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Endometriosis symptoms affects approximately 1 in 10 women of reproductive age—that’s roughly 176 million women worldwide. Yet, many suffer for years before diagnosis. At North Delhi Uro & Gynae Clinic, we help women understand and manage this chronic condition.
Endometriosis occurs when tissue similar to the uterine lining (endometrium) grows outside the uterus in other parts of the body. This tissue responds to hormonal changes, bleeds during menstruation, but has nowhere to go, causing inflammation, scarring, and pain.
Common Locations of Endometrial Tissue: – Fallopian tubes – Ovaries – Pelvic peritoneum (pelvic lining) – Bladder – Bowel – Rarely: lungs, brain, skin
Endometriosis: – Tissue grows outside uterus – Distinct lesions/implants – More superficial – Affects fertility more commonly
Adenomyosis: – Tissue grows into uterine muscle – Diffuse involvement – Deeper penetration – Usually occurs in women >40 years
Stage 1 (Minimal): – Few small lesions – No significant scarring – May have minimal symptoms
Stage 2 (Mild): – More lesions – Some adhesions forming – Mild pain possible
Stage 3 (Moderate): – Multiple lesions – Adhesions present – Ovarian involvement possible – Moderate pain likely
Stage 4 (Severe): – Extensive lesions – Dense adhesions – Ovarian involvement likely – Significant pain – Fertility often affected
Pain Symptoms (Most Common): – Dysmenorrhea: Severe menstrual cramps – Chronic Pelvic Pain: Between periods – Dyspareunia: Pain during intercourse – Dyschezia: Pain during bowel movements – Dysuria: Pain during urination (if bladder involved) – Lower Back Pain: Radiating pain – Pain During Ovulation: At mid-cycle
Severity Spectrum: – Mild: Occasional discomfort – Moderate: Regular pain requiring management – Severe: Debilitating pain affecting daily life
Other Symptoms: – Heavy or irregular menstrual bleeding – Infertility or subfertility – Fatigue – Bloating – Nausea – Diarrhea or constipation (if bowel involved) – Emotional symptoms (depression, anxiety)
Important Note: Symptom severity doesn’t correlate with disease severity. Some women with extensive disease have minimal symptoms, while others with mild disease have severe pain.
Proposed Causes:
Risk Factors: – Early menarche (first period) – Late menopause – Prolonged menstruation – Short menstrual cycles – Heavy menstrual bleeding – Family history (5-7% of first-degree relatives affected) – Never having been pregnant – Certain genetic variants – Immune system dysfunction – Estrogen and progesterone resistance
Clinical Assessment: – Detailed history of pain and symptoms – Menstrual history – Fertility history – Symptom pattern
Physical Examination: – Pelvic examination may reveal tenderness – Nodules palpable in some cases – Often normal despite disease presence
Imaging Studies:
Transvaginal Ultrasound (Most Useful): – Visualizes ovarian endometriosis – Detects deep infiltrating endometriosis – Non-invasive, no radiation – Sensitivity: 80-90% for ovarian lesions – Lower sensitivity for peritoneal disease
MRI: – Excellent for deep infiltrating endometriosis – Assesses bowel and bladder involvement – Higher cost, longer duration – Useful for surgical planning
CT Scan: – Limited usefulness – Radiation exposure
Gold Standard Diagnosis: – Laparoscopy with Biopsy – Direct visualization of lesions – Tissue confirmation (histology) – Often therapeutic (lesions removed) – Allows staging – Requires anesthesia and surgery
Blood Markers: – CA-125: Elevated but not specific – Other markers: Research stage – Not reliable for diagnosis
Conservative Treatment (First-Line):
Pain Management: – NSAIDs: Ibuprofen, naproxen for menstrual pain – Take before period starts for better effectiveness – Success rate: 50-60%
Hormonal Therapy (Reduces or Stops Menstruation):
GnRH Agonists (Advanced Hormonal Therapy): – Suppresses ovarian hormones – Induces temporary menopause state – Very effective (80-90% pain relief) – Used for 3-6 months maximum – Side effects: Hot flashes, mood changes – Add-back therapy (low-dose estrogen/progestin) to minimize side effects – Expensive – Reserved for severe cases or failed previous treatment
Surgical Treatment:
Diagnostic/Therapeutic Laparoscopy: – Gold standard for diagnosis – Allows lesion removal/ablation – Success rate: 50-80% pain relief – Relief may be temporary (need long-term management) – Can assess severity and guide treatment – Allows adhesiolysis (adhesion removal)
Conservative Surgery (Preserve Uterus and Ovaries): – Remove or ablate lesions – Lyse adhesions – Best for women wanting fertility preservation – Recurrence rate: 20-40% at 5 years
Hysterectomy (Definitive Surgery): – Removes uterus – May remove ovaries – Most effective (95% pain relief if ovaries removed) – Eliminates fertility – Reserved for women complete with childbearing – Recurrence possible if ovaries retained
Combined Medical + Surgical Approach: – Most effective strategy – Surgery to remove lesions/adhesions – Hormonal therapy afterward to prevent recurrence – Offers both immediate pain relief and long-term management
Managing Endometriosis Long-Term
Fertility Considerations: – Endometriosis affects 30-40% of infertile women – Treatment depends on stage and desire for pregnancy – Options: Expectant management, stimulated cycles, IVF – Success rates vary (30-50% per cycle for IVF) – Earlier treatment may improve fertility outcomes
Lifestyle Modifications: – Regular exercise (reduces pain, improves mood) – Heat therapy (heating pads for pain relief) – Stress management – Dietary modifications (anti-inflammatory foods) – Avoid caffeine, alcohol – Adequate sleep – Support groups and counseling
Symptom Management: – Maintain pain diary – Communicate with doctor about symptoms – Adjust treatment as needed – Regular follow-up
What Dr. Anju Bala Recommends
“Endometriosis is a chronic condition requiring long-term management. The goal is maximum symptom control with minimum side effects. This often requires combining multiple approaches—medical, surgical, and lifestyle modifications. Every woman’s situation is unique, so we develop personalized treatment plans.”
When to Seek Treatment
Consult Dr. Anju Bala For: – Severe menstrual pain not improving with NSAIDs – Chronic pelvic pain – Pain during intercourse – Infertility concerns – Heavy or irregular bleeding – Suspected endometriosis – Failed medical treatment
Why Choose North Delhi Uro & Gynae Clinic?
Endometriosis is a chronic condition, but it’s treatable. With proper diagnosis, comprehensive treatment planning, and long-term management, most women achieve significant pain relief and maintain quality of life.
Don’t suffer. Effective treatment is available.
Contact North Delhi Uro & Gynae Clinic: – Address: C-5, Model Town 3, New Delhi 110009 – Phone: 9910118030 – Doctor: Dr. Anju Bala (MBBS, MD, DNB) – Obstetrician & Gynaecologist
Reclaim your quality of life.
