Endometriosis is a puzzling hormonal and immune disease that affects girls and women from the age of eight till after menopause. The name comes from the word, ‘endometrium’, which is the tissue that lines the inside of the uterus, builds up and sheds itself each month in the menstrual cycle.
It is a benign gynaecological condition that affects one in every 10 women during her reproductive years (ages of 15 to 49). About 176 million women in the world have endometriosis. Also, between six and 12 per cent of women of childbearing age are affected by the disease.
The disease can be found in 35 to 45 per cent of women who are infertile and trying to conceive. A significant percentage of women with endometriosis may develop ovarian cancer, too.
The age of 27 is the average age when a woman is first diagnosed with endometriosis. It is the third most common cause of female infertility. We have had cause to be concerned about this disorder because of the alarming increase in the number of patients presenting with endometriosis in our clinic. Hence, I am focusing on this preventable disease.
In endometriosis, a tissue like the endometrium is found outside the uterus in other parts of the body. In those areas outside the uterus, the tissues develop into what are called nodules, tumours, lesions, implants or growths.
The most common locations of growths are in the abdomen, involving the ovaries, fallopian tubes, ligaments supporting the uterus vagina, bladder, rectum and the lining of the pelvic cavity.
Sometimes these growths can also be found in the uterine muscle, termed adenomyosis and following abdominal scar surgeries, umbilicus (laparoscopy). They can also be spotted in distant sites, such as the heart, lungs and pleura, but this is uncommon.
Endometriosis presents usually as a clinical suspicion based on the symptoms, such as chronic pelvic pain (low abdominal pain), worsening dysmenorrhea (painful menstruation), acquired dyspareunia (painful intercourse), premenstrual spotting, infertility, painful defecation with bleeding and a host of other non-specific symptoms.
It occurs in about 20 per cent to 25 per cent of females in the reproductive age (15-45 years).
Risk factors for this disease include first-degree relatives’ affected, short menstrual cycles, light complexioned women, long duration of menstrual flow, low parity, environmental toxins and infertility.