Introduction:
Endometriosis is a medical condition in which the tissue histologically resembling the uterus grows outside of it. It can lead to severe pain, especially during menstruation. Fertility problems may also arise due to this condition. However, effective treatments are available to manage the state, which include medicines, therapies, birth control pills, and surgeries.
What Is Endometriosis?
A medical condition where the tissues usually found inside the uterus (endometrium) grow outside of it is referred to as endometriosis. The condition makes it much more challenging to get or stay pregnant.
Endometriosis can affect fertility (the capacity to produce offspring), gestation (the period when the baby develops inside the mother's body), and recovery post-childbirth. However, it is different for every individual. Some people still have a successful pregnancy with fewer to no complications. If you have endometriosis and are pregnant, your doctor will closely monitor your and your baby's health.
How Are Endometriosis and Fertility Linked?
Studies suggest that infertility affects 30 percent to 50 percent of women with endometriosis. But it does not mean a person with endometriosis cannot conceive. Many women living with mild endometriosis can get pregnant without the help of medical interventions.
Why Do Women With Endometriosis Find It Difficult to Conceive?
Inflammatory swelling and scarring of the pelvic region are common findings present in endometriosis. The inflammation and scarring make it difficult for the sperm to reach the egg, making it more difficult for the embryo to implant in the uterus. As the disease progresses in the later stages, the scarring can cause structural changes in the fallopian tube, thereby preventing the egg from fertilizing. If you are living with endometriosis and want to get pregnant, consult your doctor. The doctor might suggest laparoscopic surgery or in-vitro fertilization as treatment options.
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Laparoscopic Surgery: Surgical removal of the endometrial lesion through laparoscopy can help manage pain and boost the chances of getting pregnant. Evidence has shown that pregnancy rates may improve after the surgery. But repeated surgeries are not advised as they may cause scars in the reproductive organ, making it more difficult to conceive.
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In-Vitro Fertilization: Women with or without endometriosis have the same success rate. The only requirement is that their ovaries must have the capability to produce eggs.
What Is Postpartum Endometriosis?
Endometrial tissue is usually present lining the uterus. Endometriosis occurs when these tissues develop outside the uterus. This can cause the development of large masses and scar tissues.
Having a C-section (cesarean delivery) is a risk factor for endometriosis. However, the condition is relatively rare. Endometriosis can develop after a cesarean delivery when it develops into a surgical scar, also known as incisional endometriosis. The incidence of this condition is only 0.4 percent. However, the incidence could also be more than this, as not all people realize they have endometriosis after having a cesarean delivery, and others might not report it.
What Do You Mean by Incisional Endometriosis?
When a surgeon goes for cesarean delivery, endometrial tissues are removed and moved outside the uterus. As a result, endometrial tissue can implant in the scar areas. The endometrial tissues then build up along the scar leading to painful adhesion. This process can affect a person's fertility and might contribute to painful periods. Along with this, an individual might experience pain, inflammation, and bleeding from endometrial lesions. Surgery is the most effective treatment to treat incisional endometriosis, as it involves the removal of inflamed endometrial tissue.
What Are the Signs and Symptoms Associated With Incisional Endometriosis?
Incisional endometriosis can lead to:
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Cyclic pain.
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Inflammation and swelling.
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Brown-colored leakage at the site of the scar during menstruation.
In addition to this, an individual might experience:
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Severe pain during menstruation.
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Pain during sex.
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Painful bowel movement.
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Heavy clotting and cramps during periods.
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Trouble getting pregnant.
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Bladder pain.
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Unexplained stomach ache, constipation, or diarrhea.
A person experiencing these clinical signs and symptoms should immediately consult their doctor to rule out whether they have endometriosis or any other problem with similar symptoms.
How Is It Diagnosed?
The average time between symptoms' appearance and diagnosis is around four to five years.
In the case of incisional endometriosis, doctors might take longer than usual to diagnose, as this condition is rare and not very well understood. If a person suspects endometriosis, they must see their gynecologist and ask for endometriosis testing or a second opinion. A complete medical history will be asked by the clinician. Also, a pelvic examination will be performed before testing. Several tests might be needed to reach an accurate diagnosis. If during a pelvic examination, a person feels unusual pain or discomfort, this might indicate endometriosis.
If the doctor suspects endometriosis, they will suggest other tests to confirm the diagnosis. The tests include:
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Pelvic Ultrasound Examination: During this procedure, sound waves are used by the doctor to examine the uterus and other organs. For better observation, the doctor might insert a transducer in the vagina or use it outside the abdomen.
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Biopsy: A small section of endometrial tissue is removed with the needle. The samples are then tested to check for any abnormalities or cancerous growth.
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Surgery: Laparoscopic surgery is the other way to diagnose and treat endometriosis.
What Are the Treatment Options?
Endometriosis is often described as a chronic disorder that affects females who are in their reproductive age.
Treatment begins with:
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Managing the symptoms.
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Medications.
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Alternative pain management techniques (acupuncture or massage therapy).
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Birth control pills such as progesterone.
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Hormonal contraceptive.
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In severe cases, hysterectomy and other surgeries.
However, surgery is not always the first choice of treatment. It is totally up to the doctor who chooses the best line of treatment for you. The most effective method to eliminate endometriosis and manage the condition is surgery. This is more likely if a person wants to conceive again. Even among those who have undergone surgery, endometriosis may come back.
People who have used medication such as progesterone often experience relapse after stopping the treatment. The risk of recurrence can be reduced by the hysterectomy procedure .
Conclusion:
To conclude, endometriosis can be defined as a long-lasting painful condition where the endometrial tissue (those lining the uterus) grows outside the uterus. Endometriosis commonly involves the ovaries, fallopian tubes, and pelvis. Rarely it is found outside the pelvic organs. Endometriosis makes it more challenging to get pregnant. In early-stage endometriosis, surgery may help improve the chances of conceiving. For some, in vitro fertilization is recommended. Endometriosis is associated with complications such as placenta previa, preterm babies, and miscarriage. Since the condition and its complications are unpredictable, no specific recommendations for additional interventions are suggested. However, routine monitoring of pregnancy of women with known history is advisable.
