Abstract
Endometriosis is a disease in which the tissue similar to the lining of the uterus grows outside the uterus. It affects women of reproductive age. When endometriosis involves the ovaries, cysts called endometriomas can form. The surrounding tissue may become irritated and scar tissue may form. Bands of fibrous tissue called adhesions may also form. This can cause pelvic tissue and organs to stick to each other. It can cause pain especially in the menstrual periods, and may also develop infertility. The etiology of endometriosis is still unknown. The prevalence rate of this condition in infertile women is 20–50%, but it can be as high as 71–87% in women with chronic pelvic pain. In clinical practice, there is a higher incidence of endometriosis in multitasking and ambitious women. Excessive physical and mental exertion leads to endometriosis. In this article we will discuss signs and symptoms, causes, diagnosis, risk factors and treatment according to modern and Ayurveda point of view.
Introduction
Endometriosis is a female reproductive disorder where the endometrium-like tissue develops outside of the uterus. It usually affects the ovaries and peritoneum, causing premenstrual discomfort and dysmenorrhea. It is a chronic disease associated with severe, life- impacting pain during periods, bowel movements or urination, chronic pelvic pain, pain during intercourse, abdominal pain, nausea, fatigue and sometimes anxiety and depression and infertility. According to a survey, the cost of endometriosis in India is around Rs 1 to 2 lakh per woman. Endometrium lesions are found in asymptomatic women and are detected in up to 50%.Endometriosis affects 10-15% of all reproductive age females and 70% of women with constant pelvic pain. The cause of endometriosis is unknown, but some factors cause this. The diagnosis of endometriosis is often delayed because symptoms like pelvic pain are also associated with other conditions.
Signs And Symptoms
- Excessive bleeding
- Pain with bowel movements
- Dysuria (Pain while urination)
- Dyspareunia (Pain while intercourse)
- Dysmenorrhea (Painful periods)
- Other symptoms like bloating, fatigue, diarrhoea, constipation or nausea. These symptoms are more common before or during onset of periods.
Causes
The exact cause of endometriosis is still unknown, but there are some factors that cause endometriosis. They are:
- Retrograde Menstruation: This occurs when menstrual blood flows back into the pelvic cavity through the fallopian tubes instead of out of the body.
- Surgical Scar Complication: Endometrial cells can attach to scar tissue from an incision (cut) made in the abdominal area during surgery such as a C-section.
- Embryonic Cell Change: Hormones such as estrogen can cause foetal cells (cells in the early stages of development) switch to endometrial-like cell growth during puberty.
- Transformed Peritoneal Cells Hormones or immune factors can help change cells lining the abdomen, called peritoneal cells, into cells that resemble the cells inside the uterus.
Diagnosis
There are several tests to check for endometriosis. They are:
- Pelvic Exam
- Ultrasound
- MRI (Magnetic Resonance Imaging)
Risk Factors
There are several factors that raise the risk of endometriosis includes:
1. Menstrual History
- Starting periods at an early stage
- Short menstrual cycle
- Heavy menstrual periods that lasts for more than 7 days
- Menopause
2. Family History
Family members having endometriosis increase the risk of this.
3. Age
It most commonly affects women in their 30s and 40s.
Complications
- The main complication of endometriosis is infertility.
- May have risk of getting ovarian cancer.
- Endometriosis associated adenocarcinoma.
Diet And Lifestyle Changes
- Warm bath and heating pad helps to relax pelvic muscles and also helps in pain.
- Yoga and meditation.
- Regular exercise keeps you physically and mentally fit.
- Pelvic massage.
Ayurveda View
Although there is no direct correlation of endometriosis in Ayurveda, it can be correlated with causative factors and pathogenesis. In Charak Samhita Yoni Vyapad explains mostly all the female reproductive problems. According to Ayurveda this condition occurs due to the disturbance and alteration in Vata dosha, mainly apana vayu vicar. Apana vata is a sub type of vata dosha that is responsible for the downward expulsion of faeces, urine, flatulence, menstrual blood and childbirth. Apana vata blockage or obstruction causes retrograde menstruation (menstrual blood flows back into the pelvic cavity through the fallopian tubes instead of out of the body) and accumulation or movement of endometrial tissue to settle in extra uterine surfaces such as the fallopian tube and pelvic cavity. Often severe pain and scanty menstruation are due to aggravated Vata, excessive bleeding and burning sensation are due to Pitta dosha and heaviness, lethargy and thin mucus with clots are due to bleeding related aggravated Kapha dosha.
Treatment
- The first treatment of endometriosis is to balance the vata dosha a subdivision of Vata called Apanavata is responsible for the downward flow of blood (menstruation). A disturbed Apanavata can alter the flow of blood (pitta) and cause Kapha dosha to aggress in places other than the regular ones.
- Panchakarma Therapy: It is a therapy used for detoxification and Purification of the body. Some Panchakarma procedures are helpful in Endometriosis. They are:
- Abhyanga: This is a process in which warm medicated oils massage the whole body, especially in the pelvic area.
- Uttar Basti: It is a technique specifically medicated enema to remove endometrial growths and adhesions.
Journey Of Lena Dunham With Endometriosis
Lena Dunham was diagnosed with endometriosis in 2014 after realizing years of painful periods. She had retrograde bleeding-her periods running reverse so that her stomach was full of blood. She even tried many treatments like pelvic floor therapy, massage therapy, pain therapy, etc. She had been hospitalized at least three times in less than a year. She went through 8 surgeries related to ovarian cyst and lesions, after surgery complications she also suffered from nerve damage, and was diagnosed with fibromyalgia. In Nov 2017 she had Hysterectomy at the age of 31.
Herbal Formulations for Endometriosis by Planet Ayurveda
Planet Ayurveda is a GMP certified company that offers a comprehensive array of herbal supplements and wellness products formulated using traditional Ayurvedic recipes and potent herbs. Planet Ayurveda has an amazing combination of herbal remedies that act on Endometriosis and that is the Endometriosis-Care pack. It contains 5 herbal formulations. These herbal remedies are prepared from using the best quality and strictly follow the principles of Ayurveda. They are:
- Female Health Support
- Aloe Vitals
- Padrantak Churna
- Shatavari Capsules
- Boswellia Curcumin
Endometriosis Care Pack
Products Description
1. Female Health Support
Female Health Support capsules are an herbal formulation consisting of Ashoka (Saraca indica), Lodhra (Symplocos racemosa) and Shatavari (Asparagus racemosus). It acts as an anti- inflammatory. It helps to reduce the pain during menstruation and also helps to reduce the excessive bleeding during menstruation. It balances the Vata and Pitta dosha and is also useful in female infertility.
Dosage: 2 capsules twice a day after meal with warm water.
2. Aloe Vitals
Aloe vital capsules are the standardized extract of Aloe Vera (Aleo barbadensis). It acts as an anti- oxidant which helps to remove the toxins from the body. It also helps to balance the Vata, Pitta and Kapha dosha and is also effective in the inhibition of formation and regression of endometriotic lesions.
Dosage: 1 capsule twice a day after meal with warm water.
3. Padrantak Churna
Padrantak churna is herbal formulation consist of various herbs like lodhra (Symplocus racemosa), Ashok (Saraca indica), udumbar (Ficus glomerata) and Arjuna (Terminalia arjuna). It pacifies vata dosha and also helps to balance the Kapha and Pitta dosha. It helps to reduce inflammation and re-forms the endometrium.
Dosage: 1 teaspoon twice a day with warm water.
4. Shatavari Capsules
Shatavari capsules contain standardized extract of shatavari (Asparagus racemosus). It helps to balance the hormones and reduce risk of endometriosis. It increases the fertility and vitality of females.
Dosage: 2 capsules twice a day after meal with warm water.
5. Boswellia Curcumin
Boswellia curcumin capsules consist of Shallaki (Boswillia serrata) and Hairdra (Curcumin longa). It acts as an anti- inflammatory helps to reduce inflammation and also reduces the pain.
Dosage: 2 capsules twice daily after meals with warm water.
Conclusion
Long-term conditions such as endometriosis, with symptoms such as Dyspareunia (painful intercourse), dysmenorrheal (painful menstruation), dysuria (painful urination), and chronic pelvic pain vary depending on the organ affected, but not the disease itself. A high index of concern is essential for early identification and management of bladder, ovarian and bowel endometriosis, improving quality of life and reducing infertility. Ayurvedic Panchakarma treatment was found useful in management of physical signs and symptoms of endometriosis like heavy bleeding, pelvic pain, etc. Treatment with a thorough consideration of the basic principles of Ayurveda and can definitely be helpful for the patients to fight against endometriosis.
