Endometriosis is a huge magnitude of problem amongst women of the reproductive age group. More than one in every ten women is suffering from endometriosis. But it is a tip of the iceberg because more than the diagnosed women are suffering in silence.
The uterus has 3 layers. Outer covering (perimetrium), middle muscle layer (myometrium) and innermost lining of cavity called endometrium which sheds out every month in the form of menstrual blood and regenerates during 1 month of time. When this endometrium or endometrium-like cell grows outside the uterus in an unnatural condition, it is called endometriosis.
Most common organs involved in endometriosis are the outer surface of uterus and surrounding structures like ovaries, fallopian tube, ligament of uterus, pelvic peritoneum (covering of the abdomen), intestine, urinary bladder, ureter. However, endometriosis can affect any organ in the body from brain upto the leg muscles like lungs, liver, spleen, vagina, diaphragm, kidneys, bone, operative scar incisions (scar endometriosis).
Stage 1 (minimal): Small endometrial implants over the pelvic organs.
Stage 2 (mild): More lesions which may be deeper with or without flimsy adhesions.
Stage 3 (moderate): Multiple deep lesions, ovarian endometrioma with dense adhesions.
Stage 4 (severe): DIE – deep infiltrating endometriosis, large endometrioma with large adhesions that make difficult to inspect the pelvic structure. Endometriosis can impact physical, mental, sexual, social, and economic life of a woman.
Lungs: Chest pain, coughing of blood (hemoptysis) may be during the menstrual period.
Exact cause of endometriosis is still not clear. Some possible theories like –
Factors that increase the risk of development of endometriosis include:
Earliest diagnosis of endometriosis is necessary to halut the progression of disease and prevent complications and provide good quality of life. Treatment of endometriosis depends on age, at pregnancy planning. So, every patient needs an individual plan of management.
1. Counseling: Counselling and understanding of disease is very essential not only for patients but also the family members as, support of family members is very crucial because the sufferings of women due to endometriosis is difficult to understand.
2. Diet: Avoidance of fast food, restricting estrogen-containing foods, vegetables, legumes, fibrous fruits, whole grains, leafy dark green broccoli, beans, fortified grains, nuts, seeds are recommended. Essential fatty acid, fruits salmon, trout, walnuts, chia seeds, flak seeds are useful. Antioxidant rich fruits and vegetables – oranges, berries, spinach, beetroot. Foods needs to be avoided: Estrogen influencing foods – cheese, oil, fatty foods. Inflammatory foods should never be consumed like alcohol, caffeine, gluten, red meat, saturated and trans fat.
3. Exercise, Yoga And Meditation:
Kegel’s exercise – for strengthening pelvic floor muscles and strengthening of core muscles and regular exercise like walking, running, swimming along with Yoga and meditation can improve blood flow and promote overall well being. Regular physical exercise can reduce inflammation. Endorphin release after exercise result in mood elevation
Weight Reduction: Normal BMI help in regulating blood estrogen level.
Early Pregnancy: Early pregnancy is suggested as soon as diagnosis of Endometriosis is made and the couple is desirous for planning the pregnancy. Because during pregnancy and breastfeeding there will be no menstruation and the level of estrogen in the blood will be very much low and progesterone levels are on the higher side. Hence, it helps in curing the disease.
Medicine: Painkillers and hormones.
Surgery: laparoscopic and robotic-assisted.
a) Early stage disease: Counselling, lifestyle changes, exercise and regular monitoring of the progression of the disease and intervention as and when required if. The disease progresses.
b) Moderate disease: Along with the above measures, medicines like hormones and painkillers will be helpful to relieve the symptoms. Medicine like NSAIDS, antispasmodics and neuro modulator. Hormones: progesterone in the form of tablets, injection, progesterone releasing intrauterine system will help in haulting the progression of the disease and prevent worsening of symptoms and other complications. Surgery: patient not able to conceive naturally or even after IVF. Laparoscopic/robotic fertility-preserving surgery may be required.
c) Severe/Advanced Disease with DIE (deep infiltrating endometriosis): If the disease is not responding to above all measures and making the patient to carry on her routine day to day activities then surgery is the only option. Which can be performed by laparoscopy or robotic assisted. Young unmarried girls and married women who are desirous for pregnancy in future are the ideal patients for the fertility-enhancing surgery.
Fertility preserving/Enhancing surgery where the uterus, ovaries and normal and healthy fallopian tubes are preserved after clearance of all endometriotic disease from the pelvis is required. Women in their late 30‘s or early 40’s desirous to preserve uterus, laparoscopic or robotic excision of all pelvic disease with preservation of uterus and ovaries may be a good option but further follow up for the recurrence of disease is very much essential and medicines may be required to prevent recurrence of supress the disease if recurrence occurs.
Hysterectomy with Oophorectomy: It is the definitive treatment for any kind of endometriosis to have a permanent cure.
Dr. Balaji Nalwad Reddy is one of the best Endometriosis Specialists in Pune, known for his expertise in laparoscopic and robotic-assisted surgery. He provides advanced and personalized treatment to help women overcome chronic pelvic pain and fertility issues.
Common symptoms include painful periods, pelvic pain, pain during intercourse, heavy menstrual bleeding, infertility, and digestive discomfort. If you experience any of these, consult Dr. Balaji Nalwad Reddy, a leading Endometriosis Specialist in Pune, for evaluation and care.
Dr. Reddy uses a combination of detailed clinical assessment, ultrasound, MRI, and laparoscopic evaluation to accurately diagnose endometriosis. His clinic offers comprehensive diagnostic facilities for patients across Pune.
Yes. Dr. Balaji Nalwad Reddy specializes in advanced laparoscopic and robotic-assisted procedures that are safe, precise, and effective in removing endometrial tissue while preserving fertility and ensuring faster recovery.
To consult Dr. Balaji Nalwad Reddy, call +91 9922836552 or fill out the Book Appointment form on our website. Early consultation with an expert Endometriosis Specialist in Pune ensures faster relief and better outcomes.
Consultant Gynecologist with specialisation in laparoscopic and robotic-assisted surgeries.
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