovulation, resulting in infertility. Women affected are often reluctant to attempt intercourse due to dyspareunia and this adds to the magnitude of infertility. The incidence of infertility amongst women suffering from endometriosis ranges between 30 to 40%
Proper investigations and right medical management is necessary before the formation of extensive adhesions. Combined oral contraceptives and oral progestogens is the medical line of treatment. Gonadotropin releasing hormone is administered for the atrophy of endometriotic tissue. In advanced stages, lesions of endometriosis form over ovary, ligaments of uterus etc. Adhesions form in the peritoneal cavity. So surgery is needed in such cases.
Depending on the extent of endometriosis, surgery is planned. In cases where there are many adhesions and uterus is also covered by adhesions, uterus also needs to be removed. This surgery is called as hysterectomy. So be alert about endometriosis.