Medical Treatments for Endometriosis

Endometriosis is a common and painful disorder of the female reproductive system. This medical condition is rooted to various health issues inducing painful periods, infertility etc. As a result, this medical condition needs to be treated. 

This article, written by taking references from various top-notch gynecologists like Dr. Chaitali Mahajan Trivedi, renowned for endometriosis treatment in Mumbai, may help females understand “what endometriosis is?” and “what are the symptoms and treatments of endometriosis?”.

What is Endometriosis?

Endometriosis is a medical condition of an overgrown uterus line that involves the region of the fallopian tube, the ovaries, and the tissues of the pelvic area. Formation of endometriosis leads to below-mentioned health issues:-

• Painful Period

• Pelvic Pain

• Irregular Menstrual Cycle

•  Infection of other parts of the female reproductive system like tubes, ovaries etc.

• Pain during intercourse

• Infertility

• Fatigue, Diarrhoea, Constipation, Bloating, Nausea etc.

Cause of Endometriosis

Reason of endometriosis is are underneath:

• Retrograde Menstruation: 

A condition when the flow of menstrual blood gets diverted and moves towards the fallopian tubes, ovaries, and pelvis. Blood sticks to the organs, making them stiff and unable to function. As a result, pelvic pain occurs. 

• Transformation of Peritoneal Cells

The innermost side of the abdomen is lined with peritoneal cells. Certain hormones and the immune system, among other contributing factors, can cause them to transform into endometrial-like cells.

• Embryonic Cell Transformation 

The earliest phases of development occur when embryonic cells are discovered. These cells may develop into endometrial-like cell implants throughout puberty when more estrogen hormone is secreted.

• Surgically Implanting Scars

Endometrial cells may adhere to a surgical incision following a hysterectomy or C-section, leading to endometriosis.

• Translocation of Endometrial Cells

Endometrial cells may be transferred from one area of the body to another through the blood vessels or tissue fluid (lymphatic) system.

• Immune system condition

A problem with the immune system may prevent the body from identifying and eliminating tissue that resembles endometrial growths outside the uterus.

Diagnosis of Endometriosis

The treatment of endometriosis starts with the examination of the female’s reproductive system and other body organs. This evaluation includes:

• Examination of Pelvic Area: To determine the formation of cyst and scars behind the uterus. 

• Ultrasound: To get a clear image of the uterus and the region affected by endometriosis. In order to capture the clear image transvaginal ultrasound can also be performed.  

• MRI- Before performing invasive treatment of endometriosis, some gynaecologists use MRI to get a more detailed image of the female patient’s reproductive system. 

• Laparoscopy- This technique gives a close-up internal view of the abdomen. This diagnosis usually requires a small incision to insert the laparoscopic into the body, as a result, general anaesthesia is used to make the candidate’s abdominal area numbed. This closed and detailed analysis can reveal the location, extent, and size of the endometrial implants. A tissue sample (biopsy) may be taken by the surgeon for additional analysis.

Treatment for Endometriosis

Depending on the severity and level of infection, endometriosis requires hormone therapy or an invasive procedure. Regarding this below-mentioned are the most popular endometriosis treatment:-

• Pain Medication

The most common impact of an overgrown uterus lining is pelvic pain, which may increase during the menstrual cycle. In order to manage this condition, pain relievers are the first line of defence. Females experiencing such pain can start taking pain medication under the guidance of a gynecologist.

   

• Hormone Therapy

Female sex hormones progesterone, oestrogen, and androgen regulate the health of the female reproductive system. An imbalance of these hormones caused by any reason, including stress or an unhealthy diet, may lead to endometriosis. Hormonal therapy is one of the most effective ways to reverse endometriosis and regularize a pain-free menstrual cycle.

• Hormonal Contraceptives

Birth control pills are also used to correct the uterine lining. These pills reduce the menstrual span, which leads to the removal of abnormally thickened endometrium with the menstrual blood. Contraceptive pills carry various side-effects like weight gain, menstrual cycle more than once in a month, etc. Hence, before taking any birth control pill, consultation with a gynecologist is beneficial.

  

• Gonadotropin-releasing Hormone Agonists & Antagonists

By reducing estrogen levels and avoiding menstruation, these medications limit the synthesis of ovarian-stimulating hormones. The growth of endometrial tissues is inhibited as a result. Because gonadotropin-releasing hormone agonists and antagonists induce artificial menopause, taking low doses of estrogen or progestin alongside them may lessen menopausal side effects such as hot flashes, vaginal dryness, and bone loss. When a patient stops taking the medicine, menstruation cycles and the potential to become pregnant may resume.

• Progestin Therapy 

Progestin is a synthetic form of progesterone. It  is employed to inhibit the formation of endometrial tissue and lessen the symptoms that go along with it. They function by preventing estrogen's effects on the endometrium, which helps to lessen discomfort and inflammation while also slowing the condition's progression. Progestin therapy offers a different hormonal strategy for controlling endometriosis and can be given orally, intravenously, or intrauterinely.

• Aromatase Inhibitors 

Aromatase inhibitors are also used to treat endometriosis. They function by preventing the enzyme aromatase from converting androgens into estrogen. These inhibitors assist in decreasing estrogen levels, which reduce endometrial tissue growth and relieve endometriosis symptoms.

• Conservative Surgery 

Conservative surgery is a treatment approach for endometriosis that aims to remove or destroy the abnormal endometrial tissue while preserving the reproductive organs. It involves techniques such as laparoscopic or robotic surgery to excise or ablate the lesions, providing symptom relief and improving fertility potential for individuals with endometriosis.

• Hysterectomy with Removal of the Ovaries

One of the best therapies for endometriosis is surgery to remove the uterus and ovaries (hysterectomy and oophorectomy). Endometrial experts, however, do not favor this procedure. Menopause can result from ovarian detachment. This may lead to inadequate hormone production by the ovaries, which may lessen endometriosis pain for some people. However, for some people, the symptoms caused by the leftover endometrial-like cells following surgery still exist. Early death, specific metabolic problems, and heart and blood vessel (cardiovascular) diseases are also risks associated with early menopause. Especially in women who do not intend to become pregnant, a hysterectomy can occasionally be performed to treat endometriosis signs and symptoms like excessive monthly bleeding and painful menses brought on by uterine cramps. 

To know more about endometriosis treatment, consult a medical expert like Dr. Chaitali Mahajan Trivedi- a female sexologist in Mumbai.