Endometriosis

Definition

When the tissues similar to the endometrium layer of the uterus starts to grow outside the uterus is called as endometriosis. It is the most painful condition.

Endometrium is the innermost layer of uterine wall.

The tissues implants are found on your ovaries, fallopian tubes and on tissue of pelvis. It is not usual to find the tissue outside the pelvis region.

During the time of your regular menstrual cycle, the endometrial- like tissues grow and becomes thick and will breakdown.

After certain period of time, tissues have no exit outside the pelvis and causes accumulation in your pelvis. Endometriosis causes problem like:

Irritation to surrounding tissues.
Development of scar tissues.
Adhesions: in which pelvis tissues and organ stick together, especially post surgery.
When tissues develop in ovary it forms cyst like structure called as Endometriomas.
Infertility.

Causes:

The exact cause is still unknown, but some theories are put forward to explain the possibility.

1. Retrograde menstruation- When menstrual blood flows backward through fallopian tube to pelvic region instead of flowing out to the uterus. Menstrual blood contain shedded endometrial cells.

2. Induction theory- The hormones starts acting on another organs of pelvic region and transfer peritoneal cells outside the uterus.

3. During the time of puberty estrogen hormone may converts small area of abdominial embryogenic cells into endometrial cells.

4. Post surgical condition, i.e. after C-section or hysterectomy, tissues get stick to surgical scar causing adhesion.

5. Immune system disorder- When immunity fails to recognize presence of endometrial cells outside the uterus and which are not destroyed keeps on growing.

Risk factors

The condition may develop due to:

Nulliparity (Woman who have not given single birth).
Early onset of menstrual cycle.
Heavy bleeding during periods.
Menstrual cycle appears in less than 27 days.
Family history

Symptoms

The most common and major symptom is pain.

Painful periods: Severe and unbearable pain or cramps before and during periods
Painful intercourse
Heavy blood flow during periods
Infertility
Painful bowel movement or urination
Fatigue
Diarrhea
Nausea

With pregnancy there may be relief in symptoms severity. Condition may be cured after menopause.

Stages

1. Minimal- Small lesions or wounds and shallow implants on ovary. Inflammation may be present.

2. Mild- Light lesions and shallow implants on ovary and pelvic lining.

3. Moderate- Deep implants on ovary and pelvic lining. More than one lesions are found.

4. Severe- Deep implants on ovary and pelvic lining and along with it lesions on fallopian tubes and bowels are seen.

Diagnosis

Detailed case taking is important. Your doctor will ask about location, type and intensity of pain. Family history is equally important.

Pelvic examination

Your doctor manually will feel pelvic area and will look for any kind of cyst or scar tissues.

Ultrasonography

High frequency sound waves are produce to see the pelvic organs. It will help to identify the cyst or any lesion inside the pelvis. However, this test does not give confirmatory diagnosis.

MRI

For more clear vision MRI is recommended, especially before surgery

Laparoscopy

It is the minor surgical procedure. It is most reliable to diagnose endometriosis. Small tissue sample for biopsy is taken for testing.

Homeopathic treatment for endometriosis

Homeopathy is holistic approach, which focus on whole living individual. The treatment is based on individualization. Homeopathy offers safe treatment and management for endometriosis, without causing and major side effects. Not only that, it also helps in treatment of infertility associated with endometriosis.

Cimicifuga

Indicated in endometriosis with severe pain during periods.
Pain is flying across the pelvic region from one side to other.
Menses is early, profuse, dark and coagulated.
Rheumatic dysmenorrhea. Bearing down sensation in uterine region. Sharp electric like pain.
Nausea with uterine affection. More the flow; more the pain.
Hysterical or epileptic spasm at the time of menses.

Sepia

Weak, dragging, bearing down sensation.
Dryness of vagina and vulva after menses.
Gripping, burning or sticking in uterus.
Coition is painful due to endometriosis.
Sudden flushes of heat with weakness.

Viburnum Opulus

Sudden pain in the region of uterus before menstruation. Severe backache during menstruation.
For neuralgic and spasmodic dysmenorrhea.
Bearing down sensation, pain in sacral and pubic region.
Excruciating colicky pain in lower abdomen.

Xanthoxyllum

It is the one of the chief remedy for dysmenorrhea due to endometriosis.
Dysmenorrhea- Agonising, neuralgic pain runs along the course of genitocrural nerve.
Menses is too early and profuse. Pain radiates down to the thighs.
No relief in pain in any position.
Soreness of thighs before menses.

Treatment with modern medicine

With modern medicine, as such no cure has been discovered for endometriosis. But symptomatic treatment is available.

Pain management

To manage your pain, your gynecologist will prescribe you, NSAIDs ibuprofen or naproxene.

Hormonal therapy

For sometime, it will help you to get relief by suppressing the symptoms or you may observe decrease intensity of pain. Through regular hormonal management new implants can be prevented. Yet again, its not permanent solution.

Hormonal contraception: Birth control pills, patches and vaginal rings.
Gn-RH agonists and antagonists: It blocks the ovarian stimulating hormone, i.e. estrogen. It creates artificial menopause. Side effect are vaginal dryness and hot flushes.
Progestin therapy: Levonorgestrel (Mirena, Skyla), contraceptive implants (Nexplanon), contraceptive injection (Depo-Provera) or progestin pill (Camila) are used according to individual choice. However, Depo-Provera contain medroxyprogesterone is not first choice of medication as it has multiple side effects like, decreased bone production, weight gain and depression.
Aromatase inhibitors: Reduces estrogen production. Prescribed along with other hormonal drugs.

Surgical treatment

It is most useful for women who is looking forward to conceive.

Laparoscopic surgery and fertility treatment are the prime ways.

If woman has already at menopausal stage or is above 35 years of age, then hysterectomy with bilateral oophorectomy (removal of uterus and ovaries) is to be think of; however it is the last option.