That excessive pain can be endometriosis

Dr Archana Dhawan Bajaj

Endometriosis is a medical condition in which a woman develops a uterine lining-like tissue, also known as endometrium, outside the uterus. Medical experts identify this problem as one of the most likely causes for infertility in women. In severe cases, scars, inflammation and distortion of tubo-ovarian anatomy occurs.

Detection at an early stage is one of the most critical factors for the treatment of endometriosis. Early detection is crucial as a delay can lead to further complications at a later stage. Pain is usually the most common indication of endometriosis. However, it is not necessary that its severity would indicate any particular stage of endometriosis. 

Often the pain may subside or rise infrequently during the periods but it shouldn’t be ignored as it can lead to further complications. The other symptoms inlude dyspareunia or severe pain during intercourse.

Identify the signs  

Family history is an important factor as any close relative who has been afflicted with such a condition can increase the chance by eight to 10 per cent. If there is someone in the family with a similar problem, keep an eye for any of the symptoms such as back or pelvic pain, excessive bleeding and long duration of periods.

Endometriotic spots can arise around the tissue and develop on the outer region of the uterus, including ovary, fallopian tube, intestine and bladder etc. causing painful sensations. This pain can radiate into nearby areas like the lower back or the pelvic area. It is important to take note that any kind of persistent pain that may occur near the genitals can be due to endometriosis and the patient must consult a gynaecologist immediately.

Scarring and inflammation due to endometriosis can cause fertility complications as it affects the fimbria which is responsible for transporting the egg into the fallopian tube. Besides the inflammation, which can damage the sperm and egg, also alters the tubo-ovarian anatomy. 

Diagnosis of endometriosis can be undertaken through various medical procedures like MRI, laparoscopy and ultra-sound. Laparoscopy is considered the gold standard for the diagnosis of endometriosis. The treatment for endometriosis is generally done either by medication or injectable treatment. In some cases where the detection is difficult, a surgical treatment is consulted.

  — The writer is gynaecologist, obstetrician, Nurture IVF Centre, New Delhi

Symptoms

Pelvic pain is the main symptom that often accompanies menstrual period. While cramping during menstrual period is common for most women, women with endometriosis may experience heightened pain. That increases over time.

• Periods are painful. Pelvic pain and cramps may start before the period and last several days into your period. There may also be lower back and abdominal pain.
• Pain during or after sex. 
• Pain with bowel movements or urination. These symptoms are more likely during the period.
• Excessive bleeding is there. Occasional heavy periods (menorrhagia) or bleeding between periods (menometrorrhagia) is common.
• Other symptoms include fatigue, diarrhoea, constipation, bloating or nausea, especially during menstrual periods.