Endometriosis treatment

endometriosis treatment in Iran

How do I know if I have endometriosis?

What are endometriosis risk factors?

How do you get rid of endometriosis?

Can endometriosis go away on its own?

What will happen if endometriosis is left untreated?

 

 

Endometriosis

Endometrial tissue consists of gland, blood cells, and connective tissue. It normally grows in the uterus, to prepare the lining of the womb for ovulation.

Endometrial implants are buildups of endometrial tissue that grow in locations outside the uterus.

When they grow outside the uterus, this is called endometriosis.

They can develop anywhere in the body, but they usually occur in the pelvic area.

They may affect:

  • the ovaries
  • the fallopian tubes
  • the peritoneum
  • the lymph nodes

Normally, this tissue is expelled during menstruation, but displaced tissue cannot do this.

This leads to physical symptoms, such as pain. As the lesions grow larger, they can affect bodily functions. For example, the fallopian tubes may be blocked.

The pain and other symptoms can affect different areas of life, including the ability to work, medical care costs, and difficulty maintaining relationships.

 

How do I know if I have endometriosis?

Endometriosis symptoms

The primary symptom of endometriosis is pelvic pain, often associated with menstrual periods. Although many experiences cramping during their menstrual periods, those with endometriosis typically describe menstrual pain that's far worse than usual. Pain also may increase over time.

Common signs and symptoms of endometriosis include:

  • Painful periods (dysmenorrhea). Pelvic pain and cramping may begin before and extend several days into a menstrual period. You may also have lower back and abdominal pain.
  • Pain with intercourse. Pain during or after sex is common with endometriosis.
  • Pain with bowel movements or urination. You're most likely to experience these symptoms during a menstrual period.
  • Excessive bleeding. You may experience occasional heavy menstrual periods or bleeding between periods (intermenstrual bleeding).
  • Infertility. Sometimes, endometriosis is first diagnosed in those seeking treatment for infertility.
  • Other signs and symptoms. You may experience fatigue, diarrhea, constipation, bloating or nausea, especially during menstrual periods.

 Endometriosis causes

Although the exact cause of endometriosis is not certain, possible explanations include:

  • Retrograde menstruation. In retrograde menstruation, menstrual blood containing endometrial cells flows back through the fallopian tubes and into the pelvic cavity instead of out of the body. These endometrial cells stick to the pelvic walls and surfaces of pelvic organs, where they grow and continue to thicken and bleed over the course of each menstrual cycle.
  • Transformation of peritoneal cells. In what's known as the "induction theory," experts propose that hormones or immune factors promote transformation of peritoneal cells — cells that line the inner side of your abdomen — into endometrial-like cells.
  • Embryonic cell transformation. Hormones such as estrogen may transform embryonic cells — cells in the earliest stages of development — into endometrial-like cell implants during puberty.
  • Surgical scar implantation. After a surgery, such as a hysterectomy or C-section, endometrial cells may attach to a surgical incision.
  • Endometrial cell transport. The blood vessels or tissue fluid (lymphatic) system may transport endometrial cells to other parts of the body.
  • Immune system disorder. A problem with the immune system may make the body unable to recognize and destroy endometrial-like tissue that's growing outside the uterus.

 

What are endometriosis risk factors?

about 2 to 10 percent of childbearing women in the United States between the ages of 25-40 have endometriosis. It usually develops years after the start of your menstrual cycle. This condition can be painful but understanding the risk factors can help you determine whether you’re susceptible to this condition and when you should talk to your doctor.

  • Age

Women of all ages are at risk for endometriosis. It usually affects women between the ages of 25 and 40, but symptoms can begin at puberty.

  • Family history

Talk to your doctor if you have a family member who has endometriosis. You may have a higher risk of developing the disease.

  • Pregnancy history

Pregnancy may temporarily decrease the symptoms of endometriosis. Women who haven’t had children run a greater risk of developing the disorder. However, endometriosis can still occur in women who’ve had children. This supports the understanding that hormones influence the development and progress of the condition.

  • Menstrual history

Talk to your doctor if you have problems regarding your period. These issues can include shorter cycles, heavier and longer periods, or menstruation that starts at a young age. These factors may place you at higher risk.

Read more about: Interstitial cystitis (bladder pain syndrome)

Endometriosis treatment

Understandably, you want quick relief from pain and other symptoms of endometriosis. This condition can disrupt your life if it’s left untreated. Endometriosis has no cure, but its symptoms can be managed.

Medical and surgical options are available to help reduce your symptoms and manage any potential complications. Your doctor may first try conservative treatments. They may then recommend surgery if your condition doesn’t improve.

Everyone reacts differently to these treatment options. Your doctor will help you find the one that works best for you.

It may be frustrating to get diagnosis and treatment options early in the disease. Because of the fertility issues, pain, and fear that there is no relief, this disease can be difficult to handle mentally. Consider finding a support group or educating yourself more on the condition. Treatment options include:

  • Pain medications

You can try over-the-counter pain medications such as ibuprofen, but these aren’t effective in all cases.

  • Hormone therapy

Taking supplemental hormones can sometimes relieve pain and stop the progression of endometriosis. Hormone therapy helps your body regulate the monthly hormonal changes that promote the tissue growth that occurs when you have endometriosis.

  • Hormonal contraceptives

Hormonal contraceptives decrease fertility by preventing the monthly growth and buildup of endometrial tissue. Birth control pills, patches, and vaginal rings can reduce or even eliminate the pain in less severe endometriosis.

The medroxyprogesterone (Depo-Provera) injection is also effective in stopping menstruation. It stops the growth of endometrial implants. It relieves pain and other symptoms. This may not be your first choice, however, because of the risk of decreased bone production, weight gain, and an increased incidence of depression in some cases.

  • Gonadotropin-releasing hormone (GnRH) agonists and antagonists

Women take what are called gonadotropin-releasing hormone (GnRH) agonists and antagonists to block the production of estrogen which stimulate the ovaries. Estrogen is the hormone that’s mainly responsible for the development of female sexual characteristics. Blocking the production of estrogen prevents menstruation and creates an artificial menopause.

GnRH therapy has side effects like vaginal dryness and hot flashes. Taking small doses of estrogen and progesterone at the same time can help to limit or prevent these symptoms.

  • Danazol

Danazol is another medication used to stop menstruation and reduce symptoms. While taking danazol, the disease may continue to progress. Danazol can have side effects, including acne and hirsutism. Hirsutism is abnormal hair growth on your face and body.

Other drugs are being studied that may improve symptoms and slow disease progress.

  • Conservative surgery

Conservative surgery is for women who want to get pregnant or experience severe pain and for whom hormonal treatments aren’t working. The goal of conservative surgery is to remove or destroy endometrial growths without damaging the reproductive organs.

Laparoscopy, a minimally invasive surgery, is used to both visualize and diagnose, endometriosis. It is also used to remove the endometrial tissue. A surgeon makes small incisions in the abdomen to surgically remove the growths or to burn or vaporize them. Lasers are commonly used these days as a way to destroy this “out of place” tissue.

  • Last-resort surgery (hysterectomy)

Rarely, your doctor may recommend a total hysterectomy as a last resort if your condition doesn’t improve with other treatments.

During a total hysterectomy, a surgeon removes the uterus and cervix. They also remove the ovaries because these organs make estrogen, and estrogen causes the growth of endometrial tissue. Additionally, the surgeon removes visible implant lesions.

A hysterectomy is not usually considered a treatment or cure for endometriosis. You’ll be unable to get pregnant after a hysterectomy. Get a second opinion before agreeing to surgery if you’re thinking about starting a family.

Read more about: Ovarian Cancer Treatment

How do you get rid of endometriosis?

  1. Heat

If your symptoms are acting up and you need relief, heat is one of the best home remedies you have at your disposal. Heat can relax the pelvic muscles, which can reduce cramping and pain. You can use warm baths, hot water bottles, or heating pads to treat cramping effectively.

  1. OTC anti-inflammatory drugs

Over-the-counter nonsteroidal anti-inflammatory drugs can offer fast relief from painful cramping caused by endometriosis. These drugs include ibuprofen and naproxen. Make sure you take them with food or drink to prevent stomach upset and ulcers, and don’t use them for longer than one week.

  1. Castor oil

Castor oil has been used for hundreds of years to treat endometriosis. It can be used at the very beginning, when cramping is first felt, to help the body get rid of excess tissues. It’s important that this technique is only used before the menstrual flow, and not during.

Castor oil should be massaged directly into the abdomen. You can also mix it with a few drops of a relaxing essential oil like lavender to help relax the pelvic muscles, and apply it to a warm compress to place on the abdomen.

  1. Turmeric

Turmeric has strong anti-inflammatory properties that can be beneficial to people experiencing endometriosis symptoms. It can also be used to manage endometriosis in the long term.

You can take turmeric capsules, or make turmeric tea by boiling one cup of water and adding a teaspoon of both turmeric and ginger powder. You can also add honey and lemon. Drink this three times daily while experiencing symptoms, and at least once daily when you’re using it for maintenance.

  1. Choose anti-inflammatory foods

This won’t offer fast symptom relief, but it could help manage the endometriosis long term. By avoiding foods that cause inflammation and increasing foods with anti-inflammatory properties in your diet, you can reduce symptoms in the future.

Foods to avoid include:

  • dairy
  • processed foods high in refined sugars
  • caffeine
  • alcohol

Foods to increase include:

  • green leafy vegetables
  • broccoli
  • celery
  • blueberries
  • salmon
  • ginger
  • bone broth
  • chia seeds
  1. Pelvic massages

Massaging the pelvic muscles can help relax them and reduce inflammation, reducing crampingTrusted Source. Using a few drops of high-quality lavender essential oil can help further relax the muscles. Gently massage the affected area for 10 to 15 minutes at a time.

Pelvic massages should only be used before the menstrual cycle; it may aggravate symptoms if you use it as a treatment during your period.

  1. Ginger tea

Some people with endometriosis experience nausea as a result of the condition. Ginger tea is one of the best home remedies for treating nausea.

You can purchase ginger tea packets at many supermarkets and grocery stores. Just add them to a cup of boiling water and drink two to three times daily when experiencing nausea.

Read more about: Hysteroscopy

Can endometriosis go away on its own?

For most women, endometriosis recedes with menopause. Some women find relief from endometriosis during pregnancy. In some cases, symptoms may simply go away. About one-third of women with mild endometriosis will find that their symptoms resolve on their own.

Read more about: Ovarian cyst removal surgery in Iran

What will happen if endometriosis is left untreated?

Mild endometriosis doesn't always need treatment. You are usually offered treatment to help relieve the symptoms rather that to cure the disease itself.

If left untreated, some endometriosis will improve, but most will stay the same. Some will become more severe without treatment. If left untreated, endometriosis can (however does not always) result in a range of symptoms, including:

  • Dysmenorrhoea (pain during menstruation)
  • Pelvic pain
  • Infertility (the inability to become pregnant) or subfertility (a reduced ability to become pregnant)
  • Dyspareunia (painful intercourse)
  • Dyschezia (painful defecation)
  • Lower abdominal pain
  • Back pain
  • Loin pain
  • Pain on micturition (urination)
  • Pain on exercise.

Read more about: Hysterectomy surgery

What are the 4 stages of endometriosis?

Endometriosis is classified into one of four stages (I-minimal, II-mild, III-moderate, and IV-severe) based upon the exact location, extent, and depth of the endometriosis implants as well as the presence and severity of scar tissue and the presence and size of endometrial implants in the ovaries.

  • Stage 1 (1 to 5 points)

In Stage 1, the endometriosis is considered “minimal.” The implants are small, few in number, and shallow, although keep in mind that these stages don’t correspond to pain and discomfort levels (more on that later). Just because a woman might have Stage 1 endometriosis, this doesn’t mean that her pain is minimal or that the effect on her life has been minimal.

  • Stage 2 (6 to 15 points)

In Stage 2, the endometriosis is considered “mild.” Doctors might find more implants, and they are deeper than the superficial implants found in Stage 1 endometriosis.

  • Stage 3 (16 to 40 points)

Stage 3 is “moderate” endometriosis. Not only are there many deep endometrial implants, but there may be endometrial cysts on at least one ovary. These endometrial cysts form when the tissue attaches to an ovary and begins to shed blood and tissue. The blood collects and turns brown, which is why these growths are also known as “chocolate cysts.”

Doctors may also find thin bands of tissue, called filmy adhesions, that bind organs together. These adhesions are the scar tissue that form when the body tries to heal from the inflammation caused by endometriosis. They can make organs stick together when they shouldn’t and are thought to be the cause of sharp, stabbing pains, as well as nausea, in women with endometriosis.

  • Stage 4 (40 or more points)

Stage 4 is the “severe” stage of endometriosis. In addition to many deep endometriosis implants, there are large cysts on at least one ovary and many dense adhesions throughout the pelvic region.

Read more about: Female Pelvic Laparoscopy

How serious is endometriosis?

Endometriosis affects millions of women around the world. The invisible illness is characterized by severe pain in the pelvis area, which is often worse during menstruation. While the exact cause of the disease is unknown, scientists think that estrogen levels may be responsible. Endometriosis causes inflammation and scarring of the tissue in the pelvic cavity but is often dismissed by doctors who assume that the woman is just experiencing bad menstrual cramps. 

Many women experience severe pain with the disease, often constant and can also suffer from abdominal bloating. The disease can run in families, although this is not always the case.

 

How long does it take to develop endometriosis?

Endometriosis can happen in any girl or woman who has menstrual periods, but it is more common in women in their 30s and 40s. You might be more likely to get endometriosis if you have: Never had children. Menstrual periods that last more than seven days. The symptoms of endometriosis can begin in early adolescence, or show up later in adulthood. Symptoms may occur at all times, or may be cyclical. Cyclical symptoms come and go around the same time each menstrual cycle, often occurring around the same time as menstruation.

Read more about: Myomectomy Surgery

 

10 common questions about endometriosis treatment in Iran

1How do you get rid of endometriosis?
Laparoscopy is the most common procedure used to diagnose and remove mild to moderate endometriosis. Instead of using a large abdominal incision, the surgeon inserts a lighted viewing instrument called a laparoscope through a small incision.
2What happens if endometriosis is left untreated?
If not treated, endometriosis can lead to complications such as: Infertility. Debilitating pelvic pain.
3How serious is endometriosis?
Endometriosis can be associated with severe pain and fertility problems. About 30% to 40% of women with endometriosis have some trouble conceiving. ... Over time endometrial implants may grow, or cysts may result because of endometriosis, which also may cause fertility problems.
4What foods to avoid if you have endometriosis?
“Women with endometriosis should avoid fatty foods, such as red meat and [high-fat] dairy foods that may be high in PCBs and dioxins, to reduce their exposure to these estrogenic pesticides,” adds Shepperson Mills. Use organic food whenever you can, or peel fruits and vegetables, she recommends
5Can endometriosis make you tired?
Endometriosis fatigue may be caused by low iron levels. ... A common symptom of endometriosis is heavy menstrual bleeding. Menstrual blood contains high levels of iron, and a person who regularly loses a lot of blood has a high risk of developing anemia. This condition causes a person to feel tired all the time.
6Does endometriosis worsen with age?
Endometriosis is typically a progressive condition, meaning it can get worse over time (29). ... Early management can help reduce progression of the condition, reduce complications, and keep symptoms under control
7Can endometriosis turn into cancer?
Having endometriosis doesn't necessarily increase your cancer risk. ... And there's no genetic trait associated with endometriosis that could lead to cancer. Some rare types of ovarian cancer, like clear cell ovarian cancer and endometrioid ovarian cancer, are more common in women with endometriosis
8Can endometriosis cause weight gain?
It can cause chronic pain, heavy or irregular periods, and infertility. Some people also report weight gain and bloating. Little research has explored why endometriosis might cause weight gain. ... Sometimes, other conditions such as polycystic ovary syndrome (PCOS) can mimic the symptoms of endometriosis.
9Can endometriosis be cured?
Endometriosis is a chronic condition with no cure. ... But this doesn't mean the condition has to impact your daily life. Effective treatments are available to manage pain and fertility issues, such as medications, hormone therapy, and surgery. The symptoms of endometriosis usually improve after menopause.
10Can Stage 4 endometriosis be cured?
In stage 4 endometriosis, the disease will be even more advanced, with thick scarring visible on all organs. During stage four, both fallopian tubes may also be blocked. Treating endometriosis during the latter stages is trickier and will rely on both surgery and medication to shrink the lesions.

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