Endometriosis is a painful female condition where the womb’s lining grows outside of the uterus. This endometrial tissue can grow on ovaries, fallopian tubes, the bowel, and the uterus’ outer walls. In some rare cases, the tissue has even been reported as growing on the bladder, heart, and lungs. Endometriosis is thought to affect around 5 million women in the U.S., typically between the ages of 15-44, with most cases seen over the age of 30.
Just like within the uterus, the endometrial tissue responds to hormones related to a woman’s menstrual cycle. This causes the tissue to contract, swell and bleed, but because the tissue is not growing within the uterus itself, it cannot be expelled. This leads to scarring on organs, cysts forming, and fallopian tubes becoming blocked.
Symptoms of Endometriosis
Pain
The main symptom of endometriosis is a variety of pains.
- Some women will notice that their periods are heavier than usual, and menstrual cramping is a lot more painful. Sometimes women find it hard to find sanitary towels that are able to manage the heavy flow without having to be changed very often. A recent study has discovered that many women affected by endometriosis have ditched sanitary towels for period pants as they seem to manage the heavy flow better.
- Others may notice chronic, persistent pelvic and lower back pain. Sciatica-like pain is often reported too from scar tissue pressing on nerves. The use of local analgesic products such as topic cream seems to help women and hot water bottles positioned on the lower back are effective too.
- Sex may suddenly become painful.
- Another form of pain commonly experienced by women with endometriosis is intestinal pain. This sort of pain is usually experienced during bowel movements and urination. This kind of pain needs to be addressed by a doctor as it could have several ramifications and only a professional can prescribe the best treatment.
Bleeding and Spotting
Another symptom of endometriosis is bleeding between menstrual periods. This doesn’t necessarily mean heavy bleeding, but light spotting can also be an indicator. Women may also notice blood in their stool or urine.
Infertility
An early sign of endometriosis for some women is difficulty getting pregnant. Infertility has a multitude of reasons, but an inability to become pregnant can sometimes be due to the scarring of fallopian tubes by endometrial tissue and the related development of cysts.
Digestive Issues
This symptom includes diarrhea, constipation, bloating, and general nausea, worsening around menstruation. Though these symptoms are not exclusive to endometriosis, in combination with other symptoms, it can help in determining a diagnosis.
What Causes Endometriosis
The exact cause of endometriosis is not known, but experts believe it may be largely genetic. Despite not knowing exactly why endometriosis happens, experts have identified several risk factors that correlate with the condition and may contribute to its development in women.
The most significant of these are:
- Genetic predisposition; evidenced by other family members having the condition.
- Premature menstruation, i.e., having menstrual periods before the age of 11-12.
- Not having any children is considered a risk factor, though the exact reason is not clear.
- Prolonged menstrual periods that last longer than seven days.
- Shorter menstrual cycles that are 27 days or fewer are also thought to be a contributory factor.
- Excess estrogen is also thought to overstimulate the growth of endometrial tissue.
- Low in-utero testosterone levels are also thought to be related to the condition.
How Do I Know if I Have Endometriosis?
Left untreated, endometriosis doesn’t resolve itself and can lead to a lifetime of chronic pain and possible infertility. Getting medically diagnosed, therefore, is vital to getting the correct treatment. This can sometimes be a lengthy process as there is no specific test that can determine the presence of the condition. Nevertheless, the diagnosis will begin with your doctor talking to you about your symptoms.
After a discussion of your symptoms, doctors will use one or more of the following diagnostic strategies:
- Pelvic examination: this will involve a doctor or nurse feeling for large cystic build-ups and scarring behind the uterus via the abdomen and vagina.
- Ultrasound: using the same technology sometimes used to exam babies in the womb, an ultrasound can check for cysts on the ovaries caused by endometriosis. This will either be an abdominal or vaginal ultrasound scan.
- MRI scan: through magnetic resonance imaging (MRI), doctors can build a picture of tissue inside the body, including the possible detection of endometrial tissue.
- Laparoscopic surgery: performed under general anesthesia, laparoscopic surgery is a low-risk procedure where a surgeon will insert a small tube into the body containing a camera and micro-surgical tools. This allows a sample of suspected tissue to be collected for testing or removed if required.
Endometriosis Treatment
Completely curing endometriosis is not always feasible, though the treatment of painful symptoms is possible.
The first step in treating endometriosis is often to prescribe women over-the-counter medicines such as ibuprofen and naproxen to relieve pain symptoms.
Hormone treatment is also used for less severe cases of endometriosis with the administering of hormonal birth control, which can be taken via pills, injections, or even nasal sprays. Some women may also have gonadotrophin-releasing hormone treatment recommended, which lowers estrogen levels, temporarily preventing further menstruation. However, this form of treatment is usually reserved for women who are not experiencing severe forms of pain.
In cases where the pain is more severe, an early treatment is non-steroidal anti-inflammatory drugs (NSAIDs) used to relieve symptoms by reducing inflammation.
As well as a method of diagnosing endometriosis, laparoscopic surgery is also used to remove excess tissue that can be causing issues with fertility and pain. By removing cysts and scar tissue, some women can then conceive, with pain relieved significantly. The procedure usually requires a stay of one night in the hospital and a week of light activity.
Long-term Prognosis
While not life-threatening in itself, endometriosis can affect a woman’s life significantly. It can make getting pregnant difficult (though not impossible) by damaging eggs and interfering with their movement. Chronic pain can also cause depression and sleep issues, affecting women’s mental health.
Early diagnosis is therefore vital to relieving pain, keeping pregnancy an option, maintaining mental health.
As well as the medical treatments above, studies have also shown a focus on diet can help alleviate the symptoms of endometriosis. This includes avoiding junk food, dairy, and gluten while eating a whole-food diet full of fresh ingredients and, in particular, bladderwrack algae, a traditional medicine.
Endometriosis is a painful condition that affects millions of women. It can affect fertility and mental health significantly, meaning those who believe they may have the condition should seek medical advice as soon as possible.
