Roughly 10% to 20% of US women of any walk of life (social and economic class, age, race, etc.) that are fertile suffer from endometriosis. So, this is quite a widespread illness, even if it’s not fully understood.
Endometriosis doesn’t have a definite cure, so it’s not really easy to deal with it, especially since it doesn’t follow a definite pattern either. Some women suffering from this disease could have atrocious pelvic cramps, but other women may have no symptoms at all, and still suffer from endometriosis. They could have endometriosis, and not even be aware of it, which is what makes this disease so hard to deal with.
Needless to say, endometriosis can alter a woman’s entire existence, from her working abilities, to the capability to reproduce, and to her relationships with other people around her.
What Is Endometriosis And How Does It Manifest?
The name endometriosis originates from the word “endometrium,” the tissue that lines the inner side of the uterus. If a woman is not pregnant, this tissue forms but it’s dropped monthly at the end of each menstrual cycle. This is the normal part of endometriosis, and the one that should not concern you.
The abnormal part – the one that causes pain and all that – is the tissue that forms outside of the uterus (normally, inside of the stomach cavity). This tissue looks and imitates the endometrial tissue found inside of the uterus and the reason this type of tissue causes pain is because it reacts to the menstrual cycle just like the good tissue (the one that’s inside of your uterus) does.
At the end of the menstrual cycle, when the hormones trigger the uterus to discard the tissue, the outer tissue detaches from the uterus and bleeds, and has nowhere to go since it’s not inside of the uterus.
Additionally, the tissue that covers the area where endometriosis forms can become swollen. When this happens scar tissue appears around that area, and this tissue turns into protuberances (usually called “lesions”, “implants”, “nodules” or “growths”) which is what causes pain and other symptoms. This is “endometriosis”.
Endometriosis is usually discovered in the ovaries, on the fallopian tubes, and the ligaments supporting the uterus, in the internal zone between the vagina and anus, on the external area of the uterus, and on the sheathing of the pelvic cavity. Occasionally, endometrial excrescences are discovered on the intestinal tracts or in the anus, on the bladder, the cervix and vulva, or in surgery marks inside of the stomach. Very seldom, endometrial lumps have actually been discovered outside of the belly, in the thigh, arm, or lung.
Physicians might utilize phases to explain the seriousness of endometriosis.
Endometrial growths that are reduced in size and don’t cover large areas are considered light or moderate types of endometriosis. Moderate endometriosis refers to bulkier growths or more widespread scar tissue, while really big protuberances and really widespread scar tissue is known as extreme endometriosis.
What Are the Symptoms?
The biggest and most common endometriosis symptom is definitely pain. More specifically, menstrual cramps (this symptom is called “dysmenorrhea”) that can be felt in the belly or the lower back; also, pain while / after having sex, and this symptom is called “dyspareunia”.
Normally, endometriosis symptoms start manifesting some years after menstrual cycle begins – if the woman has this illness, that is. As time goes on so do the symptoms increase because the areas where they manifest grow in size, but after menopause the growths start diminishing and, as result, endometriosis caves in.
Note 1: Infertility occurs in about 30% – 40% of women with endometriosis, so this is a pretty big deal for women who are trying to conceive a baby. If you were trying to conceive, but was unable to do it this could be one of the reasons.
Note 2: Sometimes (not often, but it could happen) the inflammation caused by endometrial growths can lead to infections, which causes a different type of pain that has nothing to do with menstrual cramps.
Note 3: In endometriosis pain and severity are not interchangeable. There are women with severe endometriosis who feel no pain, and there are ladies out there with just a slight illness but which suffer from excruciating pain.
Note 4: Regarding cancer and endometriosis… these 2 conditions rarely combine together (in less than 1% of the endometriosis cases). Also, should you – or someone you know – suffer from endometrial cancer worry not! The odds to get rid of this type of cancer are pretty good.
Endometriosis And Fertility – How Do They Relate To Each Other?
Endometriosis – severe endometriosis, that is – is one of the 3 biggest culprits for female infertility, so there is a link between this condition and fertility.
And yet, despite of this, there is still no clear understanding of why, or how this happens. There is no known cause-effect relationship between endometriosis and infertility in order to draw a definite conclusion despite of the fact that mild endometriosis, for example, is very common among infertile women.
One thing is certain, though: most endometriosis subjects do not experience fertility issues even though the pregnancy rates for these women are usually lower than the rates of those without endometriosis.
What is the Cause of Endometriosis?
As odd as it may seem, in this time and age of hyper-performant technology the causes of endometriosis are still unknown. We only have theories on what could cause this illness.
The first theory suggests that part of the menstrual tissue backs off through the fallopian tubes into the abdomen during the woman’s period, and fixes itself onto the abdomen where it begins to develop, causing pain.
A second theory states that tissue development goes wrong due to genetic factors, while a 3rd theory (that’s coming from the traditional Chinese medicine) suggests that endometriosis is the result of stagnating blood due to one of these 4 causes:
– abortion;
– lower abdominal / pelvic incision;
– having sex during period;
– emotional shock, high levels of stress, or physical / emotional abuse;
In addition to these, diet could also be a factor. More specifically, ongoing and long term intake of cold foods (raw vegetables, ice cream, frozen yogurt, etc) could thicken blood over long periods of time, resulting in the blood stagnating.
However, no matter what the real cause of endometriosis is, its advancement is a consequence of various hormones or growth factors. In helping with solidifying this theory scientists are running tests on the immune system to check whether or not this system does, indeed, trigger the activation of certain cells that are responsible with causing endometriosis by secreting certain hormones / substances. The process is a bit more complicated, but let’s keep it like this for the sake of simplicity.
In addition to these new theories researchers are also considering old theories, as well, like for example the theory according to which endometriosis is caused by delayed childbearing.
But, as we’ve mentioned, these are just theories and nothing has been confirmed yet. We still don’t know what causes endometriosis.
How Is Endometriosis Diagnosed?
Laparoscopy is how the doctor determines whether or not you suffer from endometriosis. First of all, though, your gynecologist will check your medical history, and after that you will undergo a full physical exam (including a pelvic test, as well).
After these tests have been run it’s time for the laparoscope (a small tube with a light inside) to be inserted inside of your body through a small cut in your abdomen. The doctor that performs laparoscopy on you will move that tube around your belly – after the abdomen has been expanded, first, with some CO2 to make things easier – until (s)he finds endometrial nodules (growths, implants, protuberances, or whatever you want to call them).
Laparoscopy is quite a good method of diagnosing endometriosis because the laparoscope will show with pinpoint accuracy the location(s) and the size of all the endometrial implants inside of your body, and based on this data the doctor will be able to offer you the right treatment.
How Do You Treat Endometriosis?
Normally, if your condition is not severe the doctor will most likely prescribe you pain medication, as pain is this illness’ most persistent symptom. Pain medication will help you alleviate pain, indeed, but it won’t get you rid of this illness, and the problem with endometriosis is that it’s a progressive disorder (it develops over the years), and if you leave it untreated it could develop into something ugly over time.
For mild to moderate stages of endometriosis acupuncture and herbal medicine have proved very effective methods of reducing (or totally eliminating) the pain associated with this illness, while for severe cases of endometriosis surgery or other treatments may be needed. Treating endometriosis is a whole topic in itself, so we will leave it aside for now. But acupuncture and herbs can help mitigate the pain, and they have also helped slow down and stop endometriosis recurrence.
Regarding pregnancy, if you wish to conceive a baby but you suffer from mild endometriosis doctors will advise you that, depending on your age and the level of the pain that endometriosis is causing you, you undergo a trial period of unprotected sex for 6 months to 1 year. In many cases, patients have been able to become pregnant during this time frame when their endometriosis has been mild, so this might work for you, too if the doctor allows / recommends it.
