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Endometriosis is a condition that is often associated with painful periods. The endometrium, which is the inner lining of the uterus, begins forming at the beginning of the menses and sheds during the next period if pregnancy has not occurred and the correct place for the endometrium is inside the uterus however, in Endometriosis, the same lining also starts to grow in areas outside the uterus, such as around the tubes and ovaries, inside the ovaries, on the outer surface of the uterus, on the pelvic walls and in other areas.
It is rarely also seen outside the pelvis and when this endometrium grows in these areas outside the uterus, it leads to an inflammatory reaction. Due to that reaction, the surrounding tissue tends to become irritated, developing scar tissue and adhesions leading to pelvic organs sticking to each other (adhesion-formation) and failing to function the way they are supposed to.
In an interview with HT Lifestyle, Dr Sulbha Arora, Clinical Director at Nova IVF Fertility in Mumbai, revealed, “The endometrium bleeds or sheds during a menstrual period. Nature has given a passage in the form of the vagina for the endometrium to flow out however, there is no such passage available in these other regions, so the blood shed here tends to accumulate. When this occurs inside one’s ovaries it collects and forms a cyst. With the passage of time, the colour of blood in these ovarian cysts changes and goes from red to chocolate brown hence, endometriotic cysts in the ovaries are also often called ‘chocolate cysts’. Due to these adhesions and cysts, endometriosis is often associated with severe period pain and infertility. Fortunately, effective treatments are available.”
Talking about the symptoms of Endometriosis and its association with infertility, she suggested watching out for the following signs –
• Painful periods (dysmenorrhea): Pelvic pain and cramping are commonly seen before and during menses. You may also have lower back and abdominal pain.
• Painful sexual intercourse: Pain during or after sex is common because of this condition.
• Pain with bowel movements or urination: One can experience this particularly during menstrual cycles
• Infertility: Are you aware? Endometriosis is often first diagnosed only when a couple undergoes tests for infertility as there may at times be no other symptoms. Other red flags are diarrhoea, constipation, bloating or nausea during menstrual periods.
As per the fertility specialist, the degree of pain does not always correlate with the extent of the disease. Dr Sulbha Arora highlighted, “Women with mild endometriosis may have severe pain and people with more advanced disease may have no symptoms at all. Endometriosis may also be mistaken for various other conditions such as pelvic inflammatory disease (PID) or other types of ovarian cysts. It can also overlap with irritable bowel syndrome (IBS), making one prone to diarrhoea, constipation, and abdominal cramping. If you have any of the symptoms of endometriosis and have trouble conceiving, please consult a fertility specialist who can guide you with the right fertility treatment options.”
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