Endometriosis affects about 1 in 10 women of childbearing age. It can be very physically and mentally debilitating but it’s possible to live a full life with the condition. Here’s everything you need to know about it.
Endometriosis is the growth of uterine-like tissue in places other than in the uterus. This condition occurs when tissue similar to uterine tissue grows anywhere in a woman’s pelvic region where it’s not normally found, including on the outside of the uterus or on the ovaries, fallopian tubes, bladder, or bowels. More rarely, growth occurs on other organs like the diaphragm, lungs, and even the brain. This tissue acts as it normally would, so it thickens and sheds but the blood becomes trapped. Scar tissue and adhesions, or bands of fibrous scar tissue, can then develop in many instances.
There are four different categories of endometriosis. The four classes are minimal, mild, moderate, and severe. Grouping depends on how far the disease has spread, how severe the adhesions are, and the extent of blockage of the fallopian tubes. However, the stage doesn’t depend on the amount of pain a woman is in. Someone with a minimal case might be in excruciating pain while someone else with a severe case may be in no pain at all.
There’s no definitive cause. Genetic factors predispose women to endo, so it may run in families. There are many other theories too, some of which are pretty interesting. It could be a result of the backward flow of blood through the fallopian tubes into the pelvic cavity. Or, it’s an inflammatory response to endometrial cells that are present where they don’t belong. This could happen by other cell types transforming into endometrial cells somehow, which would explain their appearance in other organs. Alternately, endometrial cells could have been planted in other places when a woman undergoes surgery like a C-section. Other gynecological and environmental factors are also possible sources.
There’s a range of awful symptoms. Extreme pelvic pain that gets worse during menstruation is common, but not all women with endo have pain. Other symptoms include heavy bleeding during periods, pain during sex, pain when urinating or having bowel movements, and sometimes infertility (more about that below). Cysts called endometriomas may form on the ovaries. Additionally, women can experience fatigue, constipation, diarrhea, bloating, and nausea.
Endometriosis sometimes leads to infertility. Women may need surgical removal of adhesions and assisted reproductive technology like IVF to help their chances of conceiving. However, there are many women with endometriosis that have no trouble getting pregnant, so it doesn’t guarantee infertility. For example, my cousin has it but was easily able to get pregnant. Also, it’s a common misconception that endo causes miscarriage, but there’s no evidence that supports this claim.
Many risk factors predispose women to endometriosis. Research has found that a woman is more likely to get this condition if she has her first period at an early age or if she has a short cycle length. If a woman has never given birth, has uterus abnormalities, obstructed menstrual flow, really heavy flow, or if she goes through menopause late in life, she’s at a higher risk. Women are more likely to get this disease if other women in their family have been affected. There’s also a higher chance of getting it if a woman has a low body mass index (BMI) or drinks alcohol.
Endometriosis increases a woman’s chance of developing ovarian cancer. Ovarian cancer does seem to occur more often in women with endometriosis than in those that don’t have it, but thankfully the risk is still pretty low.
It can be hard to diagnose. Endometriosis is difficult to confirm by imaging techniques like MRI, CT scan, or ultrasound. Unfortunately, no laboratory tests on blood or urine can verify it. The only way to identify the disease is to do a laparoscopy (surgery to examine organs) and biopsy of tissue. It can take a long time to diagnose because it may be confused with normal period symptoms or digestive problems. Women often suffer for years before getting a diagnosis.
Endometriosis is treated with medications or surgery. There’s a myth that pregnancy cures endo, but it only alleviates symptoms because of a change in hormones. Some drugs are used for symptom management. For example, over the counter pain medications can provide relief. Birth control and other hormonal drugs can regulate hormone levels and ease discomfort but can produce side effects. Surgery to remove adhesions and scar tissue can help, but there’s no guarantee. A hysterectomy and removal of the ovaries can decrease pain, but this is a drastic solution and definitely a last resort.
Other methods may lessen symptoms too. Besides drugs and surgery, management approaches include warm baths or sitz baths, and heating pads to reduce discomfort. Getting plenty of sleep, maintaining good nutrition, and reducing stress can alleviate pain. Staying hydrated can reduce bloating and cramping. Regular exercise can also manage symptoms. Other things to try are acupuncture, drinking herbal teas, and using essential oil aromatherapy. There are ways to treat the symptoms, but nothing is guaranteed to help. This disease is certainly no joke, and lots of women feel misunderstood because people can’t understand what they’re going through. Hopefully, more awareness can support those affected.
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