A very common problem that ails many women who are in their reproductive age is endometriosis. This affects 3% to 10% of women worldwide. Apart from pain in the lower abdomen, painful menstruation, or discomfort during sexual intercourse, endometriosis is also believed to be a cause for female infertility, or the inability to conceive.

What does it mean?

A certain kind of tissue (endometrium) makes up the inner lining of a woman’s womb. When these tissues are also found on other organs like the lower abdomen or pelvis, it is referred to as endometriosis.

Why does it happen?

When a woman is menstruating, some of the blood and tissue might be going out from her uterus into her abdominal cavity through the fallopian tubes. But we sometimes also find endometriosis in other unusual locations like the knee or the thumb.

This happens because some cells and tissues in those places can undergo changes to replicate the structure of the tissues in the uterine lining. A third reason is that the uterine tissues could travel to other parts of the body through the lymphatic system and give rise to endometriosis.

How does it impact fertility?

Because of the presence of the endometrial tissues, the normal functioning of the fallopian tubes could be hampered, leading to its inability to pick up the ovulated egg properly after fertilization. Endometriosis also causes inflammation in several important reproductive organs like the uterus, fallopian tube or the ovary, thereby reducing the fertility. Of all women who suffer from infertility, up to 40% also have endometriosis.

How does it relate to pregnancy?

The distress and pain associated with endometriosis has been found to go away during pregnancy and also after the baby is born. A possible reason is that the hormones released in large quantities during pregnancy cause the effects of endometriosis to reduce.

When do you need help?

Menstrual periods are something most women get used to, hence the pain caused by endometriosis is also silently absorbed or even ignored by many women. But as a thumb rule, it is advised that a woman whose daily routine is disrupted due to the pain should consult a doctor. These are a few examples of such disruptions –
• Missing work or school frequently
• Painkillers do not work
• Getting out of bed is difficult
• Symptoms seem to worsen
• Mental stress starts affecting

How can we treat it?

There are two ways to deal with endometriosis. One is palliative, where we try to alleviate the intense pain. Anti-inflammatory medicines which are non-steroidal in nature can be used effectively to reduce the pain. Since the pain is often felt during menstruation, hence another path of medication is to introduce medicines which can artificially stop the menopause for some time. Apart from pain relief, the other common treatment is surgery. This involves surgical removal of the endometrial tissues from all places outside of the uterus where it is found. This is a more long term solution, and not only helps in getting relief from the pain, but also acts as a cure for infertility, and could help the woman conceive.