Endometriosis and Fibroids: Know the difference
Endometriosis and Uterine Fibroids are the two most common gynaecological disorders that affect uterine function and women’s quality of life. Recent studies reveal an association shared between them of which, oestrogen-related pathophysiology plays a significant part. Owing to this, some of the symptoms for each of these conditions are similar or even the same. Underlying commonalities of endometriosis and uterine fibroids has allowed to causally address both conditions that increases and preserves women’s health. However, they are very different conditions that need specific interventions that focus on endometriosis treatment or fibroids removal in Chennai. Understanding the differences between endometriosis and uterine fibroids along with right medical guidance can lead on to the proper path for treatment.
Difference in incidence and definition of endometriosis and fibroids
Endometriosis is known to affect up to 10% of women of reproductive age though the real incidence is likely substantially higher. Due to the difficulty of diagnosing, lack of awareness and the absence of clinical findings, only few cases are clinically recorded. Endometrial tissue that are normally found along the inner lining of the uterine wall, grow abnormally outside of the uterus where the body is not able to expel it as it does during a normal menstrual cycle. The endometrial tissues can develop and attach itself to other reproductive organs such as fallopian tubes or ovaries and also pelvic organs like bladder, large intestine and sometimes, even the lungs. Scar tissues form along the overgrowth of tissues in the organs, causing various levels of pain and menstrual problems.
Fibroids show an incidence of around 70% in women aged 35 to 49 years old. These are noncancerous smooth muscle tumours that grow in the uterus from the muscle layers of the womb. These benign tumours generally grow slowly over a period of time and can vary in size and shape. There are a few different types of fibroids, classified by their location, and how they grow in clusters of multiple fibroids. While some women have these fibroids with no symptoms, other women with uterine fibroids suffer from abnormal bleeding, extreme pain and discomfort. Fibroids are cited to be the cause for over 50% of total hysterectomies.
Difference in symptoms of endometriosis and fibroids
Endometriosis and uterine fibroids are issues that affect the uterus, but they take different forms. Endometriosis and fibroids have a role in menstrual irregularity and pelvic pain. There are many overlapping symptoms that arise from endometriosis and uterine fibroids being uterine disorders. In either of the conditions, some women may not experience any symptoms whereas others may deal with uncomfortable or debilitating symptoms that can disrupt their daily lives. Both conditions can manifest in severe pelvic pain, painful bleeding during periods, impaired fertility or infertility, fatigue, painful intercourse (dyspareunia), as well as bladder and bowel dysfunction.
In addition to the above symptoms, uterine fibroids provoke heavy menstrual bleeding (HMB) prominently in over 30% of patients and also lead to feelings of pelvic pressure and bulging abdominal protuberances. Fibroids can be diagnosed by locating them through an ultrasound image of the uterus. Unique symptoms that can be biomarkers in clinical diagnosis of the condition are:
- Heavy or extended menstrual periods
- Abnormal bleeding between periods
- Frequent urination
- Pelvic pain or heaviness
- Pain during sexual intercourse
- Constipation and bloating
Endometriosis leads to an enhanced somatosensory perception accompanied by changes in central nervous pain processing, further increasing patient’s sensitivity to pain symptoms of the condition. Endometriosis generally requires laparoscopy to confirm the diagnosis and tissue biopsy to know if endometrial cancer treatment in Chennai would be required. Specific symptoms of endometriosis can be listed as:
- Pain before and during periods
- Painful urination and/or bowel movements during periods
- Painful sexual intercourse
Several other conditions such as diseases of the bowel and bladder or musculoskeletal conditions need to be considered in differential diagnostics. This makes differential diagnosis challenging, and together with poor awareness of endometriosis, both within the public and general practitioners leads to long delays with regards to the diagnosis and treatment of endometriosis.
Areas of difference between endometriosis and uterine fibroids can be briefed as:
- Onset – The onset of endometriosis is in adolescence or early adulthood whereas, uterine fibroids are typically reported in women of at least 40 years of age.
- Location – Endometriosis can grow and attach themselves to different organs but uterine fibroids are restricted to grow within the uterus.
- Timing of pain – Both of the conditions can cause pain during the menstrual periods, but endometriosis pain can start before the periods begin and pain when urinating during menstrual bleeding.
- Constipation – Only uterine fibroids can cause constipation if the tumour is large.
- Prolonged menstrual periods – Periods can last longer in case of uterine fibroids.
Difference in treatment for endometriosis and fibroids
Uterine Fibroids (leiomyomata) and endometriosis affect millions of women world-wide. Considerable comorbidity exists between the two conditions and needs to be taken into account when treating fibroids and/or endometriosis. Women in general may believe that they only have surgical treatment option to remove the uterus by hysterectomy as treatment for endometriosis or fibroids. For each condition, depending on the diagnosis, there are different treatment options available. Laparoscopic surgery to remove the overgrown endometrial tissues may be the right choice for endometriosis especially if the goal is to enhance fertility or reduce pain. Medications to alleviate pain or a course of hormone therapy may be tried to slow the growth of the endometrial tissue.
Myomectomy or fibroids removal in Chennai through minimally invasive non-surgical techniques to specifically target the fibroids, detach them and remove them from the uterus is possible. Along with this, there is another option to retain the uterus and still treat the fibroid. Uterine fibroid embolization is a technique that blocks the blood supply to the fibroid so that the tumour eventually dies, following which, symptoms reduce or resolve completely. Since there is substantial comorbidity between uterine fibroids and endometriosis, it is beneficial to include the option of concomitant treatment.