Early Menstrual Characteristics in A Group of Sri Lankan Women with Endometriosis in The Western Province of Sri Lanka.

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Early Menstrual Characteristics in A Group of Sri Lankan Women with Endometriosis in The Western Province of Sri Lanka.

Professor Ramya P. Pathiraja, Madura A. Jayawardena, Professor Dhammike De Silva, Ajith Fernando, Madhuka Rajakaruna, Madushan Weerasinghe
Department of Gynecology and Obstetrics, Colombo South Teaching Hospital, Sri Lanka

I. INTRODUCTION

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Endometriosis is defined as the presence of active endometrial mucosa; which can be either glands or stroma, abnormally implanted in locations other than the uterine cavity. 1
Endometriosis is a common, poorly understood and extremely debilitating benign gynaecological condition which affect both physically and psychologically. Despite extensive research, the aetiology of endometriosis remains elusive. Several theories exist that attempt to explain this disease, but none have been entirely proven. But these ectopic foci respond to cyclical hormonal fluctuations in much the same way as intrauterine endometrium, with proliferation, secretory activity, and cyclical sloughing of menstrual material leading to an altered inflammatory response characterized by neovascularization and fibrosis.
Endometriosis is classified under 4 stages depending on location, extent, and depth the implants, presence of adhesions and presence of ovarian endometriosis. However the severity or stage doesn’t correlate with the symptoms of endometriosis.2
This condition has poorly understood pathophysiology, highly variable clinical presentation and unpredictable disease course. The associated pain, adhesion formation, and anatomic distortion are responsible for the clinical consequences of this disease. Endometriosis should be suspected when a patient presents with pain syndrome with or without infertility. Presence of fix retroverted uterus, thickening or nodularity in uterosacral ligaments, retro cervical region and recto vaginal septum with or without adnexal mass will further support diagnosis. However, to confirm the diagnosis laparoscopy will be mandatory.1
No cure exists except surgical or physiological menopause. But treatments are directed toward hormonal suppression, surgical excision, and symptom alleviation. However symptoms tend to recur regardless of treatment options.
This study was conducted to early identify the demographic, sexual, gynaecological and obstetric characteristics associated with endometriosis in a group of Sri Lankan women.

II. MATERIAL AND METHODS

This is a prospective cross sectional study conducted between June 2017 to August 2019 period at the Gynaecology wards of Colombo South Teaching Hospital Sri Lanka. Patients in Western province between ages of 19 to 45, who were diagnosed with endometriosis by laparoscopically were