All information and treatment related to Endometriosis

By Cicle Health on 29 Nov, 2022
All information and treatment related to Endometriosis

What is endometriosis?

Endometriosis is often a painful disorder in which tissue similar to the tissue that is normally inside the uterus, grows outside the uterus. Endometriosis usually involves the tissue line of the ovaries, fallopian tubes, and pelvis. In rare cases, endometrial-like tissue is present outside the pelvic organ.

In endometriosis, the endometrial-like tissue acts as the endometrial tissue, it thickens and breaks down with each period, as well as bleeding. But since this tissue has no way to exit the body, it gets stuck. When endometriosis also involves the ovaries, cysts called endometriomas can form. The surrounding tissue is irritated, and fibrous tissue can form that can cause pelvic tissue and organ to stick together. Endometriosis can cause pain, especially during periods. There may also be fertility problems

Symptoms of Endometriosis

Endometriosis is characterized by pelvic pain in the beginning, which is often associated with menstruation. Although many women feel cramping during menstruation, the pain associated with menstruation in endometriosis is worse than usual. The pain may also increase over time.

The symptoms of endometriosis are:

Painful periods:-

Pelvic pain and cramps can start before menstruation and last for several days. Pain in the lower back and abdomen may also occur.

Pain during intercourse:-

Pain during or after sex is common with endometriosis.

Pain with bowel movement or urination:-

You are most likely to experience pain while passing stools or urinating during periods.

Heavy bleeding :-

Sometimes there may be heavy bleeding or bleeding between two menstrual cycles.

Infertility :-

Sometimes women who visit the doctor for infertility treatment show endometriosis.

Other symptoms:-

Fatigue, diarrhea, constipation, bloating or nausea may be experienced, especially during periods. The severity of pain doesn’t determine the severity of the disorder, there may be mild endometriosis with severe pain, or there may be advanced-stage endometriosis with little or no pain. Sometimes endometriosis is confused with another condition, such as pelvic inflammatory disease (PID) or ovarian cysts that cause pelvic pain. You may also be confused with irritable bowel syndrome (IBS), a condition characterized by diarrhea, constipation, and abdominal cramps.

Causes of endometriosis

The exact cause of endometriosis is not certain, but possible causes may be:

Retrograde menstruation:

In retrograde menstruation, menstrual blood filled with endometrial cells flows back through the fallopian tubes into the pelvic cavity instead of out of the body. These endometrial cells stick to the pelvic walls and the surfaces of the pelvic organs, where they grow and continue to thicken and bleed during each period.

Changes in Peritoneal Cells:-

Hormones or immune factors stimulate the transformation of peritoneal cells, the cells that line the interior of the abdomen, into endometrial-like cells.

Changes in embryonic cells i.e. embryonic cells :-

Hormones such as estrogen during puberty can convert embryonic cells into endometrial-like cell implants in the early stages of development.

Surgical scar implantation:-

Endometrial cells may attach to the surgical incision after surgery such as a hysterectomy or C-section.

Endometrial cell transport:-

he blood vessel or tissue fluid (lymphatic) system can carry endometrial cells to other parts of the body.

Immune system disorder:-

A problem with the immune system can make the body unable to recognize and eliminate tissue, such as endometrial, growing outside the uterus.

Types of endometriosis

There are three types of endometriosis, depending on the location:

Superficial peritoneal lesion:-

This is the most common. Lesions on the peritoneum, which is a thin layer lining the pelvic cavity.

Endometrioma (lesion of the ovary):-

These deep, fluid-filled cysts, also known as chocolate cysts, form deep in the ovary. They do not respond well to treatment and can damage healthy tissue.

Deeply Infiltrating Endometriosis:-

This type of endometriosis grows under the peritoneum and can involve organs near the uterus, such as the intestines or bladder. suffering from endometriosis. About 1% to 5% of women have this type of endometriosis.

Stages of endometriosis

There are four stages of endometriosis.

  • Minimal
  • Mild
  • Moderate
  • Serious or severe

Many factors decide the stage of the disorder. These factors may include the location, number, size, and depth of the endometrial implant.

Stage 1: Minimal

Minimal endometriosis consists of small lesions on the ovaries and a shallow endometrial implant. There may also be swelling in or around the pelvic cavity.

Stage 2: Mild

Mild endometriosis includes mild lesions and implants on the ovary and pelvic linings.

Stage 3: Moderate

Moderate endometriosis involves multiple deep implants on the ovary and pelvic lining, and lesions may also occur.

Stage 4: Serious or Severe

The severest stage of endometriosis involves multiple deep implants on the pelvic lining and ovaries. There may also be lesions on the fallopian tubes and intestines. Cysts can also occur in one or both ovaries.

Overview :- risk of endometriosis

Endometriosis usually occurs in the years following the onset of menstruation. This can be a painful condition. However, understanding its risk factors can help determine if you are more likely to have the condition.

Age: Women of all ages are at risk for endometriosis. It usually affects women in their 30s and 40s, but symptoms can begin during puberty.

family history: Talk to our doctor, if someone in your family has endometriosis, you may be at higher risk of getting the disease.

pregnancy history: Pregnancy can temporarily reduce the symptoms of endometriosis. Women who have not had children are at increased risk of developing the disorder. However, endometriosis can also occur in women who have had children.

history of irregular periods: If you have problems with your periods, talk to our doctor. Such as shorter menstrual cycles, heavier and longer periods, periods that start at an early age.

Endometriosis misconceptions

Many women think that endometriosis is really just heavy periods. While this is not true, during the menstrual cycle, hormones cause the uterine line to thicken to prepare for a possible pregnancy. If the woman is not pregnant then the period comes. In this, the tissue breaks down and comes out of the vagina. Endometriosis occurs when those hormones growing outside the uterus become thick and bleeding begins, such as in the ovaries or the egg-releasing tubes (fallopian tubes). It is often responsible for excessive bleeding during periods, but not always. Many women think that if the symptoms are severe, then endometriosis will also be in the severe stage. But that doesn't always happen. It may also happen that there may be advanced stage endometriosis without any symptoms, or severe symptoms may be due to mild endometriosis. The pain may come from scarring and irritation caused by bleeding or from endometrial tissue growing on a nerve. Some women think they can't get pregnant if they have endometriosis. But it is not necessary. Most women are able to have children in this condition. But the more severe the disease, the more likely it is to cause a problem. If endometriosis is making it difficult to get pregnant, a doctor can help with treatment.

Endometriosis screening

To check for endometriosis and other conditions, the doctor will ask about the symptoms, including the location of the pain and when it occurs.

Tests to check for physical signs of endometriosis include:

Pelvic Exam:-

During a pelvic exam, the doctor may feel for abnormalities in the pelvis, such as cysts on the reproductive organs or scars behind the uterus. Often it is not possible to feel small areas of endometriosis until they form a cyst.

Ultrasound :-

This test uses high-frequency sound waves to create images of the inside of the body. To capture the image, a device called a transducer is either pressed onto the abdomen or inserted into the vagina (transvaginal ultrasound). Both types of ultrasound can be done to produce an image of the reproductive organ. An ultrasound imaging test may not tell whether you have endometriosis, but it can identify cysts associated with endometriosis (endometriomas).

Magnetic Resonance Imaging (MRI):-

The MRI exam uses magnetic fields and radio waves to create a complete image of the internal organs and tissues of the body. In some cases, an MRI can help create a surgical plan, giving your surgeon information about the location and size of the endometrial implant.


In some cases the doctor may act as a surgeon.

They can look inside the abdomen through laparoscopy. In this, general anesthesia is given and the surgeon makes a small incision near the navel and inserts a thin viewing device (laparoscope) to look for endometrial tissue outside the uterus. Laparoscopy gives information about the location, extent and size of the endometrial implant. The surgeon may take a sample of tissue (biopsy) for further testing. Often, with a proper surgical plan, surgeons can completely treat endometriosis during laparoscopy.

Complications of Endometriosis

The main complication of endometriosis is impaired fertility. About a third to half of women with endometriosis have a difficult time getting pregnant.

For pregnancy to occur, the egg must be released from the ovary, travel through the fallopian tubes to be fertilized by a sperm cell, and attach itself to the wall of the uterus to begin development. Endometriosis can block this tube and prevent the egg and sperm from uniting. But this condition also affects fertility, such as damage to the sperm or egg. Yet many women with mild to moderate endometriosis can still conceive. Doctors sometimes advise women with endometriosis not to delay having children as the condition may worsen over time.

Women with endometriosis have a higher expected rate of ovarian cancer than others. According to some studies, endometriosis increases that risk, but it is still relatively small. Although adenocarcinoma, another type of cancer associated with endometriosis, can occur in women who have had endometriosis.

Prevention of endometriosis

While there is no way to completely prevent endometriosis, you may be able to reduce your chances of the condition and manage your symptoms. This condition occurs when the endometrium tissue that lines the inside of the uterus grows outside instead of inside. This tissue still works as it should during periods. This means that this tissue breaks down and bleeds during periods. It hurts more than this.

Reduce estrogen levels

Our doctor may prescribe medications that can lower estrogen levels. These include birth control pills, patches, or vaginal rings with low doses of estrogen. Hormone therapy can also help with pain, but its effects will last as long as you are taking hormone therapy. You should definitely talk to the doctor before taking it.


Working out is great for the whole body. And if you make a habit of doing aerobic exercise for at least 30 minutes four to five times a week, then it can reduce the chances of getting endometriosis.Exercise helps to keep body weight down and maintain low fat. One study also suggests that exercise can also increase levels of good estrogen metabolites (compounds formed when estrogen breaks down) and reduce levels of bad estrogen.

Avoid alcohol

According to studies, drinking too much alcohol can increase the amount of estrogen in the body, which can lead to endometriosis. Reduce caffeine. According to a study, women who drink caffeine through soda and green tea have higher estrogen levels. So always drink plenty of water so that you stay hydrated.

Effects of endometriosis on pregnancy and periods

Women with endometriosis have pain associated with periods when the tissue to line the uterus gets stuck outside, sticking to the ovaries and forming cysts called endometriomas. This pain often begins before normal period cramps, and may also be accompanied by lower back pain. Many doctors prescribe hormonal contraceptives to patients to reduce discomfort. According to research, no specific risk of endometriosis in pregnancy has been clearly seen. But some research says that endometriosis can increase the risk of miscarriage or other complications. Women suffering from endometriosis will have a normal pregnancy, but do discuss with our doctor for a safe pregnancy.

When to go to the doctor

See our doctor right away if you notice any symptoms associated with endometriosis. Early diagnosis allows doctors to better treat and manage symptoms.

Treatment of endometriosis

Treatment of endometriosis usually involves the option of medication or surgery. Treatment will depend on how severe your symptoms are and whether you expect to become pregnant. Doctors usually give first aid first If this is not successful then surgery is opted for.

Pain medicine

Doctors recommend taking pain relievers such as nonsteroidal anti-inflammatory drugs (NSAIDs) ibuprofen (Advil, Motrin IB) or naproxen sodium (Aleve) to reduce period cramps. If you are not trying to get pregnant, our doctor may recommend hormone therapy along with painkillers.

Hormone therapy

Supplemental hormones are sometimes effective in reducing or eliminating the pain of endometriosis. The rise and fall of hormones during the menstrual cycle causes the endometrial implant to thicken, break, and bleed. Hormone medications can slow the growth of endometrial tissue and prevent new implantation of endometrial tissue. Hormone therapy is not a permanent solution for endometriosis. Symptoms may recur after stopping treatment.

Therapies used to treat endometriosis:

Hormonal contraception:-

Birth control pills, patches, and vaginal rings help regulate the hormones responsible for producing endometrial tissue each month. When women are using hormonal contraception, periods are lighter and shorter. The use of hormonal contraceptives can reduce or eliminate pain in some cases.

Gonadotropin-releasing hormone (Gn-Rh) agonists and antagonists:-

These drugs block the production of ovarian-stimulating hormone, reduce estrogen levels and stop menstruation. This causes the endometrial tissue to shrink. Because these drugs induce artificial menopause, taking low doses of estrogen or progestin along with Gn-RH agonists and antagonists can reduce the side effects of menopause, such as vaginal dryness and bone loss. Menstruation and ability to become pregnant return when you stop taking this medicine.

Progestin therapy:-

Several types of progestin treatments, including levonorgestrel (Mirena, Skyla), contraceptive implant (Nexplanon), contraceptive injection (Depo-Provera) or intrauterine device with progestin pill (Camilla), can help stop periods and endometrial implant growth, which May relieve symptoms of endometriosis.

Aromatase Inhibitor :-

Aromatase inhibitors are a class of drugs that reduce the amount of estrogen in the body. To treat endometriosis, doctors may prescribe aromatase inhibitors with progestins or combination hormonal contraceptives.

Conservative surgery

Conservative surgery is commonly used for women who want to become pregnant or who are experiencing severe pain and hormonal treatments are not working. Through this surgery, the endometrial growth is removed or destroyed without damaging the reproductive organ.Laparoscopy is a minimally invasive surgery, used to check for endometriosis. It is also used to remove tissue such as abnormal or dysfunctional endometrial tissue. Surgeons make small incisions in the abdomen to surgically remove the growth. Lasers are now more commonly used to eliminate tissue.

Hyserectomy surgery to remove ovaries

Surgery to remove the uterus (hysterectomy) and ovary (oophorectomy) is one of the effective treatments for endometriosis. In this surgery, the ovaries are also removed, which can lead to early menopause. In some cases, endometriosis pain may improve due to a lack of hormones being made by the ovaries, but for others, endometriosis that persists after surgery continues to cause symptoms.

Removal of the uterus (hysterectomy) can sometimes be used to treat the signs and symptoms associated with endometriosis, such as heavy bleeding and cramping in the uterus. Even if the ovary is left in place in this surgery, a hysterectomy can still have long-term effects on your health, especially if the surgery is performed before the age of 35.

Preparation for surgery

Consult our doctor to be sure about the surgery. Ask questions about preparation.You may need to have tests to make sure you are healthy enough for surgery. Based on the risk factors, our doctor decides which tests you need to have. These include the following tests:

  • blood test
  • MRI scan
  • pelvic ultrasound

Tell our doctor about vitamins, supplements, and over-the-counter medications. Ask our doctor what medicines you will need to stop taking and for how long before your surgery. If you smoke cigarettes, stop smoking six to eight weeks before surgery. Cigarette smoking can slow down the healing process as well as increase the risk of heart-related events during surgery. Talk to our doctor for advice on this.

post surgery care

After the surgery, the doctor will inspect the wound and check that bleeding is not happening. If there is bleeding, it may be advisable to use a sanitary pad.

The doctor may keep you in the recovery room for a few hours before discharging you from the hospital. You may be given pain relievers after surgery.

It is important to talk about this topic. Diet plays a big role in hormonal changes. If you want, you can contact our dietician for information related to diet.

Best treatment for you

Doctors suggest medicines and treatment according to the symptoms and need. If the condition is very bad and you do not want to become pregnant then you can consider surgery.

Why choose Cicle?

Cicle is a health friendly application, where you can chat with our health service provider and get answers to your questions even if you want to keep your identity a secret. We can help with the treatment of endometriosis. Click here to book an appointment.

Frequently asked Questions

Does endometriosis progress with age?

Yes, endometriosis is a progressive condition that gets worse with time. Usually, it starts showing symptoms after a few years, stops temporarily during pregnancy, and ends permanently after menopause.

What is the Connection Between Infertility and Endometriosis?

About 4 out of 10 women with infertility have endometriosis. Inflammation of endometriosis can damage sperm or eggs or interfere with their movement through the fallopian tubes and uterus. In severe cases of endometriosis, the fallopian tubes may be blocked by scar tissue.

I have recently had a problem with endometriosis. can i still be pregnant?

Do not delay pregnancy. Over time this disease can become serious. Consult a gynecologist for further advice on improving your chances of pregnancy.

Data on Endometriosis

More than 190 million women worldwide suffer from endometriosis. Given all these risks and statistics, women should not be careless. If you are experiencing any symptoms, consult a doctor immediately. If you are trying to conceive pregnancy and are confused, then we have advice from our experts. If you want, you can also discuss with our expert doctor through video conferencing. Click here to book appointment.

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