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Endometriosis is a condition where the uterine blood lining that typically grows inside the uterus starts to grow outside it.
In a healthy female body, the endometrium blood lining grows inside the uterus and sheds out through the vaginal opening during menstruation. However, in endometriosis, instead of flowing out, this menstrual blood starts to deposit around the small intestine, rectum, fallopian tubes, ovaries, fundas, and other body organs in the abdomen. With no way out, these blood deposits start to swell, causing unbearable pain, heaviness, exertion, fever, and at times, blood in the vomit. It also severely degrades a woman’s fertility by affecting both- the health and patency of the fallopian tubes.
While the exact cause of endometriosis is uncertain, reverse menses, that is, retrograde menstrual flow is the most commonly agreed upon medical theory.
This understanding holds that while the endometrium responds to the hormones just as it should in a normal cycle and proliferates and enlarges during ovulation, it reverses its direction during menstruation. That is, instead of only flowing out of the vaginal opening, it reverses and flows inside the abdomen and creates layers of microscopic blood deposits across different organs around the uterus.
Laparoscopy is the only successful diagnostic test for endometriosis (unless the patient develops an endometrioma cyst which can be diagnosed through an ultrasound).
Procedure: As the name suggests, it is performed using a laparoscope, that is, a tiny catheter-like instrument with a camera and lens on its end.
Once you are under the influence of anesthesia, the doctor makes a minor keyhole in the abdominal areas and injects carbon dioxide gas to lift it above the small intestines and create space for the procedure. Then, the laparoscope is inserted to provide a high-definition view of the internal organs on a digital monitor. This imaging helps provide the exact status of endometriosis, its severity, and grade.
If needed, the laparoscopy test may be combined with the corresponding treatment.
Self-diagnosis is next to impossible in the case of endometriosis. In fact, since the blood deposits are minuscule and microscopic, even diagnostic tests such as ultrasound fail to confirm the condition.
Therefore, it is important that you connect with the doctor at the earliest site of symptom and undertake the diagnostic laparoscopy the soonest suggested.
While your symptoms are a good indication for detecting the probability, diagnostic laparoscopy is the only method to confirm the condition.
The risks and complications during the surgical treatment for endometriosis depend directly on the kind of treatment method used.
Endometriosis is an extremely painful condition, which, if left untreated, can be severed to grade III and IV, thus resulting in:
False. The pain and cramping felt during menses differ between every two women, and there is no standardized quantification of pain. This is especially true for women with endometriosis. The pain can become strikingly high with a burning sensation, nausea, and fever. Delay in treatment can severe the condition, leading to a similar pain being felt even in-between the periods.
No. While some medical studies do propose this theory, it is not accepted by a vast majority of medical practitioners. The exact cause for endometriosis still remains uncertain.
No. Endometriosis cannot be diagnosed unless through laparoscopic surgery.
Not entirely true. While there is no permanent cure for endometriosis, various medical and surgical procedures such as laparoscopy and ablation and laparoscopy and excision are great for providing not only immediate but long-term relief.
False. While women with endometriosis do face trouble with infertility, various procedures such as recanalization of fallopian tubes, or assisted reproductive technology such as IVF or ICSI have made pregnancy possible with endometriosis.
Symptoms of Grade I endometriosis can be managed through pain killers and oral contraceptives. The OC pills help halt ovulation through hormonal control. With no ovulation, the endometrium lining stops growing and in turn, provides the body a rest period. With this rest, the body heals itself and gradually absorbs the microscopic blood deposits to help control the pain and cluster symptoms.
For similar results, the doctor may also suggest hormone therapy.
However, note that this is not a long-term treatment. Hormonal medications must not be taken for longer than five years. Else, they pose a risk to lipid profile and increase the chances of heart-related diseases.
Typically, doctor consultations and medications for endometriosis cost an average of INR 2000- INR 3000 in India.
The surgical treatments for endometriosis vary basis the grade of severity and the patient’s individual needs for fertility or otherwise.
LAPEX/ Laparoscopic Ablation / Ovarian Cystectomy/ LAPEX and Hysterectomy:
Yes, insurance covers the surgical treatment cost for endometriosis. However, fertility treatments are an exception. That is, all surgical options such as LAPEX, laparoscopy and ablation, ovarian cystectomy, or LAPEX and hysterectomy are covered under insurance as they fall under the ‘medically necessary’ list of treatments. However, fertility treatments such as recanalization, IVF, and ICSI are voted out because of their classification under treatments taken out of voluntary choice.
Insurance coverage and the treatment cost capping varies case to case. Please confirm the same from your healthcare or insurance provider.
More than 190 million women suffer from endometriosis worldwide.
Endometriosis is best treated by a gynecologist. At times, both- a gynecologist and endocrinologist, or general surgeon may work together to treat some of the co-morbidities such as thyroid, diabetes, etc.
The typical medications prescribed for endometriosis include birth control, pain killers, and hormone therapies. These halt ovulation and endometrial proliferation while the body rests and absorbs the existing blood deposits over the abdomen. However, they are not the best course of treatment because of their short-lived nature and commonly experienced side effects.
Birth control pills take an average of 3 weeks to 3 months to properly adjust to the body. During this time, many patients report extreme mood swings, bloating, intermenstrual bleeding, nausea, drowsiness, and more. Also, they must not be taken for longer than five years, or they may risk heart-related diseases.
Grade IV is the most advanced and critical stage of endometriosis. It involves severe blood adherations, unbearable pain, and endometrioma cyst on the ovary.
Yes, endometriosis is a progressive condition that worsens with time. Typically, it starts to show symptoms after a few years of puberty, temporarily pauses during pregnancy, and permanently ends after menopause.
Yes, but only at grade III or grade IV with endometrioma cyst. Typically, the endometrial tissues deposited outside the uterus are so minuscule and microscopic that they cannot be seen except through a naked eye. Therefore, abdominal laparoscopy is the only gold standard of an endometriosis diagnosis.