What is endometriosis?
Endometriosis is a chronic condition, and as such, there is no cure. However, it can be treated to control the pain and prevent the symptoms from worsening. One treatment option that is suitable for many women is hormone therapy. This uses a combination of estrogen and progestin to cease menstruation.
With endometriosis, the endometrial-like tissue acts as endometrial tissue would — it thickens, breaks down, and bleeds with each menstrual cycle. But because this tissue has no way to exit your body, it becomes trapped. When endometriosis involves the ovaries, cysts called endometriomas may form. Surrounding tissue can become irritated, eventually developing scar tissue and adhesions — abnormal bands of fibrous tissue that can cause pelvic tissues and organs to stick to each other.
Endometriosis can cause pain — sometimes severe — especially during menstrual periods. Fertility problems also may develop. Fortunately, effective treatments are available.
There is no cure for endometriosis. Hormone therapy or taking out tissue with laparoscopic surgery can ease the pain. But pain often returns within a year or two. Taking out the ovaries (oophorectomy) and the uterus (hysterectomy) usually relieves pain.
The primary symptom of endometriosis is pelvic pain, often associated with menstrual periods. Although many experience the cramping during their menstrual periods, those with endometriosis typically describe menstrual pain that's far worse than usual. Pain also may increase over time.
Common signs and symptoms of endometriosis include
- Painful periods (dysmenorrhea). Pelvic pain and cramping may begin before and extend several days into a menstrual period. You may also have lower back and abdominal pain.
- Pain with intercourse. This is the number one complaint with endometriosis.
- Pain with bowel movements or urination. You're most likely to experience these symptoms during a menstrual period.
- Excessive bleeding. You may experience occasional heavy menstrual periods or bleeding between periods (intermenstrual bleeding).
- Infertility. Sometimes, endometriosis is first diagnosed in those seeking infertility treatment.
- Other signs and symptoms. You may experience fatigue, diarrhea, constipation, bloating, or nausea, especially during menstrual periods.
The severity of your pain isn't necessarily a reliable indicator of the extent of the condition. You could have mild endometriosis with severe pain, or you could have advanced endometriosis with little or no discomfort.
Endometriosis is sometimes mistaken for other conditions that can cause pelvic pain, such as pelvic inflammatory disease (PID) or ovarian cysts. It may be confused with irritable bowel syndrome (IBS), a condition that causes bouts of diarrhea, constipation, and abdominal cramping. IBS can accompany endometriosis, which can complicate the diagnosis.
When to see a doctor
See your doctor if you have signs and symptoms that may indicate endometriosis.
Endometriosis can be a challenging condition to manage. An early diagnosis, a multidisciplinary medical team, and an understanding of your diagnosis may result in better management of your symptoms.
Now the Hard Truth
Although the exact cause of endometriosis is not absolute, possible explanations include:
- Retrograde menstruation. In retrograde menstruation, menstrual blood containing endometrial cells flows back through the fallopian tubes and into the pelvic cavity instead of out of the body. These endometrial cells stick to the pelvic walls and surfaces of pelvic organs, where they grow and continue to thicken and bleed throughout each menstrual cycle.
- Transformation of peritoneal cells. In what's known as the "induction theory," experts propose that hormones or immune factors promote the change of peritoneal cells — cells that line the inner side of your abdomen — into endometrial-like cells.
- Embryonic cell transformation. Hormones such as estrogen may transform embryonic cells — cells in the earliest stages of development — into endometrial-like cell implants during puberty.
- Surgical scar implantation. After a surgery, such as a hysterectomy or C-section, endometrial cells may attach to a surgical incision.
- Endometrial cell transport. The blood vessels or tissue fluid (lymphatic) system may transport endometrial cells to other parts of the body.
- Immune system disorder. A problem with the immune system may make the body unable to recognize and destroy endometrial-like tissue that's growing outside the uterus.
Several factors place you at greater risk of developing endometriosis, such as:
- Never giving birth
- Starting your period at an early age
- Going through menopause at an older age
- Short menstrual cycles — for instance, less than 27 days
- Heavy menstrual periods that last longer than seven days
- Having higher levels of estrogen in your body or greater lifetime exposure to estrogen your body produces
- Low body mass index
- One or more relatives (mother, aunt or sister) with endometriosis
- Any medical condition that prevents the standard passage of menstrual flow out of the body
- Reproductive tract abnormalities
Endometriosis usually develops several years after the onset of menstruation (menarche). Signs and symptoms of endometriosis may temporarily improve with pregnancy and may go away entirely with menopause unless you're taking estrogen.
Fertilization and implantation
The main complication of endometriosis is impaired fertility. Approximately one-third to one-half of women with endometriosis have difficulty getting pregnant.
For pregnancy to occur, an egg must be released from an ovary, travel through the neighboring fallopian tube, become fertilized by a sperm cell, and attach itself to the uterine wall to begin development. Endometriosis may obstruct the tubes and keep the egg and sperm from uniting. But the condition also seems to affect fertility in less-direct ways, such as by damaging the sperm or egg.
Even so, many with mild to moderate endometriosis can still conceive and carry a pregnancy to term. Doctors sometimes advise those with endometriosis not to delay having children because the condition may worsen with time.
Ovarian cancer does occur at higher than expected rates in those with endometriosis. But the overall lifetime risk of ovarian cancer is low, to begin with. Some studies suggest that endometriosis increases that risk, but it's still relatively low. Another type of cancer, endometriosis-associated adenocarcinoma, can develop later in life in those who have had endometriosis.
More Hard Facts
In women with endometriosis, the tissue typically spreads into the pelvic area but, in some cases, can travel as far as the chest cavity. The endometrium, no matter where it applies in the body, is on the same cycle as a woman's period, which is regulated by the female hormone estrogen.
The most recent studies have shown that endometriosis recurs at a rate of 20% to 40% within five years following conservative surgery. The use of oral contraceptives, other suppressive hormonal therapy, or progesterone intrauterine device (IUD) after surgery has been shown to reduce the recurrence of pain symptoms.
Where else can endometriosis spread to in the body?
- Stomach/ Stomach Cavity
Can Endometriosis Become Life Threatening?
YES, yes it can. If not correctly diagnosed in time and treated and the endometriosis has spread to your other organs or attached to the ovaries and caused ovarian cancer, it can become life-threatening.
Because endometriosis is an autoimmune disorder, dairy is the number one anti-inflammatory food to avoid! Period!
Studies show that you should void gluten, beer, and fried foods.
Some evidence suggests that a high intake of red meat may be associated with higher levels of estrogen in the blood ( 12, 13 ). Since endometriosis is an estrogen-dependent disease, higher levels of estrogen in the blood may increase the risk of the condition (14 ).
"Too much caffeine once again creates inflammation in the body and aggravates the digestive system." "Dairy products can cause inflammation through hormones," Hartung said. "Dairy products containing growth hormones and antibiotics can also worsen endometriosis symptoms."
Some people can easily digest yogurt, but not milk, or butter, but not cheese. In the context of endometriosis, it's ideal for eliminating all dairy entirely for at least a period. You can always consider slowly reintroducing it after you've found sustainable relief from endometriosis.
Several Personal Stories
- At the age of 17, after my second son was born, I was diagnosed with endometriosis. I went on Depo-Provera at the time. This caused me not to have monthly menstrual cycles. I did not go off of this medication until around 1996. Once off of this medication, my monthly cycles were not consistent; they were painful and very gross, to say the least. My first laparoscopy discovered that the endometriosis was on my small bowel and my ovaries. The doctor did his best to remove it and suggested I have a hysterectomy. I was stubborn and wanted to have another child. After 3 years of unsuccessful fertility treatments, I could no longer take it. I opted for a second laparoscopy to remove more endometriosis growth and spread and went back on the Dep-Provera. By 2005, I was again attempting to have another child, with no success; also, my cycles were horrific. I was in the process of planning a hysterectomy in Septemeber of 2009, and low and behold, I began hemorrhaging basically. I had an emergency hysterectomy on 9/11/2009. The endometriosis covered my ovaries, bowels, parts of my intestines, my entire uterus, part of my bladder. It also spread to my cervix and fallopian tubes. My doctor said my ovaries were the size of plums, and my uterus was the size of a grapefruit. After my hysterectomy, I felt much better. That was my first bought with an autoimmune disease. I genuinely believe that was just the beginning. If you have read this blog prior, you know I have numerous autoimmune illnesses, and they are still rearing their ugly heads.
- My cousin, at the age of 21, had a hysterectomy for endometriosis.
- Her sister, my other cousin, by the age of 30, had a hysterectomy due to endometriosis. After her hysterectomy, the doctors later found that the endometriosis spread into her stomach cavity.
- My aunt had endometriosis and hysterectomy in her late 20's, early 30's. She has stomach issues too.
- My grandmother also dealt with endometriosis. She then developed lupus, lung issues, rheumatoid arthritis, etc.
- I know numerous ladies that are suffering now, and it has spread to their anus, lungs, and other parts of their bodies.
I genuinely see a pattern with this painful autoimmune illness that is still so unresearched and not enough attention surrounding. Most autoimmune diseases are underfunded; people are unaware; the saying goes, "you don't get it until you get it." It is true, it is a fact!
You learn to become a warrior, a true survivor, you learn coping mechanisms become pain medications are no longer prescribed, the doctors are baffled, and treatment is scarce. It's a mystery: trial and error.
So that is the skinny on endometriosis.
If you have a story about your personal experience with endometriosis, I would love to feature you here on the blog; this will help spread awareness, and honestly talking about it may help you and others.
You are NOT alone!
Endometriosis affects about 200 million women worldwide and nearly 1 out of every 10 women in the United States. Yet the disease is often misdiagnosed or missed altogether, says the Endometriosis Foundation of America (EndoFound) as of March 2020.
Dedicated to my friend Dawn!
When things are tough, you are tougher, you are a warrior and ENDO Strong!