Endometriosis – Pelvic Pain

Endometriosis is a common condition that affects women of reproductive age. It is a complex disease that occurs when endometrial cells (which normally line the inside of the uterus) grow outside of the uterine cavity, usually in the abdominal cavity.

10 facts about Endometriosis

  1. Period Pain is NOT normal
  2. Teenagers can get Endometriosis
  3. Endometriosis has NO cure.
  4. Pain due to Endometriosis is NOT related to the extent of the disease
  5. Endometriosis, if untreated can lead to chronic pain and infertility
  6. Endometrioma is an ovarian cysts with endometriosis. It has detrimental effect on the ovary
  7. Deep infiltrating endometriosis is a variant that is more aggressive and is often challenging to treat as it can involve the bowel and the bladder.
  8. Pregnancy cannot cure it, however the symptoms will improve during pregnancy and breast feeding.
  9. Endometriosis can only be diagnosed by laparoscopy and is the only effective way to remove it
  10. Hysterectomy cannot cure Endometriosis, unless one suffers from a variant of endometriosis which affects the muscle wall of the uterus called Adenomyosis.

It generally presents with 2 main kinds of symptoms:

  1. Pain – during periods (dysmenorrhea), during sexual intercourse (dyspareunia), during bowel motions (dyschezia), before a period (pre-menstrual pain), pain all the time (chronic pelvic pain)
  2. Infertility – Difficulty to conceive

Treatment involves both medical and surgical therapies. Treatment needs to be individualised to achieve the best outcomes for the patient.

Though medical therapy is the first line of treatment, it does not remove the disease. Cessation of medical therapy causes recurrence of symptoms.  Diagnostic laparoscopy, offered by most doctors aims to identify endometriosis but the disease is not removed. These patients are then treated with medical treatments or referred to an expert for an second surgery. Hence, it is important to see an Advanced Gynaecological Surgeon with adequate expertise. They can not only diagnose endometriosis, but will also  aim to remove visible endometriotic disease and correct anatomy. A second stage laparoscopy is generally reserved for cases involving other structures such as the bowel and bladder. Endometriosis surgery can be complex, sometimes involving other specialist colleagues such as Colorectal Surgeons and Urologists. Studies have shown that complete resection of endometriosis at the first surgery leads to the best results.

Speak to Dr Yogesh Nikam to find out how he can help by evaluating your concerns.