It was like any other day for Sarita , 25 years working as a software developer in her Mumbai office ,when she suddenly started having pain in the lower abdomen .”Oh No” not now and not today she said to herself . She had an important presentation with her client after a couple hours . She immediately popped a Tablet Meftal spas and sat on the chair , hoping and waiting the pain would subside ,but in another hour she was in agonising Pain and had to be rushed to the hospital by her colleagues .

Sarita suffered from Endometriosis. A condition in which there is accumulation of cells of the uterine cavity(womb) in the abdominal cavity and pelvis outside the uterus . The resultant effect is such that when she gets periods and uterus starts shedding out the menstrual blood , the same  process happens in the outside the uterus in the abdomen , as there is no outlet for this blood it keeps accumulating and forms brown chocolate cysts or Endometriomas. Each time there is menses , each time patient has severe pain from the abdominal deposits .In some cases the pain does not settle with oral medications and patient has to be admitted and given injectables .

Why does it start ? There is no reason for this disease . It can happen to any woman , especially those having early puberty , late menopause, and those avoiding pregnancy. Pregnancy is protective .Basically any treatment by which patient has fewer menstrual cycles . This can be achieved with pills or Injections , but there is limit to the duration especially the injections. If the patient desires pregnancy the treatment is to fast track the fertility treatment and achieve pregnancy ,giving tablets or injections to avoid periods is a waste of time.

There are conditions when patient has to resort to surgery . Laparoscopy (or key hole surgery) is the preferred modality of approach . In this the cysts are removed with precision preserving the function of the remaining ovary as much as possible , the adhesions (bands which are formed due to the disease due to which the organs are stuck to each other ) are separated , the fallopian tubal patency is checked . This guides in further treatment of patient for fertility , whether spontaneous trial should be given or medical treatment or patient should be advised direct IVF/ICSI. At times patients having repeated cysts , repeated laparoscopies , or those who haven’t undergone laparoscopy but have large cysts or the ovarian function of the wife is too low , these have to resort to direct IVF/ICSI without doing surgery .So there is a definite indication of surgery and NOT ALL patients have to under the knife !!

So Endometriosis is a disease which keeps coming back , having no fool proof cure . Does that mean it is CANCER ? the chances are very rare , 1 in 1000 cases may turn cancerous.

So in a nutshell , if you have this disease, understand how the progression is , seek proper guidance , timely plan your pregnancy

14 Comments