Battling endometriosis
Celebrities have been opening up about various health issues, some considered taboo by society, others little known and discussed ailments, thus encouraging ordinary people to come out and seek help for such problems. One of these is endometriosis
Actor Sumona Chakravarti recently took to social media to share an important message about her health. She wrote that she has been battling endometriosis since 2011.
“Endometriosis is a condition in which endometrial tissue, normally found only in the lining (the endometrium) of the womb (uterus), grows outside the uterus. It occurs in about 5%10% of the female population. One in six women with pelvic pain and 20% of women with fertility problems will have endometriosis. It commonly occurs in the 25-40 age group and is rarely seen after menopause,” says Dr Vaishali Joshi, senior Obstetrician & Gynaecologist at Kokilaben Ambani Hospital, Mumbai.
Endometriosis often goes undiagnosed, and women like Amy Schumer, Padma Lakshmi and Lena Dunham have been raising awareness about the condition, so that other women don’t have to suffer in silence.
UNDERSTANDING ENDOMETRIOSIS
Endometriosis is classified into one of four stages (I-minimal, IImild, III-moderate, and IVsevere) depending on location, extent and depth of endometriosis implants, presence and severity of adhesions, and presence and size of ovarian endometriomas. “Severity of symptoms do not always reflect the severity of the disease,” cautions Dr Vaishali.
WHAT CAUSES ENDOMETRIOSIS?
The exact cause is not known. It could be because of immunological, genetic or hormonal factors, or due to retrograde menstruation. “During periods, menstrual blood is thrown out of the body through the cervix or neck of the womb. It can also back track into the abdomen through the openings of the Fallopian tubes,” the doctor explains. In most women, this is mopped up by the body’s natural mechanism. But in some women, the process fails and small islands of tissue thrive in the body like parasites and cause inflammation, pain, swelling.
TREATMENT
Endometriosis is a disease which can last for the complete reproductive lifespan of a woman, i.e., from menarche to menopause. “The treatment options need to be tailored to meet each woman’s symptoms, age of presentation, plans for the fertile stage, and risks involved in surgical treatments,” says Dr Vaishali.
The limited evidence available from research studies suggest that untreated endometriosis may get better in three out of 10 women and becomes worse in three others, while remaining unchanged
in the remaining women. “At present there are no curative treatments for endometriosis or associated symptoms, and when offering treatments to women with endometriosis, doctors cannot predict who is likely to have their endometriosis worsen if untreated. Even with treatment, endometriosis can recur,” Dr Vaishali notes.
The approach should be holistic, and include lifestyle management, simple pain management, hormonal treatment and surgery to excise the endometriotic patches in cases of minimal to mild disease. “Severe or Grade IV endometriosis needs extensive and complex surgery which should be done with a multidisciplinary approach, involving gynaecologists, bowel surgeons, urologists, radiologists and pain specialists,” according to Dr Vaishali.
After surgery, most women have relief from pain. But the pain can recur in eight out of 10 women within two years of surgery. This may be due to endometriosis that was not visible or could not be removed at the time of surgery.
As a last resort, removal of the uterus, cervix, fallopian tubes and ovaries may be offered, mainly for women who have completed their family.
Endometriosis
often goes undiagnosed, and women like Amy Schumer, Padma Lakshmi and Lena Dunham have been raising awareness about the condition, so that other women don’t have
to suffer in silence
Endometriosis is a condition in which endometrial tissue, normally found only in the lining of the womb (uterus), grows outside the uterus. It occurs in about 5%-10% of the female population. One in six women with pelvic pain and 20% of women with fertility problems will have endometriosis. It commonly occurs in the 25-40 age group
— Dr Vaishali Joshi, senior Obstetrician &
Gynaecologist