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Treatment of Endometriosis

Treatment of Endometriosis
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Welling Clinic offers highly specialised treatment protocol to cure Endometriosis permanently. The treatment protocol has been developed after an exhaustive in-house research. Our clinics consults for more than 7500 patients of Endometriosis globally, every year. You too can be benefitted by our expertise.

What is Endometriosis?

The endometrium is the tissue that lines the inside of the womb (uterus).

Endometriosis is the abnormal growth of cells (endometrial cells) similar to those that form the inside or lining the tissue of the uterus, but in a location outside of the uterus.

Endometrial cells are the lining cells of the uterus and are cells that are shed each month during menstruation.

Endometriosis occurs when cells like the lining of the uterus grow in or on tissues outside the uterus; these areas are called endometriosis implants.

These implants are most commonly found on the ovaries, the Fallopian tubes, outer surfaces of the uterus or intestines, and on the surface lining of the pelvic cavity. They can also be found in the vagina, cervix, and bladder, although less commonly than other locations in the pelvis.

Rarely, endometriosis implants can occur outside the pelvis, on the liver, in old surgery scars, and even in or around the lung or brain.

Endometrial implants, while they can cause problems, are benign (not cancerous).

Causes of Endometriosis

Currently the exact cause of endometriosis is unknown. Most experts agree that there are many responsible factors, possibly including genetic, immunological, and hormonal reasons. But following theories are been proposed:

1.Retrograde menstruation:One theory is that the endometrial tissue is deposited in unusual locations by the backing up of menstrual flow into the Fallopian tubes and the pelvic and abdominal cavity during menstruation (termed retrograde menstruation). The cause of retrograde menstruation is not clearly understood. But retrograde menstruation cannot be the sole cause of endometriosis. Many women have retrograde menstruation in varying degrees, yet not all of them develop endometriosis.

2.Coelomic metaplasia:

  1. Another possibility is that areas lining the pelvic organs possess primitive cells that are able to grow into other forms of tissue, such as endometrial cells. (This process is termed coelomic metaplasia.)
  2. It is also likely that direct transfer of endometrial tissues during surgery may be responsible for the endometriosis implants sometimes seen in surgical scars (for example, episiotomy or Cesarean section scars).
  3. Transfer of endometrial cells via the bloodstream or lymphatic system is the most likely explanation for the rare cases of endometriosis that develop in the brain and other organs distant from the pelvis.
  4. Finally, there is evidence that shows alternations in the immune response in women with endometriosis, which may affect the body’s natural ability to recognize and destroy any misdirected growth of endometrial tissue.
  5. Patches of endometriosis tend to be ‘sticky’ and may join organs to each other. The medical term for this is adhesions. For example, the bladder or bowel may ‘stick’ to the uterus. Large patches of endometriosis may form into cysts which bleed each month when you have a period. The cysts can fill with dark blood; this is known as ‘chocolate cysts’.

Symptoms of Endometriosis

Patches of endometriosis can vary in size from the size of a pinhead to large clumps. Many women with endometriosis have no symptoms. If symptoms develop they can vary, and include those listed below.

In general, the bigger the patches of endometriosis, the worse the symptoms. However, this is not always the case. Some women have large patches of endometriosis with no symptoms. Some women have just a few spots of endometriosis, but have bad symptoms.

  • Painful periods: The pain typically begins a few days before the period and usually lasts the whole of the period. It is different to normal period pain which is usually not as severe, and doesn’t last as long.
  • Type of Pain: Throbbing, gnawing, and dragging pain to the legs are reported more commonly by women with endometriosis, Compared with women with superficial endometriosis, those with deep disease appear to be more likely to report shooting rectal pain and a sense of their insides being pulled down.
  • Painful sex. The pain is typically felt deep inside, and may last a few hours after sex.
  • Pain in the lower tummy (abdomen) and pelvic area. Sometimes the pain is constant, but is usually worse on the days just before and during a period.
  • Endometriosis lesions react to hormonal stimulation and may “bleed” at the time of menstruation. The blood accumulates locally, causes swelling, and triggers inflammatory responses with the activation of cytokines.
  • Other menstrual symptoms may occur. For example, bleeding in between periods.
  • Difficulty becoming pregnant (reduced fertility). This may be due to clumps of endometriosis blocking the passage of the egg from an ovary to the Fallopian tube.
  • Other symptoms include pain on passing poo (faeces), pain in the lower abdomen when you pass urine, and, rarely, blood in the urine or faeces.
  • Very rarely, patches of endometriosis occur in other sites of the body. This can cause unusual pains in parts of the body that occur at the same time as period pains.
  • Endometriotic lesions can develop their own nerve supply, thereby creating a direct and two-way interaction between lesions and the central nervous system, potentially producing a variety of individual differences in pain that can, in some women, become independent of the disease itself.

Complications of Endometriosis

If endometriosis is left untreated, it becomes worse in about 4 in 10 cases. It gets better without treatment in about 3 in 10 cases. For the rest it stays about the same. Endometriosis is not a cancerous condition.

Complications sometimes occur in women with severe untreated endometriosis. For example, large patches of endometriosis can sometimes cause a blockage (obstruction) of the bowel or of the tube from the kidney to the bladder (the ureter).

Once the endometriosis has gone with treatment, it may recur again in the future. Further treatment may need to be considered if symptoms recur.

Diagnosis of Endometriosis

How is Endometriosis Diagnosed?

  • Endometriosis can be suspected based on symptoms of pelvic pain and findings during physical examinations in the doctor’s office
  • Unfortunately, neither the symptoms nor the physical examinations can be relied upon to conclusively establish the diagnosis of endometriosis.
  • Imaging studies, such as ultrasound, can be helpful in ruling out other pelvic diseases and may suggest the presence of endometriosis in the vaginal and bladder areas, but still cannot definitively diagnose endometriosis.
  • For an accurate diagnosis, a direct visual inspection inside of the pelvis and abdomen, as well as tissue biopsy of the implants are necessary.
  • Laparoscopy is the most common surgical procedure for the diagnosis of endometriosis. During laparoscopy, biopsies (removal of tiny tissue samples for examination under a microscope) can also be performed for a diagnosis. Sometimes biopsies obtained during laparoscopy show endometriosis even though no endometrial implants are seen during laparoscopy.

Staging of Endometriosis:

Surgically, endometriosis can be staged I–IV (Revised Classification of the American Society of Reproductive Medicine). The process is a complex point system that assesses lesions and adhesions in the pelvic organs, but it is important to note staging assesses physical disease only, not the level of pain or infertility. A person with Stage I endometriosis may have little disease and severe pain, while a person with Stage IV endometriosis may have severe disease and no pain or vice versa. In principle the various stages show these findings:

Stage I (Minimal)

Findings restricted to only superficial lesions and possibly a few filmy adhesions

Stage II (Mild)

In addition, some deep lesions are present in the cul-de-sac

Stage III (Moderate)

As above, plus presence of endometriomas on the ovary and more adhesions.

Stage IV (Severe)

As above, plus large endometriomas, extensive adhesions.

Endometrioma on the ovary of any significant size (Approx. 2 cm +) must be removed surgically because hormonal treatment alone will not remove the full endometrioma cyst, which can progress to acute pain from the rupturing of the cyst and internal bleeding.

Endometrioma is sometimes misdiagnosed as ovarian cysts.

Treatment for Endometriosis

While there is no cure for endometriosis, there are two types of interventions; treatment of pain and treatment of endometriosis-associated infertility.

  • In women in the reproductive years, endometriosis is merely managed: the goal is to provide pain relief, to restrict progression of the process, and to restore or preserve fertility where needed.
  • In younger women with unfulfilled reproductive potential, surgical treatment attempts to remove endometrial tissue and preserving the ovaries without damaging normal tissue.
  • Pain Management: Nonsteroidal anti-inflammatory drugs or NSAIDs (such as ibuprofenor naproxensodium) are commonly prescribed to help relieve pelvic pain and menstrual cramping. These pain-relieving medications have no effect on the endometrial implants.
  • Hormone therapy 
  • Birth controlhormones (patch, pills, or ring) stop monthly ovulationand the growth, shedding, and bleeding that makes endometriosis painful. Birth control hormones improve endometriosis pain for most women. And they are the hormone therapy that is least likely to cause bad side effects.
  • Gonadotropin-releasing hormone agonist (GnRH-a)therapy lowersestrogen, triggering a state that is like menopause. This shrinks implants and reduces pain for most women.
  • Progestin (pills or Depo-Proverashot) stops ovulation and lowersestrogen. For most women, it shrinks endometriosis growths and reduces pain.
  • Danazoltherapy lowers estrogen levels and raises androgen levels, triggering a menopause-like state. This shrinks growths and reduces pain for most women. This relief usually lasts for 6 to 12 months after treatment. But danazol side effects can be significant.

All hormone therapies for endometriosis can cause side effects and pose certain health risks. Some cause especially unpleasant side effects. Before starting a medicine or hormone therapy, review its possible side effects. If they sound less difficult than your endometriosis symptoms, discuss the therapy with your doctor.

  • Surgery: Sometimes an operation is advised to remove some of the larger patches of endometriosis. An operation may ease symptoms and increase the chance of pregnancy if infertility is a problem. If you have completed your family, and other treatments have not worked well, removal of the womb (uterus) – a hysterectomy- and removal of the ovaries may be an option.

Homeopathic treatment for Endometriosis

Homeopathic remedies are prescribed by symptoms rather than conditions, as each case of a particular illness can manifest differently in different people.

Homeopathy is one of the most popular holistic systems of medicine. The selection of remedy is based upon the theory of individualization and symptoms similarity by using holistic approach.

This is the only way through which a state of complete health can be regained by removing all the sign and symptoms from which the patient is suffering.

The aim of homeopathy is not only to treat endometriosis but to address its underlying cause and individual susceptibility.

As far as therapeutic medication is concerned, several remedies are available to treat endometriosis that can be selected on the basis of cause, sensations and modalities of the complaints.

For individualized remedy selection and treatment, the patient should consult a qualified homeopathic doctor in person. There are following remedies which are helpful in the treatment of endometriosis:

Aconite, Arsenic Album, Belladonna, Bryonia, Cimicifuga, Gelsemium, Iodium, Pulsatilla, Sabina, Secale Cor, Sepia, Silicea, Aurum Mur, Calcaria Carb, Carbolic Acid,

Homeopathy is a holistic treatment; therefore the homeopathic medicine not only treats fibroid but also improves overall health.

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