What is endometriosis?
Endometriosis is a painful condition where tissue similar to the lining of your uterus starts to grow outside your uterus. This endometrial tissue can attach itself to nearby organs such as your ovaries, fallopian tubes, and pelvic cavity lining. It grows, breaks down, and bleeds just like the lining of your uterus does during your menstrual cycle. However, this tissue cannot leave the body and can cause inflammation, ovarian cysts, and lesions in the surrounding areas.
What are the symptoms of endometriosis?
The most common symptom of endometriosis is pain during your period. Many women experience some form of discomfort during their menstrual cycle, but endometriosis pain is more intense. It can affect your ability to work or even get out of bed days. For some, the pain increases as they get older.
Some other endometriosis symptoms include:
- Abdominal or lower back pain during and in between your periods
- Long or heavy periods
- Spotting or bleeding in-between periods
- Pain during sex
- Pain during urinating and bowel movements
- Diarrhea or constipation
The amount of pain you have does not always correlate to the severity of your endometriosis. It all depends on which organs and pain receptors are being affected. You could have mild endometriosis with severe pain and vice versa.
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The only way to know the severity of your endometriosis is to have testing done by your healthcare provider.
What causes endometriosis?
No one knows for sure what causes endometriosis. A few possible explanations are:
- Irregular cycles – women who have short cycles (less than 25 days) or periods that last longer than seven days tend to have higher rates of endometriosis.
- Retrograde menstruation – During your period, the uterus lining travels down and out of the vagina. In retrograde menstruation, some of those cells travel up the fallopian tube and into your pelvic cavity instead.
- Immune system disorders – Your immune system doesn’t recognize the uterine-like tissue outside the uterus and allows it to grow anywhere.
- Chemical exposure – An industrial chemical called dioxin has been linked to endometriosis.
- Surgery – Having abdominal or pelvic surgery (like a C-section) may allow the endothelial tissue to attach to the incision.
Is endometriosis genetic?
While the exact cause of endometriosis remains unknown, there is sometimes a genetic component. Endometriosis tends to show up more frequently in some families. If a close relative in your family has endometriosis, you also have a higher chance of being diagnosed with it.
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Genetics is not the only risk factor for endometriosis. Some others include:
- High levels of estrogen
- Never having been pregnant
- Starting your period at an early age
- Going through menopause at a later age
- Reproductive tract disorders
- Not maintaining a healthy body weight
What are the complications of endometriosis?
The biggest complication of endometriosis is infertility. Up to 50% of all women with endometriosis will have trouble conceiving naturally. The endometrial tissue can attach to your ovaries or fallopian tubes and prevent sperm and egg from ever meeting. It also affects your hormones and can trigger your immune system to attack a fertilized egg.
The pain associated with endometriosis can negatively impact your quality of life. Episodes can be so painful that they prevent you from participating in daily activities. Many women will struggle with depression and anxiety surrounding their period.
Endometriosis can also increase your risk for two types of cancer: ovarian cancer and endometriosis-associated adenocarcinoma.
How can I get tested for endometriosis?
Most women start by going to their healthcare provider because they are having painful periods or trouble getting pregnant. If your provider suspects endometriosis, they’ll most likely perform a pelvic exam and send you for some imaging tests – either an ultrasound or an MRI of your pelvic area.
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A type of surgery called laparoscopy is also an option for a more definitive diagnosis. During a laparoscopic procedure, a surgeon will make a small incision near your belly button and insert a tiny tube with a camera on end. They’ll be able to see where and how much endothelial tissue is growing outside your uterus. They can even take a small sample of tissue out for further testing.
What is the treatment for endometriosis?
Unfortunately, there is no cure for endometriosis, but treatments are available to help reduce the symptoms. Treatment usually involves medication or surgery.
Pain medication – Over-the-counter pain relievers called NSAIDs (non-steroidal anti-inflammatories) are recommended first to help reduce pain. Ibuprofen (Motrin, Advil) and naproxen (Aleve) work well for many people to lower endometriosis pain.
Hormone therapy – Certain types of hormone therapy lower estrogen and may even stop your period. Hormonal birth control, gonadotropin-releasing hormone medications, and danazol (Danocrine) are three different options for lowering estrogen levels. If you’re trying to get pregnant, you won’t be able to use hormone therapies.
Surgery – If pain relievers and hormone therapies are not helping or you can’t take them because you’re trying to get pregnant, surgery may be your next option. During a laparoscopic procedure, the surgeon can cut away and remove tissue. This can help achieve pregnancy. A hysterectomy is an option in more severe cases. However, most healthcare providers steer away from this procedure because it comes with its own issues and health risks.
Lifestyle changes – reducing stress, exercising, and healthy eating are all lifestyle changes that can lower pain during your menstrual cycle.
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If you’re trying to get pregnant, IVF or ovary-stimulating therapy may be your best option. Which treatment you decide on is a personal decision involving you and your healthcare provider.
Best ways to manage endometriosis
While there is no cure, there are treatments out there to help you live a better life with endometriosis. Reducing the amount of pain you experience during your period can drastically improve your quality of life and mental health. If you think you have endometriosis – don’t wait– talk to your healthcare provider about your symptoms. The lesions and pain from endometriosis can worsen with time and further impair your ability to get pregnant.