Endometriosis is a common gynecological issue that can cause pain and discomfort. The World Health Organization reported that around 10% of women who are in their reproductive years, or ages 15 to 49, have endometriosis. That’s approximately 190 million people worldwide.
Unfortunately, we do not know the exact cause of endometriosis. Several theories have emerged over the years, including:
Cell Transformation
The cells lining the abdominal cavity, known as peritoneal cells, can turn into endometrial-like cells. Hormones like estrogen can cause the transformation and lead to the condition.
Retrograde Menstruation
Retrograde menstruation occurs when blood flows in the opposite direction, moving from the uterus through the fallopian tubes into the pelvic cavity. Endometrial tissue can move backward and implant and grow, causing endometriosis.
Genetic Causes
A connection between family history and an increased risk of endometriosis has been identified. That means a woman who has a relative like a sister, mother, or grandmother who was diagnosed with endometriosis is more likely to also develop the disease.
Immune Dysfunction
The immune system removes endometrial cells that are shed during menstruation. If the immune system malfunctions, this process may stop and allow endometrial tissue to grow outside of the uterus.
Environmental Factors
There are indications that endocrine-disrupting chemicals can act like hormones and lead to endometriosis. These include chemicals like dioxins and PCBs. They damage the immune system and disrupt the natural balance of hormones in the body.
If you have concerns about your endometriosis risk, a doctor can help. Make a gynecologist appointment to discuss this and these 9 health screenings that every woman needs to schedule this year.
What Does Endometriosis Do to the Body?
Endometriosis is present when the inner lining of the uterus grows outside of the organ. The tissue can move to the fallopian tubes, ovaries, and pelvic area. In rare cases, it may extend outside of the pelvic region.
Endometriosis tissue behaves much like the lining inside of the uterus. It will thicken and then break down and bleed during menstruation. When it is found along the ovaries, a cyst known as an endometrioma can form. This causes irritation around the ovary and can lead to scar tissue. Fibrous adhesions can also grow and cause organs and tissues to attach to each other.
Endometriosis isn’t fatal, but it can cause serious pain and discomfort. It can also cause medical complications like bowel obstruction or ectopic pregnancy. Some complications can be life-threatening if they are not treated.
Endometriosis ranks among the leading causes of infertility. Excess tissue can block sperm and egg movement, making contraception difficult.
Any woman who experiences symptoms or changes should make an appointment with a gynecologist right away.
The Symptoms of Endometriosis
Endometriosis can be a very uncomfortable disease. Severity varies from one patient to the next. Symptoms usually intensify just before and during menstruation. This is due to hormonal shifts that cause inflammation during this time.
The common symptoms of endometriosis include:
- Pelvic pain
- Painful period cramps
- Back or abdominal pain between periods
- Light bleeding between periods
- Heavy bleeding during periods
- Dyspareunia or pain during intercourse
- Discomfort while urinating or defecating
- Unexplained bloating, constipation, or diarrhea
- Infertility
It’s important to note that some women have endometriosis with no symptoms. They may not know they have the condition until they try to get pregnant and experience fertility problems.
The level of discomfort felt isn’t related to the severity of the disease. Some women have a small amount of excess tissue and experience strong pain while others may have less pain and bigger areas of tissue growth.
How to Treat Endometriosis
Your doctor will recommend an endometriosis treatment based on your age, severity of symptoms, and if you plan to have a child in the future. Most treatment plans focus on pain management and improving fertility.
Medications used to treat endometriosis include:
- Hormonal Birth Control
Hormonal birth control can be administered in different forms including a pill, patch, shot, implant, vaginal ring, or IUD (intrauterine device). These may be used as combination therapy with estrogen and progestin or progestin only.
- GnRH Antagonists or Agonists
GnRH (Gonadotropin-releasing hormone) antagonists and agonists are medications that stop the hormones that cause the menstrual cycle. It pauses the reproductive system. This type of treatment includes the oral GnRH antagonist Orilissa and the injected GnRH agonist Lupron.
- Danazol
Danazol, which is often branded as Danocrine, is another treatment option. It stops the hormones that cause periods. Patients may occasionally have a period or may stop entirely while taking this medication.
While these medications provide relief, they aren’t a cure for endometriosis. If a patient stops taking the prescribed medication, then symptoms may return. Doctors don’t usually recommend these medications for women who are pregnant or are trying to conceive.
In some cases, your doctor may recommend surgery for endometriosis. This can relieve pain and improve fertility because it removes the excess tissue growth. This is usually done one of two ways:
Laparoscopic Surgery
Laparoscopic surgery involves making a small cut in the abdomen. A thin tube with a camera is inserted so that the doctor can see where endometriosis is present. Surgical instruments can be inserted to remove tissue that is causing problems.
Hysterectomy
Women with severe endometriosis may be advised to have a hysterectomy. This involves removing the uterus only or the uterus and ovaries. Infertility will occur if the ovaries are removed, so patients should speak with their doctors about their future plans before choosing a treatment option.
Can I Lower My Endometriosis Risk?
There is nothing a woman can do to reduce her endometriosis risk to zero. However, there are risk factors that everyone should know about, and lifestyle changes that can help lower risk. Women who are more likely to develop endometriosis also:
- Have a family history of the condition
- Have short menstrual cycles that are fewer than 27 days between periods
- Have long and heavy periods that extend more than eight days
- Have never had a child
Women who have had a child and who breastfeed seem to have a lower risk of endometriosis.
Healthy habits can help regulate hormones in the body, which can lower endometriosis risk. Doing the following will help women keep their risk as low as possible:
- Stay at a healthy weight to avoid an increase in estrogen levels
- Get regular exercise to reduce inflammation and estrogen levels
- Lower alcohol and caffeine intake – studies show excessive intake increases estrogen
- Stay hydrated to reduce bloating and promote good health
Your doctor can guide you in the right direction when it comes to managing hormones and overall health. If you notice changes, it could be one of the 8 signs that you need to make a gynecologist appointment now.