Rising burden of Endometriosis: Diagnostic and treatment options

The 8th of March is celebrated as International Women’s Day worldwide. It is a celebration of womanhood with the inherent nature of being able to bear and nurture life from within. This comes with its own price which affects women in the reproductive age group in multiple ways. Endometriosis is one such condition. This article is an attempt to create awareness about the same. What is Endometriosis? Nowadays menstrual leave has become a topic of interest with many corporates worldwide factoring in leaves for women. This is especially important for women who suffer from chronic conditions related to their monthly cycle. Many a time, for women who suffer from pain during periods or for those who visit their gynaecologist for not being able to conceive, the doctor gives the diagnosis of “Endometriosis”. It is estimated that over 42 million women in India suffer from endometriosis. The reasons for Endometriosis remain unclear even after over 100 years of research. You might have wondered what is meant by this term. We need to understand a few basics here. The lining of the inner cavity of the uterus is called “Endometrium”. The endometrium is a specialized tissue consisting of glands and stroma which undergo cyclical changes in unison with the hormonal interplay of the normal menstrual cycle. It is this endometrium that gets shed every month during the periods. Whenever there is a pregnancy, the gestational sac implants itself in the endometrium which nourishes the embryo to grow into the baby. Whenever such a specialized endometrial tissue is found anywhere outside the uterine cavity lining, it is called as “Endometriosis”. So, basically, Endometriosis is ectopic endometrial tissue found at different sites in the body. The reason for the occurrence of endometriosis is not clear, although many theories have been put forward. Genetic predisposition is a known factor. The common sites of occurrence include Ovaries, uterine ligaments, pelvic peritoneum or rarely laparotomy scars. One important aspect to understand in Endometriosis is the inflammatory response associated with the condition. The inflammatory reaction is due to the shedding of the endometrial tissue at the ectopic site which leads to the formation of scar tissue also known as adhesions. Another important factor that cannot be ignored is the mental and emotional aspect associated with Endometriosis and its complications including infertility. Chronic pelvic pain before and during the menstrual period is known to cause depression, anxiety and panic attacks. Rising Burden of the disease: As per World Health Organisation, endometriosis affects 10 per cent of women and girls in the reproductive ages globally. The symptoms include severe dysmenorrhea (pain during periods), pelvic pain and infertility. Usually, it is a chronic disease. The pain is due to the effect of hormones on the ectopic endometrial tissue in the regular menstrual cycle. This affects the quality of life in these women and reduces their productivity. The healthcare cost associated with the same is also on the rise. The disease is mainly restricted to women in their active reproductive age population group. All three subtypes of endometriosis; superficial peritoneal, ovarian endometrioma, and deep infiltrating endometriosis were reported in Indian women. Diagnosis of Endometriosis: Usually, endometriosis is diagnosed with the detailed clinical history given by the patient. Also, clinical examination and an ultrasound scan of the abdomen and pelvis help in confirming the same in many cases. Nowadays, even CT scans and MRI scans may help in a few cases. But the Gold Standard in demonstrating the endometriosis would be a laparoscopic surgery with the visualization of the endometriotic deposits, biopsy and histopathological confirmation of the same. Treatment of Endometriosis: Endometriosis is a chronic disease of the reproductive age group women. The treatment is given based on when is the patient presenting to the doctor. If patients present with pain alone, analgesics are tried initially along with medical management with progesterone-containing pills. Hormones like estrogen and progesterone play an important role in endometriosis and is closely associated with the condition. Therefore treatment also includes regulating the levels of these hormones. If the patient presents with infertility, then the disease is controlled with pills along with treatment for infertility. If it doesn’t respond, then surgical treatment with the aim to remove the endometriotic focus is considered. The treatment will be customized for each patient, based on the site of endometriosis and the symptoms with which the woman presents to the doctor. In conclusion, it can be said that awareness of Endometriosis as an entity is the need of the hour. Even though it is a chronic disease, it can be controlled and managed. Do not hesitate to seek medical consultation whenever needed. The author is Technical Lead-South & Chief Pathologist, SRL Diagnostics, Bangalore. Views expressed are personal. Read all the Latest News , Trending News , Cricket News , Bollywood News , India News and Entertainment News here. Follow us on Facebook, Twitter and Instagram.