Endometriosis is more common than you think. It affects 1 in every 10 women and leads to pain and infertility. As per the World Health Organisation (WHO) it is a disease in which tissue similar to the lining of the uterus grows outside the uterus. It causes severe pain in the pelvis and can start at a person's first menstrual period and last until menopause.

This happens when the tissue that lines the uterus or the womb grows outside of it and in other parts of the abdomen and pelvis, such as the bowel and bladder.

The common signs and symptoms of endometriosis include:

• Pain on or around your period or ovulation
• Pain during or after sex
• Pain during bowel movements or urinating
• Pain in the pelvic region or lower back
• Heavy bleeding or irregular bleeding

If you have these symptoms, your doctor would ask you to get an MRI, a pelvic exam and a minor surgical procedure called a laparoscopy done, to confirm endometriosis. The extremely painful conditions one faces with endometriosis lead to seeking the last resort of hysterectomy or uterus removal. However, it is not always helpful.

Dr Archana Kankal, Director, Obstetric and Gynaecology, Sahyadri Hospitals MomStory, Pune, says, "Although it can relieve symptoms, it doesn’t always completely solve the problem because endometriosis can occur outside of the uterus and remain even after the uterus is removed. Therefore, when deciding to go forward with this surgery, it's important that all the endometriosis is removed to improve the chances of relieving symptoms."

Factors That Can Lead to Hysterectomy

Several factors influence the decision to opt for a hysterectomy in cases of endometriosis, explains Dr Kankal. The severity and location of the disease play a crucial role; if endometriosis has spread to other organs like the ovaries or fallopian tubes, more extensive surgical measures may be required. Age and fertility aspirations also significantly influence this decision. "Younger patients who wish to have children may opt for more conservative treatments, while those who have completed their families or are not concerned about fertility might consider this surgery as a viable option," explains Dr Kankal.

Additionally, how well other treatments such as hormonal therapies or pain management strategies have worked can also determine whether or not to proceed with a hysterectomy. There are alternatives to avoid hysterectomy, including medical management. This is where hormonal treatments like birth control pills, patches or vaginal rings can help with the growth of endometriosis tissue and reduce symptoms. Through conservative surgery like laparoscopy, doctors can remove endometriosis tissue through small cuts in the abdomen, without removing the uterus. Some people, suggests Dr Kankal, also find changes in diet or exercise can help manage symptoms.

Things You Should Know About Endometriosis

It is possible for endometriosis to persist or to come back after a hysterectomy. "This happens if not all the endometriosis was removed during surgery or if the ovaries are left in place. These ovaries can continue to produce hormones that might cause the remaining endometriosis tissue to act up. This, a comprehensive surgical approach, sometimes including the removal of the ovaries, might be necessary to reduce the likelihood of the disease returning," says Dr Kankal.

While a hysterectomy can significantly alleviate the symptoms of endometriosis, it can come with potential long-term effects. The removal of ovaries with the uterus can lead to immediate menopause, regardless of the patient's age. "This can lead to typical menopausal symptoms like hot flashes, night sweats, and mood changes. There's also an increased risk of developing cardiovascular diseases and osteoporosis due to the decrease in hormone levels. Additionally, some women experience significant emotional or psychological impacts after the surgery, which may require support and counselling," explains Dr Kankal.

Preserving Fertility With Endometriosis

Dr Maunica Sorakayalapeta, IVF Specialist, Ferty9 Fertility Center, LB Nagar talks about the treatment for patients who want to preserve fertility. "GnRH agonists are another treatment option, inducing a temporary menopause-like state to alleviate symptoms. However, these drugs must be used with caution due to potential side effects, such as bone density loss," she says. In addition, aromatase inhibitors may be used to lower oestrogen levels and are often combined with other treatments to enhance their effectiveness.

The focus remains on effective pain management, as it is critical and usually involves non-steroidal anti-inflammatory drugs (NSAIDs) to directly address discomfort. Some patients also find relief through alternative methods such as acupuncture, physical therapy, and dietary changes, which can offer a more natural approach to symptom management.

Sorakayalapeta also points out that regular monitoring of the patient’s response to treatment is important to allow for timely adjustments and ensure that patients receive ongoing support as they navigate their fertility journey. "For those considering fertility treatments, these follow-ups are crucial in preparing them physically and emotionally for the next steps," she says.

There are fertility options for those who wish to conceive, including ovulation induction using hormonal medications to stimulate ovulation and increase the chances of conception. "Intrauterine insemination (IUI) may be an option for patients with mild endometriosis and no additional fertility issues. In cases of more advanced endometriosis or unsuccessful treatments, in vitro fertilization (IVF) can offer an effective solution, allowing for egg retrieval while bypassing any blockages caused by endometriosis," she explains.

A dental implant is not just a cosmetic fix; it is a decision that reshapes your smile, speech, eating habits, and even the structure of your jaw. While dental implants are reliable and widely recommended, they are not a one-size-fits-all solution. A dental implant is not just “a new tooth”. It plays a vital role in supporting your bite, preserving facial structure, improving your diet, and boosting confidence.

And patients who ask the right questions tend to see better long-term outcomes—both in function and appearance. When you ask the right questions, you are more likely to get a personalised treatment plan that fits your needs, anatomy, and lifestyle. And that is when the results truly last.

Here are six crucial questions every patient must ask their dentist before getting an implant:

1. Am I the right candidate for an implant?

“Dental implants rely on healthy, stable jawbones for long-term success,” says Dr. Sanjeet Shanker, Founder and CEO at Epikdoc. He warns that if a tooth has been missing for a while, the bone beneath it may have started to resorb, even if there are no visible signs.

This makes a detailed X-ray or 3D CBCT scan non-negotiable. “We need to assess bone height, width, and density before planning an implant,” he explains. In cases where bone is lacking, your dentist may suggest bone grafting, a preliminary step that adds time and cost but provides a solid foundation for success.

2. What type of implant and crown will you use in my case?

Implants differ in length, width, design, and material depending on the patient’s needs. “Titanium implants are the gold standard and work well in most cases,” he says. However, zirconia implants are also an option for those with metal sensitivities or specific aesthetic preferences.

When it comes to the visible crown, options include porcelain-fused-to-metal for durability in back teeth and all-ceramic or zirconia crowns for a more natural look in the front. Dr. Shanker recommends asking your dentist why a particular system is being suggested and how it suits your bite forces, gum contours, and smile line.

3. What will the treatment involve over the next few months?

Implant treatment is rarely a one-day procedure. Here is how a typical journey looks:

Tooth extraction (if needed), bone grafting (if required), implant placement, healing time (osseointegration), and then crown placement.

The expert stresses the importance of knowing whether you will get a temporary crown, a removable denture, or have to manage without a tooth during healing. A clear treatment timeline helps you prepare your schedule, diet, and expectations.

4. What kind of daily care will my implant need?

“Even though implants do not decay, the surrounding gums and bone can get infected if not cared for properly, a condition called peri-implantitis,” Dr. Shanker warns.

He advises patients to ask:

• How do I clean around the implant?
• Do I need special tools like interdental brushes or water flossers?
• How often should I return for cleanings?

An implant is like a luxury car. With regular maintenance, it will serve you for decades. But neglect it, and problems pile up fast.

5. What does the total cost include?

Dr. Shanker points out that pricing can vary dramatically. Some clinics bundle everything, while others charge separately for scans, surgeries, crowns, and follow-ups.

He recommends asking clearly:

• Is bone grafting included if required?
• Will I have temporary teeth during healing?
• What’s the policy on emergencies or crown replacement?

Getting clarity upfront helps you avoid surprises and make accurate comparisons.

6. Does the brand of implant matter?

This, according to Dr. Shanker, is one of the most frequently asked questions. “It is like tennis. Give Roger Federer an average racket, and he will still win the match,” he says.

In implants, the surgeon’s skill and case planning are far more important than brand names. The real hierarchy, he says, is:

1. The doctor’s experience and planning

2. Your own health and bone condition

3. The quality of the implant system

While established brands offer reliable results, focusing only on labels is a distraction. “Choose a clinician you trust and one who explains the ‘why’ behind their choice,” Dr. Shanker advises.

When you think of endometriosis, the image that typically comes to mind is a woman doubled over in pain, battling fatigue or struggling with infertility. But for a significant portion of women, this chronic condition creeps in silently, without a single symptom to give it away. Known as asymptomatic or silent endometriosis, this elusive form can cause severe and irreversible damage before it is ever detected.

Endometriosis is commonly linked with menstrual pain, tiredness, and fertility problems. But asymptomatic or silent endometriosis is a type of condition that is much more insidious. It does not come with the familiar warning signals, so it becomes more difficult to identify and, worse, more likely to lead to long-term damage.

No Pain, But Plenty of Harm

"Since there is no pain or any apparent symptoms, the disease tends to silently grow, spreading outside the reproductive system," explains Dr. Smeet Patel, endometriosis specialist at Mayflower Women’s Hospital, Ahmedabad.

In its advanced stages, silent endometriosis does not stop at the ovaries or uterus. It can, over time, infiltrate major organs like the colon, bladder, and even deep pelvic tissues. "In a few advanced conditions, it can migrate up to the parametrium, internal vessels, or S2–S3 segment of the spine, invading the sciatic nerve and generating extreme complications," he says.

First Clue: Infertility

"What is especially dangerous about silent endometriosis is that its very first symptom is usually infertility," warns Dr. Smeet Patel. "By the time a woman presents to us with a fertility evaluation, the disease has already begun to deplete her ovarian reserve, reduce egg quality, or occlude her fallopian tubes—all without so much as a twinge or an early warning sign."

The disease progresses with no outward signs, which makes it incredibly deceptive. It is worth mentioning that nobody actually knows why certain people are experiencing severe pain and others experience nothing at all. However, the expert says if a patient is going for IVF or there is a family history of endometriosis, they always keep in mind the possibility of having a hidden case.

Difficult to Detect

"It is difficult to diagnose," Dr. Smeet Patel admits. "Laparoscopy is still the gold standard, but high-resolution MRIs and transvaginal ultrasounds sometimes can catch indicators."

He explains that treatment is highly individualised. "The treatment is customised based on the goals of the patient—whether that is pain management, fertility, or prevention of complications down the line. For women not attempting to get pregnant, we might observe the condition closely instead of performing surgery at once. However, if fertility is an issue, early treatment—hormonal treatment, laparoscopic surgery, or assisted reproduction methods—can be a game-changer in results."

What Dr. Smeet Patel always tells his patients is this: silence does not mean peace. Just because your body is not shouting does not mean it is not sending signals. "The more aware we become of silent endometriosis, the better we can protect reproductive health and improve quality of life before irreversible damage occurs," he says.

A Hidden 25%

Dr. Sanjay Patel, endometriosis surgeon, points out the hidden nature of this condition. He explains that while most cases present with pain and discomfort, silent endometriosis does not. Patients can appear and feel perfectly healthy as the disease advances within. "About 20–25 per cent of endometriosis patients are asymptomatic. These individuals are often found accidentally during operations for other conditions or upon seeking treatment for infertility," he says.

The Danger of Delay

The actual risk is with the delay. "When we do find it, it might already have affected fertility, caused adhesions, or invaded important organs. Rarely, it can invade the bowel or bladder with dangerous consequences," Dr. Sanjay Patel warns.

He also touches on the psychological toll. "Psychologically, it is confusing to patients—being told you have a disease you never had can be difficult to accept."

And for those who think they are in the clear because they feel fine, Dr. Sanjay Patel offers a word of caution: "If there is a family history, trouble getting pregnant, or unexpected cysts on routine imaging, we must explore further. Just because it does not hurt does not mean it is not bad."

Losing a spouse is one of the most difficult things that a person can go through. It is a thing that many people go through as they age. Many people who lose their partners often find comfort in their close ones, their children as well as their friends. However, can the void left by a deceased spouse be healed by your loved ones?

A new study suggests that adult children likely won't fill the emotional void left when a parent loses their spouse. While becoming a widow or widower might make the bond with their children stronger, this deeper connection doesn't seem to make up for the loneliness of losing a life partner. These surprising findings were published on July 14 in Aging & Mental Health.

Going Against Common Ideas About Loneliness and Loss

This study's findings actually challenge a common belief. Many people think that widowed individuals who have children feel less lonely compared to those who don't. However, this research tells a different story.

The loss of a spouse causes loneliness that sticks around for a long time. Interestingly, it also makes the family ties between parents and their children stronger, especially for mothers, who often take the lead in keeping families connected. But even with these stronger family bonds, the study found that the increase in loneliness – both social (feeling disconnected from others) and emotional (missing a deep, personal connection) – doesn't go away.

How the Research Was Carried Out

The study involved talking to over 5,600 married people who had grown-up children. These individuals were part of a larger study about aging in Germany. Among them, nearly 500 had experienced the death of their spouse.

Losing a spouse is known to be one of life's most difficult and stressful events. It can lead to various health problems, including heart issues, and mental health challenges like depression or chronic loneliness.

Participants in the study answered a series of questions. These questions were designed to understand their emotional and mental well-being, as well as how connected they felt to their adult children.

Long-Lasting Impact of Loneliness

The results clearly showed that loneliness significantly increases after a spouse passes away and stays at a high level for a long time. This was true even when adult children kept in regular touch with their widowed parent.

The most difficult period for loneliness seemed to be the first three years after the loss. However, the study found that loneliness continued to be a factor for as long as seven years after their spouse's death.

These findings were quite surprising to the researchers because previous studies had shown that older parents' happiness and well-being are greatly influenced by how good their relationships with their adult children are. It appears that the sadness and impact of losing a spouse are so profound that even strong emotional and social support from one's children can't fully lessen it.

More Research Needed

It's important to note that this study didn't look at how relationships with other people might affect a person's loneliness. This includes close friends or even just people they know casually.

The researchers pointed out that interactions with people who aren't family members might have a bigger impact on feelings of social loneliness than interactions with one's own children.