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Endometriosis & infertility Clinic


What is Endometriosis?

The endometrium is the tissue that lines the inside of the womb (uterus). Endometriosis is a condition where endometrial tissue is found outside the uterus. It is ‘trapped’ in the pelvic area and lower tummy(abdomen) and, they found on the ovaries, on the lining of the pelvis behind the uterus and covering the top of the vagina, rarely in other areas in the body.


Who gets endometriosis?

The exact number of women who develop endometriosis is not known. This is because many women have endometriosis without symptoms, or with mild symptoms, and are never diagnosed. If symptoms develop they typically begin between the ages of 25-40. Sometimes symptoms begin in the teenage years. Endometriosis can affect any woman.


What causes endometriosis?

The exact cause of endometriosis is not known, but researchers have some theories. It may result from something called “retrograde menstrual flow,” in which some of the tissue that a woman sheds during her period flows through her fallopian tubes into her pelvis. Researchers believe that endometriosis likely results from a combination of factors, including some of the following:

  • Because endometriosis runs in families, genes are probably involved with endometriosis to some degree.
  • Estrogen also likely contributes to endometriosis, because endometriosis is an estrogen-dependent, inflammatory disease.
  • In some cases of endometriosis, the immune system fails to destroy endometrial tissue, which enables it to grow outside the uterus.
  • Environmental exposures in the womb, such as to chemicals.

How can I reduce my chances of getting endometriosis?

There are no definite ways to lower your chances of getting endometriosis. Yet, since the hormone estrogen is involved in thickening the lining of the uterus during the menstrual cycle, you can try to lower levels of estrogen in your body. To keep lower estrogen levels in your body, you can:

  • Exercise regularly
  • Keep a low amount of body fat
  • Avoid large amounts of alcohol and drinks with caffeine

What are the symptoms of endometriosis?

Pain is the main symptom of endometriosis. There may be no symptoms. A woman with endometriosis may have:

  • Painful periods
  • Pain in the lower abdomen before and during menstruation
  • Cramps for a week or two before menstruation and during menstruation
  • Pain during or following sexual intercourse
  • Pelvic pain that may occur at any time during the menstrual cycle

Diagnosis

Tests that are done to help diagnose endometriosis include:

  • Pelvic exam
  • Transvaginal ultrasound
  • Pelvic laparoscopy

What is Treatment?

Treatment depends on the following factors:

  • Age
  • Severity of symptoms
  • Severity of disease
  • Whether you want children in the future

If you have mild symptoms and do not ever want children, you may choose to have regular exams every 6 – 12 months. But for moderate and severe you need:

  • Medications to control pain
  • Hormone medications to stop the endometriosis from getting worse
  • Surgery to remove the areas of endometriosis or the entire uterus and ovaries

Surgery is used for women with severe endometriosis: many growths, a great deal of pain, or fertility problems. Methods are:


can be used to diagnose and treat endometriosis. During this surgery, doctors remove growths and scar tissue or burn them away. The goal is to treat the endometriosis without harming the healthy tissue around it. Women recover from laparoscopy much faster than from major abdominal surgery.

involves a much larger cut in the abdomen than with laparoscopy. This allows the doctor to reach and remove growths of endometriosis in the pelvis or abdomen.

is a surgery in which the doctor removes the uterus. Removing the ovaries as well can help ensure that endometriosis will not return. This is done when the endometriosis has severely damaged these organs. A woman cannot get pregnant after this surgery, so it should only be considered as a last resort.


Complications of endometriosis

The main complication of endometriosis is difficulty getting pregnant (subfertility) or not being able to get pregnant at all (infertility). In some cases, there may also be adhesions or ovarian cysts.