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Endometriosis, commonly known as the chocolate cyst is not as fancy as it sounds. In fact, the problem is very aggressive and progresses at a considerably fast pace. The problem originates in the ovaries or the peritoneum where the endometrial tissue and blood start to accumulate, leading to the formation of a cyst. When this cyst starts to leak, the impure blood falls on the nearby structures (i.e. uterus, fallopian tubes, intestines, urinary bladder etc.) as a result of which they start to stick to each other and lead to the formation of a consolidated mass.

The normal working of the ovaries, uterus and fallopian tubes is very important for healthy reproduction because only then the ovaries will be able to release healthy eggs, the fallopian tube will be able to hold these eggs and the pregnancy can take place. The consolidated mass, however, affects the normal function of the reproductive organs and makes it difficult to conceive.

The patient is likely to experience irritation, scar formation, adhesions, severe pain during periods and infertility.

Symptoms indicating that you might have endometriosis

The following symptoms are a clear indication of endometriosis and should not be taken for granted.

  • Chronic pain during periods
  • Experiencing pain during or after sexual intercourse
  • Experiencing pain while urinating or passing stools
  • Excessive pain during and in between periods
  • Fatigue and general body weakness
  • Digestive problems like nausea, diarrhoea, constipation and bloating.

Possible causes

The various possible causes of endometriosis are mentioned below:

  • Retrograde menstruation – a condition in which the menstrual blood flows backwards through the fallopian tubes into the pelvic cavity.
  • Transformation of peritoneal cells into endometrial like cells owing to various hormonal or immune factors.
  • Transformation of embryonic cells into endometrial like cell implants due to hormones like estrogen.
  • Accumulation of endometrial cells near a surgical scar from previous surgery.
  • Transportation of endometrial cells to various body parts via the blood vessels or the lymphatic system.
  • Certain immune disorders may also prevent the body from damaging unnecessary endometrial cells which then start to accumulate. 
  • Not being able to conceive 

Risk factors

There are several risk factors that can increase your vulnerability to developing endometriosis. These are as under

  • Early menstruation 
  • Late menopause
  • Short menstruation cycles (with a gap of less than 27 days)
  • Heave menstruation for more than a week.
  • Elevated levels of estrogen in the body
  • Low BMI
  • Family history of endometriosis
  • The restricted flow of menstruation blood from the body
  • Abnormalities in the reproductive tract
  • Never being pregnant

Various stages of endometriosis

Endometriosis is usually divided into 4 different stages depending upon the adversity of its symptoms and how far it has spread:
Stage I or minimal endometriosis
Stage II or mild endometriosis
Stage III or moderate endometriosis
Stage IV or severe endometriosis

Diagnostic procedures

The diagnosis of endometriosis involves detailed physical examinations and screenings as well as a case study of the patient’s medical history. 
Physical examination of the pelvis can help the doctors to detect any cysts or scars.
Transvaginal or abdominal ultrasound can help in the clear imaging of your reproductive organs for easy identification of the cyst.
The cyst can be directly viewed by a procedure known as laparoscopy.

Treatment options available

It is possible to treat endometriosis both by the use of simple medicine as well as surgically. 
Medicinal treatment is usually used in case of patients who do not want instant fertility and just want to manage the symptoms. Surgery, on the other hand, is recommended to patients who are planning to conceive. These include conservative surgeries, complex surgeries as well as radical surgeries like hysterectomy and oophorectomy. 

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