What is endometriosis?
Endometriosis occurs when cells comparable to those that line the uterus (womb), known as endometrial, begin to proliferate in other areas of the body. They often develop in the pelvis, but can spread to virtually any other portion of the body. Even though they are outside of the uterus, the cells continue to respond to signals from the ovaries. Endometriosis tissue swells month-to-month and then bleeds during the woman's period. This process can, over time, contribute to inflammation and scarring, as well as cause organs to adhere to one another (known as adhesion's). Endometriosis is a chronic, progressive disease. It can be extremely uncomfortable, impact fertility, and hinder women from fully participating in education, job, or sports. Endometriosis causes tens of thousands of hospitalisations annually and affects around 1 in 9 Australian women by their 40's. There is no cure for endometriosis, which can endure until menopause or beyond. However, there are effective therapies that can alleviate the symptoms.


What are the symptoms of endometriosis?
Every woman affected by endometriosis will encounter numerous symptoms. The severity of the symptoms does not correlate with the severity of the disease, but rather with the location of the endometriosis. Common symptoms include stomach or pelvic pain before and during menstruation, during or after sexual activity, or after using the restroom. Pain is felt in the thigh or leg, and it may intensify over time. For some women, the pain is so severe that they are unable to participate in education, employment, or sports; heavy periods or irregular bleeding, often with clots, are the most common causes. Bleeding from the bladder or bowel, or alterations in urine or bowel motions, such as the urge to urinate more frequently, may also indicate endometriosis. bloating, with or without discomfort fatigue, particularly around the time of your period Experiencing anxiety or depression due to the inability to conceive (infertility) However, not all endometriosis patients suffer symptoms.

What causes endometriosis?
Although the causes of endometriosis are unknown, there are several risk factors that place women at a higher risk. Retrograde menstruation follows this condition, menstrual (period) blood flows backwards via the Fallopian tubes and into the pelvic, rather than out of the body. This blood could contain endometrial cells. These endometrial cells adhere to the surfaces of pelvic organs and begin to proliferate in certain women. Endometriosis can develop from regular pelvic tissue. The term for this is metaplasia. Family origins are Seven to ten times more likely to get endometriosis are women who have a close relative with the disorder. Endometriosis develops when tissue comparable to the uterine lining grows outside the uterus. Other probable endometriosis contributors include heavy and lengthy periods numerous intervals or brief cycles beginning your period before age 11 and becoming pregnant later in life. Disorders of the immunological system low body weight alcohol use.

How is endometriosis diagnosed?
Many women are diagnosed with endometriosis when they visit a doctor for infertility or when it is discovered during an operation for another condition. Unfortunately, endometriosis is frequently misdiagnosed, and the average time to receive a diagnosis is seven years. To diagnose endometriosis, your physician will likely enquire about your symptoms and menstrual cycles. Endometriosis can only be confirmed through a laparoscopy, which is a form of surgery that allows doctors to inspect for endometriosis tissue in the abdomen, and a biopsy, in which a small sample of tissue is removed for laboratory examination. There is now growing evidence that specialised ultrasound can aid in the diagnosis of many, but not all, conditions. Endometriosis has four phases or grades, depending on the severity of the disease:
Stage/grade I (mild): Small endometriosis patches are dispersed throughout the pelvis.
Stages 2 and 3 (moderate): The disease has spread to the ovaries and other pelvic organs. Additionally, there may be substantial scarring and adhesions.
The disease has expanded to the majority of pelvic organs at Stage / Grade 4 (severe).
When should I visit my physician? If you suspect you have endometriosis, discuss your symptoms with your doctor.
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How is endometriosis treated?
‍If you have endometriosis, a gynecologist will  take care of you. Most of the time, endometriosis can be treated with medicines, surgery, and other treatments like physiotherapy and counselling. The treatment will depend on: what you're feeling how severe your endometriosis is if you want to get pregnant or not. Endometriosis can be treated with hormone-based drugs like the pill, an implant, or an IUD, as well as painkillers. Hormone treatments can ease pain and stop endometrial cells from growing. But they only work as long as you keep taking them, so the endometriosis may return. The goal of surgery for endometriosis is to get rid of as much of it as possible. There are a few options, such as laparoscopic surgery, in which a small cut is made in the abdomen so that the endometrial tissue can be looked at and removed. Surgery and medicines can also be used together. In very bad cases, a hysterectomy could be done to remove the whole womb. A physiotherapist can help if you have problems with your bladder or bowels, and a clinical psychologist can help you deal with long-term pain. Most women with endometriosis get pregnant without help from a doctor, but about one in three have trouble getting pregnant. IVF and other methods can help most of these women get pregnant. Pain may not go away even if the endometriosis is treated. Endometriosis could return. So make sure you talk to your doctor about the pros and cons of any treatment they suggest.  If you have endometriosis, make sure you get enough sleep, work out often, and try to avoid stress as much as you can.

What is Adenomyosis?
Adenomyosis is a disorder affecting the uterus (womb). It may result in unpleasant, heavy periods. This disorder affects between 20% and 35% of women. If you have adenomyosis, you may also have endometriosis, a related disorder. The symptoms of each of these illnesses overlap.

What are the symptoms of adenomyosis?
The following can be adenomyosis symptoms: heavy periods Painful periodsex-related pelvic painchronic (ongoing) pelvic painintermenstrual bleedinginfertility Some individuals could experience modest symptoms. However, they can be severe enough to interfere with your ability to work, study, and enjoy life. Occasionally, there are no symptoms.

What causes adenomyosis?
Adenomyosis develops when the cells that ordinarily coat the uterine lining additionally grow in the muscle layer of the uterine wall. It is unknown how or why uterine lining cells get access to the muscle wall. Adenomyosis exclusively occurs in women of reproductive age. It occurs as a result of the hormone oestrogen. It often disappears during menopause, when oestrogen levels decline. A diagram depicting the development of adenomyosis in the uterine muscle layer. When should I visit my physician? Consult a physician if your periods are unpleasant or heavy. Also consult your physician if you experience: unexpected vaginal bleeding or pain during sexual activity.

‍How is adenomyosis diagnosed?
Adenomyosis is frequently difficult to diagnose. Your physician will examine you and discuss your symptoms. During the examination, your uterus may be palpable and swollen. Your physician may recommend that you get an ultrasound. In certain instances, they may suggest magnetic resonance imaging (MRI scan). Your physician may also recommend you to a specialist for additional testing and care.

How is adenomyosis treated?
Your physician will discuss the potential therapies with you. The treatment you receive depends depend on your symptoms and age. This includes considering whether you are planning a pregnancy or if you desire to have a child in the future. Self-care measures Warm baths and heat packs may help alleviate adenomyosis-related pain. Additionally, exercise, meditation, and acupuncture may be explored. However, there is minimal to no evidence that they alleviate the symptoms of adenomyosis.
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Pain-relief medicines
If you experience adenomyosis-related pain, your physician may offer anti-inflammatory medications. They may recommend using these medications with paracetamol.

Hormonal treatments
Hormonal therapies can alleviate pain and stop excessive bleeding. They accomplish this by managing your body's oestrogen levels. Your physician may suggest: the tablet (combined oral contraceptive pill) A progestogen-only pillan intrauterine device (IUD) that releases progestogena hormone-releasing implant are all examples of progestogen-only pills. These hormone medications are contraceptives, therefore you cannot become pregnant when using them correctly. After discontinuing any of these therapies, it may take several months for fertility to return. Therefore, consult your physician regarding the most appropriate treatments for your age.
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Surgery
For the treatment of adenomyosis, a number of surgical techniques are available. These may involve removing:abnormal portions of the uterine muscle layer of the uterine lining For women with severe adenomyosis who have not responded to prior therapies, hysterectomy is an option. In light of the fact that these procedures may have an effect on your fertility, you should discuss your options with your doctor.

Can adenomyosis be prevented?
As the cause of adenomyosis remains unknown, there is nothing that can be done to avoid this condition. Adenomyosis can result in the following complications: fertility problems increased likelihood of pregnancy problems due to excessive bleeding, anemia

There is more information on adenomyosis from Adenomyosis Australia