Advocating Endometriosis Awareness

Endometriosis affects 10% of women of reproductive age. It has significant social and public health impact with economic implications as it affects quality of life, decreases work hours and affects sexual and reproductive health.

It is a chronic disease in which tissue like that lining the womb grow outside the womb, like in and on the lining of the abdomen (peritoneum), ovaries, tubes, pouch of Daylen bowel, bladder, uterus, vagina, wounds and sometimes outside the pelvis. Due to overall chemicals and hormonal associations it causes inflammation and scars around the disease sites leading to signs and symptoms. It may start at any stage after menarche and up to menopause and may subside after menopause. The definite cause is not known exactly and in complex with various theories like retrograde menstruation, cellular metaplasia, stem cell theory etc.

It presents a severe pain during or before or after periods, pain during intercourse, chronic pelvic pain, bowel and bladder symptoms like cyclic bleeding in urine, stools, pain defecation, urination, excess bleed during periods, bleeding in between periods, depression and anxiety and also difficulty in conception.

Shamita Shetty, renowned actor and Bigg Boss 15 contestant, recently took to social media to share her personal battle with endometriosis, shedding light on a condition that affects millions of women worldwide. Endometriosis, a chronic disease characterized by the growth of tissue similar to the lining of the womb outside the uterus, often goes undiagnosed and untreated, leading to significant pain and health complications. In her heartfelt message, Shetty revealed that she underwent surgery for endometriosis, emphasizing the importance of educating oneself about this often-misunderstood ailment. "Did you know that almost 40% of women suffer from endometriosis, and most of us are unaware of this disease?" she wrote, urging women to familiarize themselves with its symptoms and seek timely medical attention.

Shetty expressed gratitude to her medical team, particularly Dr. Neeta Warty, her gynecologist, and Dr. Sunita Banerjee, her general practitioner, for their dedication in identifying the root cause of her pain. With the endometriotic deposits surgically removed, Shetty looks forward to a future of improved health and fewer painful days.

Her courageous disclosure not only raises awareness but also encourages women to prioritize their reproductive health and seek proper diagnosis and treatment for endometriosis. Through her advocacy, Shetty aims to empower women to break the silence surrounding this debilitating condition and take proactive steps towards better management and care.

The disease can be superficial or deep. There is no known method to prevent the occurrence, although early diagnosis and appropriate management may half or slow the progression of the disease and reduce the long-term burden due to symptoms.

Diagnosis is based on the history or symptoms or ultrasound or MRI, Laparoscopic visualization and HPE. Treatment is vary based on symptoms or desire for pregnancy and if a family is complete or not. Pain can be reduced with pain relaxing drugs like Mefenemic acid, hormonal treatment includes Oral Contraceptive pills or IUD or patch and implants.

Surgery may be required to remove Endometriotic deposits and cysts or total remove of uterus and ovaries and adhesion and can be open laparoscopic or robotic.

Infertility due to endometriosis may need IUI or IVF. Reoccurrence is seen sometimes as treatment required awareness of the condition or symptoms both by physician and patient. Seeking early consultations and initiation of treatment. Avoiding diagnostic delays may help reducing further progression of the condition. A multidisciplinary team in the surgical skills is needed to deal with deep and infiltration Endometriosis.

(Dr Andal Reddy, Consultant Obstetrics &Gynecology,Apollo Cradle & Children’s Hospital, Hyderabad)