What is Endometriosis?
The World Health Organization defines endometriosis as “a disease [which affects roughly 10% of reproductive age women and girls globally] in which tissue similar to the lining of the uterus grows outside the uterus.” This tissue can respond to hormonal fluctuations during the menstrual cycle, causing it to build up and break down. This can lead “to inflammation and scar tissue forming in the pelvic region and (rarely) elsewhere in the body” (source).
Endometriosis is a chronic condition with four stages, though its stage does not necessarily reflect its severity.
The exact cause of endometriosis is unknown, but it’s believed to be caused from:
Retrograde menstruation: endometrial (uterine lining) tissue enters the fallopian tube and moves through the tube into the pelvis (or other part of the body). These cells then implant outside of the uterus and create endometriotic lesions.
Cellular metaplasia: cells in the pelvis (or other body part) spontaneously change into another cell type (in this case, endometrial cells).
Stem cells (cells that are capable of becoming any type of cell) from the bone marrow travel through the body and end up becoming endometrial cells situated in the pelvis (or other body part).
Immune system dysfunctions: the immune system may not recognize endometriotic cells as foreign and will therefore not destroy them.
Women with endometriosis may exhibit any or all of the following signs and symptoms:
Severe pelvic pain during menstruation, intercourse, or bowel movements
Abdominal bloating or cramping
Diarrhea, constipation, nausea, and/or fatigue around the time of menstruation
Heavy menstrual bleeding or bleeding between periods
Infertility (endometriosis can affect the ovaries, fallopian tubes, and other tissues in the pelvis)
Endometriomas (cysts filled with blood line the ovaries)
Depression and anxiety
Some women have no symptoms at all (silent endometriosis)
How is endometriosis diagnosed?
Doctors may suspect endometriosis if someone has a history of painful periods, intercourse, or bowel movements. However, the only way to definitely diagnose endometriosis is through a laparoscopy procedure, during which small incisions are made in the stomach and a small camera is inserted into the pelvis to identify endometriotic lesions. Tissue from these lesions can be biopsied and sent for definitive testing.
How is endometriosis treated?
There is currently no cure for endometriosis, but symptoms can be managed by any or all of the following:
Birth control can help suppress hormonal fluctuations to reduce endometriotic flare-ups and lessen the severity of symptoms
Pain medicals such as Ibuprofen can be used to treat pain associated with endometriosis
Surgery to remove the endometriotic lesions (though these lesions tend to grow back) can lessen the symptoms
Women with endometriosis may require fertility treatment such as IVF in order to conceive.
Complications of endometriosis
Endometriosis can cause debilitatingly painful periods. Further, it can affect relationships since it often causes painful intercourse. Endometriosis is also a leading cause of infertility, which can cause depression, anxiety, and stress. Some studies also suggest that women with endometriosis are at a higher risk of developing ovarian cancer.
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