Endometriosis and Adenomyosis: Everything You Need to Know

Hello, I’m Dr. Mini Salunkhe, Consultant Obstetrician and Gynecologist at Momstory Hospital, Hadapsar Annex. Today, I want to discuss an essential topic—endometriosis and its impact on women’s health.

What is Endometriosis?

Endometriosis is a chronic condition that affects approximately 1 in 10 women of reproductive age. It occurs when tissue similar to the lining of the uterus grows outside the uterus, leading to pain, heavy bleeding, and in some cases, infertility.

Common Symptoms of Endometriosis:

• Pain before or after menstruation
• Heavy or prolonged periods
• Premenstrual or postmenstrual spotting
• Severe pain during:
  • Intercourse
  • Urination
  • Bowel movements
• Abdominal bloating and cramping
• Difficulty in conceiving

In advanced stages, the pain can become so severe that it disrupts daily activities, making it hard for women to attend school, work, or manage their routines.

What Causes Endometriosis?

The exact cause of endometriosis is still unknown, but one widely accepted theory is retrograde menstruation. In this condition, menstrual blood flows backward through the fallopian tubes into the pelvic cavity instead of exiting the body.

This process can lead to:

• The formation of endometriotic deposits in the pelvic region, including the ovaries and bowel.
• Development of chocolate cysts (blood-filled cysts in the ovaries).
• Inflammation and scarring due to adhesions and fibrosis.

Contributing Factors:

• Higher levels of estrogen.
• Genetic predisposition.
• Irregular menstruation or hormonal imbalances.

What is Adenomyosis?

Adenomyosis is often referred to as internal endometriosis. While endometriosis involves tissue growing outside the uterus, adenomyosis occurs when uterine lining tissue penetrates the muscle wall of the uterus, causing:

• An enlarged, bulky uterus.
• Heavy and painful periods.
• Spotting before and after menstruation.

How Endometriosis Affects Fertility and Quality of Life

Endometriosis is one of the leading causes of infertility. The condition affects fertility in several ways:

• The presence of chocolate cysts and scarring can reduce ovarian reserve.
• Lower Anti-Müllerian Hormone (AMH) levels make conception more challenging.
• Adhesions in the pelvic cavity may hinder egg release or fertilization.

Beyond fertility, endometriosis significantly impacts a woman’s daily life. Chronic pain, fatigue, and emotional distress can lead to a reduced quality of life.

Diagnosing Endometriosis

Early diagnosis is critical in managing endometriosis effectively. Some diagnostic tools include:

1. Ultrasound: Used to detect cysts and abnormalities.
2. MRI (Magnetic Resonance Imaging): Provides detailed imaging of pelvic structures.
3. Laparoscopy: A minimally invasive surgical procedure that allows direct visualization and removal of endometriotic tissue.

Treatment Options for Endometriosis

Treatment for endometriosis varies based on the severity of symptoms and the extent of the condition.

1. Medical Treatments

• Pain Management: Painkillers are often prescribed to alleviate discomfort.
• Hormonal Therapy:
  • Oral contraceptives
  • Hormonal IUDs (e.g., Mirena)
  • Injectable medications
• Menstrual Regulation: Helps slow disease progression and reduce symptoms.

2. Surgical Treatments

• Laparoscopic Surgery: Used to remove endometriotic deposits, adhesions, and cysts.
• Adhesiolysis: A procedure to separate tissues that have become stuck together due to scarring.

Surgical intervention is often recommended for women experiencing severe pain or infertility.

Can Endometriosis Be Prevented?

Preventing endometriosis is challenging, but early awareness and timely medical attention are key. If you experience symptoms like heavy periods, severe menstrual pain, or difficulties conceiving, consult your gynecologist promptly.

Final Thoughts

Endometriosis and adenomyosis are manageable conditions when diagnosed early. With the right treatment, it is possible to improve your quality of life and address complications like infertility.

At Momstory Hospital, we’re committed to helping women navigate these challenges with personalized care. For consultations or further information, feel free to contact us.

We’re here to support you 24/7!