Seven years. That is the average time between a woman’s first symptoms of endometriosis and her diagnosis in India. Seven years during which she may have been told her period pain is normal, that all women feel this way, that she is being dramatic, that there is nothing abnormal on an ultrasound so there is nothing wrong. Seven years of pain, often progressively worsening, while the disease continues to advance.<\/p>\n\n\n\n
Endometriosis affects approximately 10 percent of women of reproductive age. It is one of the top three causes of female infertility. It is a major cause of chronic pelvic pain and severe dysmenorrhoea. It is associated with reduced quality of life, impaired work productivity, and significant psychological burden. And it is almost entirely invisible on standard diagnostic imaging \u2014 ultrasound does not show the peritoneal lesions that constitute the majority of endometriotic disease, and even MRI can miss subtle disease. The only definitive way to diagnose endometriosis is by direct visual inspection of the pelvis at laparoscopy.<\/p>\n\n\n\n
The diagnostic challenge means that endometriosis is frequently underdiagnosed \u2014 dismissed as ‘bad periods’ or attributed to psychological causes. Many women cycle through GPs, gynaecologists, and gastroenterologists for years before someone considers the diagnosis. This delay is not acceptable. The symptoms of endometriosis \u2014 severe dysmenorrhoea that is progressive (getting worse over time), deep pain during intercourse, chronic pelvic pain outside of menstruation, and difficulty conceiving \u2014 should trigger a specialist evaluation.<\/p>\n\n\n\n
Treatment of endometriosis comes in two forms: hormonal suppression and surgical excision. Hormonal suppression \u2014 the contraceptive pill, progestogens, GnRH analogues \u2014 suppresses the disease while the medication is taken, providing symptom relief. But it does not eliminate the disease. When the medication is stopped \u2014 for example, when a woman wants to conceive \u2014 the disease returns. And prolonged hormonal suppression, while symptoms are controlled, does not prevent disease progression.<\/p>\n\n\n\n
Laparoscopic surgical excision \u2014 the removal of all visible endometriotic tissue \u2014 is the definitive treatment. Proper excision, as distinct from superficial ablation (burning the surface of lesions), removes the disease at its root. After thorough excision by a skilled surgeon, symptom recurrence rates are substantially lower than after ablation, and fertility outcomes are significantly improved. The key word is ‘skilled.’ Laparoscopic excision of endometriosis \u2014 particularly deep infiltrating disease involving the bowel, bladder, or ureter \u2014 is among the most technically demanding procedures in gynaecological surgery. It should only be performed by a surgeon with specific advanced training. Dr. Krishnakumar’s ECRES certification \u2014 the only one in India \u2014 is the highest available validation of exactly this expertise.<\/p>\n","protected":false},"excerpt":{"rendered":"
Seven years. That is the average time between a woman’s first symptoms of endometriosis and her diagnosis in India. Seven years during which she may…<\/p>\n","protected":false},"author":1,"featured_media":619,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11],"tags":[],"class_list":["post-628","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-endometriosis"],"_links":{"self":[{"href":"https:\/\/101connect.in\/krishnakumar\/wp-json\/wp\/v2\/posts\/628","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/101connect.in\/krishnakumar\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/101connect.in\/krishnakumar\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/101connect.in\/krishnakumar\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/101connect.in\/krishnakumar\/wp-json\/wp\/v2\/comments?post=628"}],"version-history":[{"count":2,"href":"https:\/\/101connect.in\/krishnakumar\/wp-json\/wp\/v2\/posts\/628\/revisions"}],"predecessor-version":[{"id":1109,"href":"https:\/\/101connect.in\/krishnakumar\/wp-json\/wp\/v2\/posts\/628\/revisions\/1109"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/101connect.in\/krishnakumar\/wp-json\/wp\/v2\/media\/619"}],"wp:attachment":[{"href":"https:\/\/101connect.in\/krishnakumar\/wp-json\/wp\/v2\/media?parent=628"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/101connect.in\/krishnakumar\/wp-json\/wp\/v2\/categories?post=628"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/101connect.in\/krishnakumar\/wp-json\/wp\/v2\/tags?post=628"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}