Endometriosis

This is a condition where cells similar to Endometrium(lining inside the uterus) are present in sites other than the uterus.

• Women may present with chronic pelvic pain— Lower back and lower abdominal pain.
• Painful periods—which becomes worst over time
• Pain during intercourse and
• Pain during passing urine.

About 1/3rd of women may present with infertility.

• Genetic predisposition, runs in families.
• Women who have not given birth, Women with early menarche & menopause are at higher risk.

• Diagnosed by physical Examination and ultrasound pelvis. A vaginal ultrasound may be necessary.
• At times—Ultrasound may not show any significant changes. In such cases, Diagnostic Laparoscopy is done if the pain is persistent.

Those presenting with infertility--) may have

• Ovarian cysts-choclate cysts which have to be removed with Laparoscopy.
• May have tubal adhesions-in such cases Diagnostic hysterolaparoscopy is done and
  adhesions released and tubal patency is checked.
• In patients with minimal Endometriosis, IUI can be tried.
• In patients with severe Endometriosis, IVF may be needed.
• In women presenting with dysmenorrhea and pelvic pain--) Oral contraceptive pills and progestogen will help.