Endometriosis is a chronic, common and progressing disease that causes pain. It usually appears at around 10% of the females in their reproductive age. Around 25-50% of the infertile women have endometriosis, and 30-50% of the women suffering from endometriosis have difficulties getting pregnant.
Endometriosis is a disease that causes fear, a lot of dilemmas and assumptions by only thinking of it and the fact that it always causes infertility. There are some rumors and beliefs that getting pregnant as well as hysterectomy can be cures for endometriosis. However, all of the assumptions mentioned above are completely wrong and that combined with the fact that people do not know much about this disease can explain why a lot of women fear it.
What is endometriosis?
Endometriosis is a condition at which small parts of the endometrioum (linings of the uterus) are abandoning the cavity of the uterus (cavum uteri), and attach to other organs, most often in the area of the pelvis.
Each month there are processes that prepare woman’s body for a potential pregnancy. The endometrioum affected by the hormones gets bigger and it prepares to accept the future fetus. If the woman gets pregnant, the ovum attaches to the endometrioum and it starts to grow. Otherwise, it falls apart, it bleeds and a process also known as a menstruation happens.
The endometrial cells, transplanted to other organs will do the same thing as the endometrioum. They grow and bleed when affected by the hormones. That leads to inflammation, and cists and scars may be spotted around the surrounding tissue. Because of that, pain can be felt a couple of days before the menstruation, and it usually ends with the last day of the period.
Endometriosis usually appears in the area of the pelvis and it affects the surrounding organs of the reproductive system such as ovary, the external wall of the uterus, the ligaments holding the uterus, the space in between the uterus and the rectum. In rare cases it might spread outside of the abdomen and it might affect other organs such as the lungs.
The real causes of endometriosis are unfortunately not known so far. There are some assumptions what might be the reason behind it. The first assumption is that it is genetically transferred from generation to generation. The other one is called “retrograde menstruation”, and the third assumption is the inability of the immune system to eliminate the endometrial cells coming out from the uterus. But none of these assumptions has been confirmed yet. Neither has been confirmed why the endometrial tissue spreads over the other organs, and other parts of the body.
What are the risky endometriosis groups?
Endometriosis can affect:
- Women in their reproductive age
- Infertile women
- Have a menstrual period longer than a week
- Have menstrual cycles shorter than 28 days
- Got their first menstruation before the age of 12
- Have a positive family history of endometriosis. In a family where a mother or a sister has endometriosis chances that someone else from the family will get it are 7-10 times higher.
- Women who have uterus anomalies, or ovary disorders
There are not symptoms that can be 100% when it comes to endometriosis. A research showed that there were women who had this disease but were asymptomatic to it. At some other cases, some of the women had stomachache, and the third group showed nothing different than normal PMS symptoms. However, there are cases where stomachaches were really bad and they didn’t allow some of the women to do their normal daily activities.
Most common symptoms of the endometriosis:
Pain which may be:
- Dysmenorrheal – painful menstruation periods. If suffering from endometriosis, pain may show up a few days before the menstrual periods and to continue on after it is over.
- In times of ovulation
- Dyspareunia – Pain during sexual intercourse
- In the lower part of the back 1–2 days before the menstrual period begins
- Pain during urination
- Having difficulties while trying to get pregnant. This might be the only symptom that some women may feel if they suffer from endometriosis.
Abnormal bleeding which may include:
- Vaginal bleeding during sexual intercourse
- More bloody menstrual periods than usual
- Prolonged menstrual bleeding
- Blood in the stool or during urination
- Vaginal bleeding before menstrual period
- Irregular menstrual period
- Flatulence during menstrual periods
Exhaustion, fatigue, lack of energy.
Most of these symptoms appear a few days before the menstrual period, or a few days after it ends. Gynecologists say that the symptoms cannot be directly connected to the seriousness of the endometriosis. Some of the women have really strong symptoms and their endometriosis is not really serious and vice versa. Another thing that is common regarding this topic is that these symptoms are lowered, or completely gone during the menopause, when the estrogen levels are getting lower as well.
Diagnosing the endometriosis
Ultrasound can be used to diagnose potential endometriosis, but its usage is limited because of the insufficient specificity and sensitivity. A sure method to diagnose endometriosis is the diagnostic laparoscopy. It also locates the disease and it can show how serious the disease is at that phase.
Can endometriosis be cured?
Fortunately, there are some therapies that can lower the symptoms and ease the pain, as well as raise the chances of getting pregnant. The treatment of this disease depends on what you want to achieve. Do you want to ease the pain, or do you want to raise your chances of getting pregnant?
- Hormonal therapies: These therapies affect the hormones in ways that it conducts a fake menopause. The goal of these therapies is to terminate the stimulation of endometrial cells. These therapies are good for women who want to get pregnant.
- Medications for easing the pain: A lot of women suffer from strong pain during the endometriosis. There are a some medicine that can help you ease the pain
- Laparoscopy: If the endometrial tissue cannot be removed by laparoscopy, in some cases doctors advise to do a laparoscopy or abdominal surgery.
- Hysteroscopy or oophorectomy: Removal of the uterus and the ovary is only done at specific cases when the disease has progressed a lot. It will lower the estrogen levels and it will remove the symptoms. Although, at 15% of the women who removed their uterus and the ovary, the disease recurred.
Ask for expert help if:
- All of a sudden your menstrual pain become painful (and they weren’t painful before)
- Menstrual pain obstructs you to do your normal daily activities
- Menstrual pain lasts for more than two days or it continues after the menstrual period
- You feel pain during the sexual intercourse
- Cannot control the urine, you have bloody stool
- 12 or more months have passed since you last tried to get pregnant