What is Endometriosis?

Endometriosis is a chronic condition in which tissue similar to the lining of the uterus (called the endometrium) grows outside of the uterus. These growths can occur on the ovaries, fallopian tubes, the outer surface of the uterus, and other organs in the pelvic region. In rare cases, endometrial tissue may grow outside the pelvic cavity altogether.

Each month, as a woman’s hormonal cycle progresses, the endometriotic tissue thickens, breaks down, and sheds, just like the lining inside the uterus. However, when this tissue grows outside the uterus, it has nowhere to go, which can cause inflammation, pain, and scar tissue formation. Over time, this leads to the following complications:

• Pelvic pain: One of the most common symptoms of endometriosis.
• Infertility: Endometriosis is a significant factor in infertility, making it difficult for women to conceive.
• Heavy periods or spotting: Many women with endometriosis experience heavy, painful periods and irregular bleeding between cycles.
• Painful intercourse: Endometriosis can cause pain during or after sexual activity.
• Chronic pain: Pain can be constant, particularly during menstruation.

Though the exact cause of endometriosis remains unclear, factors like genetics, immune system dysfunction, and menstrual flow issues are believed to play a role in the condition.

How is Endometriosis Diagnosed?

Diagnosing endometriosis can be challenging, as its symptoms often overlap with other conditions like pelvic inflammatory disease (PID), irritable bowel syndrome (IBS), or ovarian cysts. However, accurate diagnosis is essential to develop a treatment plan that addresses your needs.

1. Medical History and Symptom Review

At Janya Fertility Center, the first step in diagnosis begins with a comprehensive review of your medical history. We will ask about the nature and duration of your symptoms, menstrual history, and any concerns regarding fertility. Additionally, we may inquire about your family’s medical history since endometriosis often runs in families.

2. Physical Examination

A pelvic exam is performed to check for abnormalities in the reproductive organs. However, in many cases of endometriosis, external tissue growth may not be detectable through a simple pelvic exam.

3. Imaging Tests

Though an ultrasound may not directly diagnose endometriosis, it can help rule out other conditions that might mimic its symptoms, such as ovarian cysts or fibroids. A transvaginal ultrasound can help assess the ovaries and uterus. Sometimes, an MRI may be recommended for a more detailed image, especially if deep endometriosis is suspected.

4. Laparoscopy (Surgical Diagnosis)

The gold standard for diagnosing endometriosis is a laparoscopy. This minimally invasive surgical procedure involves inserting a small camera (laparoscope) through a tiny incision in the abdomen to directly view the pelvic organs. Laparoscopy is the only way to definitively diagnose endometriosis, as it allows for visualization of the tissue growth and biopsy if necessary.

Treatment Options for Endometriosis at Janya Fertility Center

While there is currently no cure for endometriosis, there are several treatment options available to help manage symptoms, improve fertility, and improve quality of life. At Janya Fertility Center, we provide comprehensive care that is customized to your specific needs. Whether you are dealing with pelvic pain, heavy periods, or fertility challenges, we can develop a treatment plan that works for you.

1. Pain Management

One of the most immediate concerns for women with endometriosis is pain management. At Janya Fertility Center, we employ a combination of medications and non-invasive techniques to help alleviate discomfort.

• Pain Relievers: Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, are commonly used to reduce pain and inflammation.
• Hormonal Therapy: Hormonal treatments are designed to regulate or suppress the menstrual cycle, which can help reduce pain. These options include:
  • Birth Control Pills: Birth control pills can regulate periods, reduce menstrual flow, and ease cramping.
  • Progestin Therapy: Progestin-only treatments (such as the Depo-Provera shot or intrauterine devices like Mirena) can reduce or eliminate periods, which can alleviate pain.
  • GnRH Agonists: These medications suppress ovarian hormone production, inducing a temporary menopause-like state that can reduce endometriosis symptoms.
  • Danazol: A synthetic steroid that limits the growth of endometrial tissue by suppressing ovarian function.
  • Dydrogesterone / Dinogest : A synthetic progesterone which suppresses the growth of endometrial tissue thereby reducing the pain and symptoms

These treatments aim to reduce the symptoms associated with endometriosis but are not a permanent solution. They may need to be used in conjunction with other treatments for long-term relief.

2. Fertility Treatment Options

For women with endometriosis who are trying to conceive, fertility can be significantly impacted due to the scarring of reproductive organs and hormonal imbalances. Fortunately, fertility treatment options at Janya Fertility Center can help improve the chances of pregnancy.

• Ovulation Induction: Hormonal medications such as Clomiphene Citrate or Letrozole can help stimulate ovulation in women with endometriosis. These medications help promote the release of eggs from the ovaries.
• Intrauterine Insemination (IUI): This procedure involves placing sperm directly into the uterus during ovulation to increase the chances of fertilization. IUI can be effective for women with mild to moderate endometriosis.
• In Vitro Fertilization (IVF): IVF is often recommended for women with more severe forms of endometriosis or for those who have not had success with IUI. During IVF, eggs are retrieved from the ovaries, fertilized in the lab, and then implanted into the uterus.
• Egg Freezing: For women who are diagnosed with endometriosis at a younger age and wish to preserve fertility for the future, egg freezing can be an option.

Our fertility specialists at Janya Fertility Center are experts in tailoring treatment plans for women with endometriosis who are struggling to conceive. We work with you to determine the best course of action to optimize your chances of a successful pregnancy.

3. Surgery for Endometriosis

In some cases, when symptoms are severe and conservative treatments are not effective, surgery may be recommended. The goal of surgery is to remove endometrial tissue, scar tissue, and adhesions, improving pelvic anatomy and relieving pain.

• Laparoscopic Surgery (Minimally Invasive): Laparoscopy is often used to remove or vaporize the endometriosis tissue. This surgery involves small incisions and is less invasive than traditional surgery, leading to shorter recovery times.
• Hysterectomy: In severe cases of endometriosis, a hysterectomy may be recommended. This is the removal of the uterus, and in some cases, the ovaries as well. While a hysterectomy is considered a last resort for women who do not wish to have children, it can provide significant relief from the pain associated with endometriosis.

4. Lifestyle Modifications

At Janya Fertility Center, we also emphasize the importance of lifestyle changes that can improve the overall management of endometriosis. These include:

• Dietary Changes: A diet rich in anti-inflammatory foods (such as fruits, vegetables, and omega-3 fatty acids) may help reduce inflammation and ease symptoms. Our team can provide nutritional counselling tailored to your needs.
• Exercise: Regular physical activity can help reduce pelvic pain, improve mood, and increase energy levels. It also promotes better hormonal balance.
• Stress Management: Chronic stress can worsen the symptoms of endometriosis, so incorporating mindfulness practices such as yoga, meditation, or deep breathing exercises can be beneficial.

Living with Endometriosis can be challenging, but with the right treatment plan, it is possible to manage the symptoms, enhance fertility, and improve your overall quality of life. At Janya Fertility Center, we offer comprehensive care that is tailored to your specific needs, helping you navigate the complexities of endometriosis with confidence and support.

Whether you are struggling with chronic pain, menstrual irregularities, or fertility challenges, our experienced team of gynaecologists and fertility specialists is here to provide expert care and the latest treatment options. With a combination of medical treatments, surgical interventions, and lifestyle modifications, we are committed to helping you live a fulfilling life and, if desired, achieve your dream of starting a family.

Contact Janya Fertility Center today to schedule a consultation and begin your journey toward effective endometriosis management and improved reproductive health.