Endometriosis, a prevalent condition among women of reproductive age, often manifests as a painful disorder wherein normal endometrial tissue, typically lining the uterus, grows outside its confines. This displaced tissue, found commonly within the abdominal cavity, can attach to various areas such as the ovaries, bowel, or pelvic lining, and occasionally extend beyond the pelvic region. Mimicking the behavior of uterine lining, this displaced tissue thickens, breaks down, and bleeds cyclically with menstruation, yet lacks an exit route from the body, leading to entrapment. Persistent bleeding and irritation prompt the formation of scar tissue and adhesions, potentially causing abnormal adhesions in the abdomen and pelvis, and resulting in symptoms like varying degrees of pain, especially during menstruation.
The symptoms of endometriosis can vary widely among individuals, ranging from no symptoms to severe pain. Common indicators include painful or heavy periods, lower abdominal, pelvic, or back pain, discomfort during sexual intercourse, bleeding between periods, and fertility-related issues.
Treatment approaches for endometriosis typically begin with medication, reserving surgery as a last resort. The chosen treatment is influenced by factors such as symptom severity and fertility goals. Pain management often involves over-the-counter pain relievers like ibuprofen. Hormone therapy, including hormonal contraceptives, Gn-RH agonists and antagonists, danazol, medroxyprogesterone, and aromatase inhibitors, can effectively alleviate or control endometriosis-related pain.
In cases where medication fails to provide relief, conservative surgery may be recommended to excise endometrial implants, particularly for individuals desiring future pregnancies. In severe instances, hysterectomy coupled with removal of the ovaries may be advised, as hysterectomy alone is insufficient.