Endometriosis

Endometriosis affects nearly 10% of women during their reproductive years and is a major cause for infertility. This gynecological condition occurs when the tissue lining the uterus (endometrium) grows outside the uterus. The endometrium then grows on the ovaries, fallopian tubes and outer surface of the uterus and even sometimes on the bladder, bowel, intestines, colon, vagina, cesarean and laparoscopy scars. This endometrial growth does not get regularly sloughed off with the menstrual cycle and keeps building up to form ovarian cysts. In fact endometriosis can even cause distortion of a woman's internal anatomy. While the theory of retrograde menstruation holds that some menstrual blood flows back through the fallopian tubes and grows there, it is not yet fully substantiated yet. Some women have a genetic predisposition to endoemetriosis. The role of immune system dysfunction and environmental influence on endometriosis is also being studied.

Severe pelvic pain is the characteristic symptom associated with endometriosis. This pain is felt while passing urine, during sexual intercourse and during ovulation. A woman suffering from endometriosis may notice heavy irregular bleeding and abdominal bloating. Infertility is noticed in more than 40% of women suffering from endometriosis. A pelvic examination is conducted on a woman complaining of symptoms of endometriosis. It can reveal the presence of tender nodules in the ovary regions or the posterior vaginal wall. Pelvic ultrasound is used to locate endometriosis areas. Laparoscopy can aid in checking pelvic organs for endometrial tissue. It gives a clear idea of the extent and location of endometriosis.

Hormone therapy is advocated by some as treatment against endometriosis. Birth control pills or progestins are often prescribed. This may help in tempering the estrogen production and relieving some of the signs and symptoms of endometriosis. Progesterone pills or injections can be used to treat endometriosis. The drug Danazol is also sometimes prescribed. Anti-gonodotropins produce a psedomenopausal state and can relieve some of the problems associated with endometriosis. But treatment of endometriosis with drugs is limited to about six months or so to prevent a detrimental effect on bone density. Laparoscopic surgery is yet another endometriosis treatment advocated by some doctors. The surgeon aims at removing all endometriosis lesions, cysts and adhesions. This is done is severe cases of endometriosis and infertility.

Ovarian Cancer

Ovarian cancer us not easy to detect in the early stages. Often the symptoms of ovarian cancer are easily mistaken for other conditions and unfortunately most cases of ovarian cancer are diagnosed only in the advanced stages. Ovarian cancer is normally observed in women over 40 years. Women who have had endometriosis or undergone infertility treatment such as stimulation of the ovaries are at higher risk of ovarian cancer. Women who have given birth to 2-3 children reduce their risk fo developing ovarian cancer as also those who have opted for tubal litigation. A woman who has used oral contraceptives has reduced chances of cancer of the ovaries.

A woman suffering from ovarian cancer is likely to suffer from pelvic discomfort and abdominal pressure and bloating. There is increased need to urinate and unexplained change in bowel habits. The other symptoms associated with ovarian cancer are unexplained weight gain or loss and unusual fatigue. Since most of these symptoms are vague, often ovarian cancer is not detected in the early stages. A patient may feel pain during sexual intercourse and urination.

A gynaecologist will conduct a rectovaginal pelvic examination of the patient to trace any irregularity in the shape or size of the ovary. If ovarian cysts or tumors above a specific size are noticed, they are usually removed or a biopsy is conducted for better diagnosis. Trans-vaginal sonography helps in detecting ovarian irregularities. It can help in locating the site of the tumor. Blood test CA-125 is also helpful in diagnosing ovarian tumor. Women suffering from ovarian cancer tend to have elevated levels of CA125 in their blood. 'Ovarian Pap Test' consists of a smear of the cells from the ovarian surface that is tested for any obnormalities. Surgery is almost always the first treatment ovarian cancer. Both the ovaries, fallopian tubes and uterus are removed.

CA 125 blood test

CA 125 blood test measures the level of blood antigens that are considered tumor markers. Typically the CA 125 blood test is used monitor the progress of ovarian cancer. But the CA 125 blood test is not considered a very accurate diagnostic tool. This test is used in combination with transvaginal ultrasound and pelvic examination. CA 125 blood tests often return false positive results. Besides hardly about 50% of women with ovarian cancer have elevated levels of CA 125. CA 125 levels can be elevated due to menstruation, endometriosis, fibroids and pregnancy. The newer CA 125 blood test is said to be more accurate. This test is called CA 125 - II. Readings of above 35 U/ml are considered abnormal. CA 125 blood test is used to check the effect of treatment on women suffering from ovarian cancer. It is not used to check otherwise healthy women for ovarian cancer.