It takes a decade to diagnose this disease in women, a keyhole surgery is the only way to find out

A minor surgical procedure laparoscopy is the only way to check for endometrial growth, making it a notoriously difficult disease to diagnose.

A chronic disease affecting nearly 42 million women and girls in the country is often a mystery for the physicians and patients alike.

Experts suggest it could take about 7 to 10 years to diagnose endometriosis in a woman, a disease prone to missed or delayed diagnosis.

For the longest, a minor surgical procedure laparoscopy is the only way to check for any endometrial growth, making it a notoriously difficult disease to diagnose without a knife.

Though the exact causes of the disease are not known, most healthcare providers rely on the management of the symptoms.

Recent studies have shown it might not be limited to the reproductive system and can affect multiple organ systems in the body.

What is endometriosis?

Endometrium is the lining of the womb or uterus. Sometimes, the cells similar those found in the uterus’ lining start to grow in places outside it, usually fallopian tubes, ovaries and the pelvis.

In some cases, they can also grow near the bladder, rectum and even chest. 

Unlike the lining of the uterus, this growth is not shed and causes constant discomfort. The person affected by endometriosis experiences severe period pain, heavy periods, pain in bowel or bladder, bloating, inflamed abdomen, extreme fatigue, pain after sex and other symptoms.

With diverse and vague symptoms, the disease is easy to be dismissed as something not serious.

Why does it take so long to diagnose?

It has always been awkward for women to talk about menses, leave alone problems with it, experts have said.

Pain in bladder or in bowel movements can also make it difficult for women to open up with their treating physician.

Most experts agree that the intensity of menstrual cramps is subjective in the country, ranging from mild discomfort to debilitating pain as experienced by women in endometriosis. Since the pain is hard to quantify, it gets ignored or suppressed using painkiller medications.

However, the pain gets worsened for women having endometriosis as the disease progresses. It is usually after coping with the discomfort for years, a patient might knock a clinic door for answers.

The scattered endometrial tissue in the body responds to the hormones in a similar way the tissue inside the uterus would. Hence, the menstrual phase worsens the systems, making patients highly sensitive to pain.

Making it more twisted, there is no non-invasive imaging test or blood test to diagnose endometriosis, with most doctors putting a small incision in the abdomen to look for signs of endometrium growth.

For an ultrasound, the scan has to be transvaginal, making it difficult for doctors to diagnose without a small surgery.

What are the probable causes?

There are no definite answers for endometriosis, with only a few theories trying to make sense of the condition.

As per experts, it is a possibility that endometrium tissue could be transported to other parts of the body through the lymphatic system much like the spread of cancer cells. This could also happen during surgeries like C-sections or periods if the tissue takes a reverse direction into the fallopian tubes as opposed to the natural flow of blood. Others suggest the reasons could be purely genetic.

As per a media report, immune cells are unable to clear lesions in women having endometriosis, associating the disease with altered immunity.

What is the treatment?

There are no definite answers for endometriosis, with most treatments are around hormonal therapy and pain management.

Hormonal drugs like oral contraceptives (containing estrogen and progesterone) are given to control hormones. In some cases, progestins (progesterone) and other similar functioning hormones are given to stop the menstrual cycle and prevent growth of the endometrium tissue. 

When symptoms are not manageable with medication, a person has to undertake a surgery for the surgeon to incise the growth from unwanted places. 

However, symptoms do re-occur in women, making endometriosis a chronic ailment, with some women getting their uterus or ovaries removed for relief. 

As per new studies, a new blood and saliva test is emerging to replace invasive laparoscopy for diagnosis of endometriosis.