Endometriosis is a painful disorder in which the tissues similar to the inner lining of the uterus or endometrium grow outside the uterus. It is a long term condition which can have a significant effect on the physical, sexual, psychological and social aspect of a woman, and also a couple trying to conceive. “Endometriosis often involves the ovaries, Fallopian tubes and the tissues lining the pelvis, called the peritoneum. However, in severe cases, it may involve the bladder, bowel and ureters. Due to the absence of an outlet, when these tissues shed within the body, the blood tends to collect in a closed space and form cysts in the ovary,” explains Dr Geeth Monnappa, Gynecologist, Fortis La Femme, Bengaluru.
She adds that this leads to the production of a dense inflammatory response leading to a condition called ‘Frozen pelvis’. “This is where the tubes and ovaries are stuck to the uterus, thus altering the anatomy and interfering with egg pick up,” she tells indianexpress.comWhen is it suspected that one is suffering from endometriosis?
There are multiple reasons, but one of the most prevalent ones is when a woman complains of long-term lower abdominal or pelvic pain which affects her daily activities. “Other is having painful stools or urination during periods. In some cases, women also suffer excruciating pain during or after sexual intercourse,” says Dr Monnappa, adding: “Endometriosis often causes problems in conceiving as it distorts the anatomy of the Fallopian tube and ovary and interferes with the egg pick up by the fallopian tube.” “Not only that, but endometriosis also interferes with the egg release and the quality along with the receptivity of the inner lining of the uterus to pregnancy, thus making it difficult for a woman to conceive naturally,” she says.
How can one confirm the diagnosis?
Dr Monnappa shares the various options available to confirm the diagnosis. These include:
Abdominal and pelvic examination: This examination is inconclusive and the diagnosis requires imaging in the form of ultrasound or MRI
Ultrasound: This can easily detect endometriotic cysts in the ovaries or even its deposits in the bowel, bladder and uterus.MRI: Can be considered to assess the extent of endometriosis. especially if it involves the organs outside the pelvis prior to surgery for better planning of the procedure.
Laparoscopy: The best way to diagnose and treat endometriosis.
Dr Monnappa says, “what is alarming about endometriosis is that the severity of the symptoms doesn’t often correlate with the severity of the condition. This is because an asymptomatic or mildly symptomatic woman may have severe endometriosis and vice-versa making it difficult for the patient to comprehend the nature of the disease or the severity of her condition.”