ENDOMETRIOSIS – AN ENIGMA
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What is the incidence of endometriosis?
Endometriosis is a condition in which there is presence of functional endometrium in places other than normal uterine cavity. This leads to hemorrhage in those sites during periods which leads to severe pain and that cripples the life of a woman and severely deteriorates the quality of her life. The incidence of endometriosis is roughly 5 to 10 % in Indian population
Has the incidence of Endometriosis increased in the last decade?
Truly speaking … the answer is yes
Why is it so?
Firstly because of the postponement of the first pregnancy due to career issues. It has been established that retrograde menstruation is the main cause of Endometriosis. Therefore a woman having such retro flow of menstrual blood exposes herself to many more number of periods before she conceives thus increasing the chances of endometriosis
Secondly because of the early detection by improved imaging techniques which are more commonly used nowadays
Thirdly because previously dysmenorrhea was often ignored and disregarded and women were encouraged to accept it as being normal. The importance of the suffering was waived by the misconception that it would vanish after marriage and childbirth which is wrong if it is a case of endometriosis.
ENDOMETRIOSIS ….AN ENIGMA
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What is the average delay in the diagnosis of Endometriosis?
The average delay is 7 to 10 years
Why does this delay occur?
The main symptom of endometriosis is pain in the abdomen. The initial phases of mild to moderate dysmenorrhea is often ignored .This pain is usually in the form of progressively increasing dysmenorrhea but gradually with the increase in the stage of the disease it can take the picture of chronic pelvic pain. Now a chronic pelvic pain can be attributed to many other Gynecological diseases like Pelvic inflammatory disease, pelvic tumors etc and it may also mimic many non gynecological diseases like , irritable bowel disease, appendicitis etc. This leads to a confusion and hence delay in arriving at or pin pointing the diagnosis
ENDOMETRIOSIS ….AN ENIGMA
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Why are we concerned with endometriosis?
Endometriosis is a long term, recurrent debilitating disease affecting an estimated 1 in 10 women during their reproductive years( ie usually between the ages of 15 to 49 ). It is experienced by 5 to 10 % of all women, in upto 60% of those with dysmenorrhea and in up to 30% of women with subfertility with a peak incidence in the age range of 25-30 years
Endometriosis is often considered as a “social disease” because it reduces the quality of life to a great extent. Women with endometriosis reported an average of 38% reduction in work productivity, attributed to reduced work effectiveness in the presence of pelvic pain rather than work absence. Literature shows that about 87% of women investigated with endometriosis had depressive symptoms and 88% had anxiety. Delays in diagnosis, high rates of hospital admission, lifelong medications, surgical procedures and incidence of co morbid conditions contribute to making endometriosis an economic burden on families and society