Navigating through the diagnosis, symptoms, and treatment of endometriosis can be complex due to its unknown etiology, silent progression, lack of standard blood tests, lack of awareness of the disease existence and overlapping signs with other conditions. Here’s a clear, structured guide to understanding each stage of endometriosis diseases by Dr Sandip Sonara best Endometriosis doctor in Gujarat.
1. Symptoms of Endometriosis
Most comman symptoms of endometriosis are inflammation and pain caused by the disease. Common complaints include:
- Pelvic pain especially before and during periods-dysmenorrhea
- Chronic pelvic pain not realted to menstruation
- Long time back pain not cured by painkillers
- Pain during intercourse
- Pain with bowel movements or urination
- Heavy menstrual bleeding
- Presence of blood in urine or stool during periods
- Difficulty conceiving
- Bloating, nausea, other gastrointestinal symptoms
- Chronic fatigue
- Chronic depression
Note: Some women may have no symptoms, making early detection difficult.
2. Diagnosis of Endometriosis
Diagnosis of endometriosis can be challenging and often delayed. The average delay is 7–10 years from symptom onset.
Medical History & Symptom Review
- Detailed discussion of menstrual cycles, pain patterns, pain while having intercourse and fertility concerns can point towards disease existence.
Non-Invasive Tests
- Pelvic clinical examination: this may detect tender painful areas in pelvis, ovarian cysts or endometriotic nodules in bimanual examination
- Ultrasound: is considered dynamic imaging where extent, and size of endometriosis disease is very well detected if the doctor is well experience and skillful in perfoming ultrasonography. Also it allows on the sport explanation of disease to the patient and showing the images of the disease.
- MRI Endometriosis protocol : is the gold standard and objective method of diagnosing the presence and disease extent.
- Blood tests: CA-125 may be elevated but is not diagnostic and sometime misleading.
Definitive Diagnosis
- Imaging (usg/ mri done by the expert) and corelation of symptoms with finding of imaging
- Laparoscopy (Minimally Invasive Surgery):
- Gold standard method for diagnosis
- Allows direct visualization and biopsy of lesions in case of confusion
- Can also treat during the same procedure.
3. Treatment Options
Dr Sandip Sonara who offers best Endmetriosis treatment in Ahmedabad, suggest that treatment depends on symptom severity, age, and fertility plans of the couple, future fertility wishes, extent of the disease to the surrounding organs
A. Medication
- Pain killers: NSAIDs (e.g., ibuprofen) just to provide timebeing relief from pain, does not cure the disease.
- Hormonal therapy:
- Birth control pills/patches/rings
- Progestins (e.g., Depo-Provera, Mirena IUD)
- GnRH agonists injections(e.g., Lupron)- produces artificial menopause by suppressing the disease
All these hormonal treatment options suppress the disease for small duration and cause partial improvement in the symptom of pain, but it does not cure the disaeas. In fact many times women are misguided by their gynecologists to take hormone treatment for years without much improvemet in the overall symptoms.
Long term hormone treatment can lead to fibrosis of the endometriotic lesions which ultimately leads to incease the disease morbidity and surgery more difficult due to loss of tissue planes.
Hormone treatment is generally advised when patient is unfit for the surgery.
B. Surgical Options
- Laparoscopic excision of endometriotic lesions when the fertility is desired : Complete removal of all endometriotic implants is the gold standard treatment for endometriosis.
Most gynecologists can not perform this surgery as in depth knowledge, surgical skills and years of experience is required to be the master of the endometriosis surgery. Dr. Sandip Sonara is one of the leading gynaecologist in Ahmedabad, who can perform such kind of difficult endometriosis surgeries with utmost precision.
- Hysterectomy with complete removal of all endometriotic lesions in severe cases, if childbearing is complete.
C. Fertility Treatment:
Have you thought of when to get help of best endometriosis doctor in India if you have fertility issue with endometriosis?
Best treatment approach: Fertilitypreservation+endometriosis surgery
- Where fertility is main concern for the woman, ideally fertility preservation (in the form of eggs freezing or embryo freezing) followed by endometriosis surgery followed by natural trial for short time if tube status, AMH and semen parameters are within normal limits. If any of other causes affecting fertility are present such as blocked tubes, low amh, or abnormal semen parametes, help of assisted reproductive techniques are sought sooner then later.
D. Lifestyle & Complementary Therapies
- Diet changes Add anti-inflammatory foods
- Regular exercise
- Acupuncture to relieve stress and chronic fatigue
- Stress management (yoga, mindfulness)
Key points to flash suggested by endometriosis specialist- Dr Sandip Sonara:
- Early detection is critical to minimize damage and improve quality of life.
- Endometriosis specialist, gynecologists, pain specialists, fertility experts, gastrointestinal surgeons, urologists, radiologists, sonographers, endometriosis nurse specialist
- Tailored treatment of endometrioisis is based on symptoms and personal goals of the woman such as pain relief, fertility, and quality of life.