Overview :
Endometriosis is often a painful disorder in which tissue that normally lines the inside of your uterus — the endometrium — grows outside your uterus. Endometriosis most commonly involves your ovaries, fallopian tubes and the tissue lining your pelvis. Rarely, endometrial tissue may spread beyond pelvic organs.
With endometriosis, displaced endometrial tissue continues to act as it normally would — it thickens, breaks down and bleeds with each menstrual cycle. Because this displaced tissue has no way to exit your body, it becomes trapped. When endometriosis involves the ovaries, cysts called endometriomas may form. Surrounding tissue can become irritated, eventually developing scar tissue and adhesions — abnormal bands of fibrous tissue that can cause pelvic tissues and organs to stick to each other.
Endometriosis can cause pain — sometimes severe — especially during menstrual periods. Fertility problems also may develop. Fortunately, effective Ayurvedic treatments are available.
Symptoms
The primary symptom of endometriosis is pelvic pain, often associated with menstrual periods. Although many experience 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, diarrhoea, constipation, bloating or nausea, especially during menstrual periods.
The severity of your pain isn't necessarily a reliable indicator of the extent of the condition. You could have mild endometriosis with severe pain, or you could have advanced endometriosis with little or no pain.
Endometriosis is sometimes mistaken for other conditions that can cause pelvic pain, such as pelvic inflammatory disease(PID) or ovarian cysts. It may be confused with irritable bowel syndrome (IBS), a condition that causes bouts of diarrhoea, constipation and abdominal cramping. IBS can accompany endometriosis, which can complicate the diagnosis.
When to see a doctor
See your doctor if you have signs and symptoms that may indicate endometriosis.
Endometriosis can be a challenging condition to manage. An early diagnosis, a multidisciplinary medical team and an understanding of your diagnosis may result in better management of your symptoms.
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 displaced 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 cells.
- Embryonic cell transformation - Hormones such as estrogen may transform embryonic cells — cells in the earliest stages of development — into endometrial 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 tissue that's growing outside the uterus.
Endometriosis stages
Endometriosis has four stages or types. It can be any of the following:
- Minimal
- Mild
- Moderate
- Severe
Different factors determine the stage of the disorder. These factors can include the location, number, size, and depth of endometrial implants.
Stage 1: Minimal
In minimal endometriosis, there are small lesions or wounds and shallow endometrial implants on your ovary. There may also be inflammation in or around your pelvic cavity.
Stage 2: Mild
Mild endometriosis involves light lesions and shallow implants on an ovary and the pelvic lining.
Stage 3: Moderate
Moderate endometriosis involves deep implants on your ovary and pelvic lining. There can also be more lesions.
Stage 4: Severe
The most severe stage of endometriosis involves deep implants on your pelvic lining and ovaries. There may also be lesions on your fallopian tubes and bowels.
Risk factors
Several factors place you at greater risk of developing endometriosis, such as:
- Never giving birth
- Starting your period at an early age
- Going through menopause at an older age
- Short menstrual cycles — for instance, less than 27 days
- Heavy menstrual periods that last longer than seven days
- Having higher levels of estrogen in your body or a greater lifetime exposure to estrogen your body produces
- Low body mass index
- One or more relatives (mother, aunt or sister) with endometriosis
- Any medical condition that prevents the normal passage of menstrual flow out of the body
- Reproductive tract abnormalities
Endometriosis usually develops several years after the onset of menstruation (menarche). Signs and symptoms of endometriosis may temporarily improve with pregnancy and may go away completely with menopause.
Complications
Infertility
The main complication of endometriosis is impaired fertility. Approximately one-third to one-half of women with endometriosis have difficulty getting pregnant.
For pregnancy to occur, an egg must be released from an ovary, travel through the neighbouring fallopian tube, become fertilized by a sperm cell and attach itself to the uterine wall to begin development. Endometriosis may obstruct the tube and keep the egg and sperm from uniting. But the condition also seems to affect fertility in less-direct ways, such as by damaging the sperm or egg.
Even so, many with mild to moderate endometriosis can still conceive and carry a pregnancy to term. Doctors sometimes advise those with endometriosis not to delay having children because the condition may worsen with time.
Cancer
Ovarian cancer does occur at higher than expected rates in those with endometriosis. But the overall lifetime risk of ovarian cancer is low to begin with. Some studies suggest that endometriosis increases that risk, but it's still relatively low. Although rare, another type of cancer — endometriosis-associated adenocarcinoma — can develop later in life in those who have had endometriosis.
Diagnosis
To diagnose endometriosis and other conditions that can cause pelvic pain, your doctor will ask you to describe your symptoms, including the location of your pain and when it occurs.
Tests to check for physical clues of endometriosis include:
Pelvic exam
Ultrasound
Magnetic resonance imaging (MRI).
Laparoscopy
Aetiology of Chronic Disease According to Ayurveda
According to Ayurveda, most chronic disease come about when toxins (Ama) accumulate in tissues and start to disrupt the delicate balance of the tissues. Toxic build up can also obstruct the channels of circulation and elimination in the affected areas. This blockage prevents proper nutrition from reaching the tissues and also prevents the removal of the tissue waste. As a result of this toxic build up, the natural defences are lowered and the natural biological rhythms are disrupted.
This is the very process whereby all chronic disease, including endometriosis is created. In the case of endometriosis specifically, chronic toxin accumulation in the reproductive tissue irritates the tissue into responses that result in the slow accumulation of excess tissue. Since the accumulation of Ama is the underlying factor here, it is vital to stop the process of Ama creation and accumulation. This can be done through various means including: improving digestion by regulating the digestive fire (Agni), eating foods that are nourishing and easy to digest, ensuring proper elimination, and by balancing the mind.
Endometriosis According to Ayurveda
Endometriosis is primarily a Kapha problem due to the increasing build up of cells and overgrowing much like a tumour. Endometriosis can also be thought of as a Pitta problem because of the involvement of blood, hormones, and menstruation as well as the inflammatory nature of the disease. Vata is also involved in a number of ways. One is the painful nature of endometriosis which places Vata at the centre of the imbalance. Then, there is the involvement of Apana Vayu in the downward movement of menstrual flow and also the involvement of Vata in the circulation of blood. Perhaps the most obvious sign of the role of Vata is the displacement of endometrial cells from their original location in the uterus to places outside. Therefore, endometriosis is a Sannipatika condition involving all three doshas although the proportion of each may vary to a certain extent according to the individual patient. Endometriosis can also be compared to Yoni Kanda or Vaginal Tumour.
Ayurvedic Treatments for Endometriosis -
Since disease is a result of toxin accumulation, poor nutrition, poor digestion, and imbalances of the mind and nervous system, treatment must include steps to correct the imbalances and reverse the process of disease. The goal of the Ayurvedic approach is to enliven the body's natural self-healing abilities to not only treat endometriosis, but also to prevent disease in general and create a state of health and well-being.
Since endometriosis is a condition of Ama accumulation, the treatment should focus on Detoxification/Reduction or Shodhana Chikitsa in order to remove the Ama and get the doshas back into their original locations Therefore, Pancha Karma is indicated along with Agneya Chikitsa. Most importantly, the liver should be cleansed or tonified as it has a role in menstruation and hormone production.
The treatment focuses on balancing the imbalances in the person and not on the treatment of the disease or its symptoms. For which Shamana chikitsa (Palliative researched Ayurvedic medicines) and Rasayana Chikitsa (Rejuvenation). Indeed, it is in the treatment of complex diseases such as endometriosis that the gifts of Ayurveda can be truly appreciated.
Diet restrictions, life style modifications, Stress Management are also the essential factors practiced for the best possible results.
At Vardhan Ayurveda Hospital, we are providing highly effective treatment for "Endometriosis". We have experienced best treatment success rate in treating Endometriosis through Ayurveda.