Endometriosis

Endometriosis-What Is It?

Defined as the presence of endometrial-like tissue found OUTSIDE the walls of the uterus

Endometrial-like tissue that has migrated outside of the uterus. It often affects the ovaries, fallopian tubes & the tissue lining the pelvis. Although it is rare,  it can affect other areas of the body, like the lungs, diaphragm etc. 

The tissue continues to act like it would in the uterus, i.e. thickening, breaking down & bleeding during the menstrual cycle. Resulting in for example: Endometriomas, cysts in the ovaries, surrounding tissue being irritated & forming scar tissue. Bands of fibrous tissue-adhesions, can cause the pelvic tissues & organs to stick together, which makes them less mobile.  

Endometriosis often debuts in teenagers.

What Are The Risk Factors To Develop Endometriosis?

Never giving birth.

Getting 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 a greater lifetime exposure to estrogen your body produces.

Low body mass index.

One or more relatives with endometriosis, such as a mother, aunt or sister.

What Are Common Symptoms Of  Endometriosis?

Pain during ovulation

Pain during the menstrual period

Heavy irregular periods

Chronic pelvic pain

Intestinal cramping

Constipation/Diarrhoea

It can be misdiagnosed as IBS, or you can have both at the same time

Bloating (endo belly) 

Lower back & hip pain

Pain during or after sex

Fertility problems

Painful bowel movements or urination (especially before & during the period)

Butt lightning (shooting nerve pain in the bum)

Pain & heaviness in the legs

Fatigue

Nausea

Can lead to anemia, depression & anxiety

Why Do You Get It?

The amount of endometrial tissue might not be an indication of how severe your pain is. People with little endometrial tissue can have severe problems & those with a lot of endometrial tissue can have little issues. 

The reason it happens is still unknown, but according to mayoclinic, potential reasons could be; 

Retrograde menstruation. This is when menstrual blood flows back through the fallopian tubes and into the pelvic cavity instead of out of the body. The blood contains endometrial cells from the inner lining of the uterus. These cells may stick to the pelvic walls and surfaces of pelvic organs. There, they might grow and continue to thicken and bleed over the course of each menstrual cycle.

Transformed peritoneal cells. Experts suggest that hormones or immune factors might help transform cells that line the inner side of the abdomen, called peritoneal cells, into cells that are like those that line the inside of the uterus.

Embryonic cell changes. Hormones such as estrogen may transform embryonic cells — cells in the earliest stages of development — into endometrial-like cell growths during puberty.

Surgical scar complication. Endometrial cells may attach to scar tissue from a cut made during surgery to the stomach area, such as a C-section.

Endometrial cell transport. The blood vessels or tissue fluid system may move endometrial cells to other parts of the body.

Immune system condition. A problem with the immune system may make the body unable to recognize and destroy endometriosis tissue.

Leading to cells thriving in places they shouldn’t be, which can cause inflammation & fusion of tissue.  

The exact cause of endometriosis is still unknown, but according to Mayo Clinic and Praktiskmedicin, several factors may contribute. These include retrograde menstruation, where menstrual blood flows backward through the fallopian tubes into the pelvic cavity, allowing endometrial cells to attach and grow outside the uterus. Hormonal influences during puberty may also cause embryonic cells to develop into endometrial-like tissue. Additionally, surgical scars from procedures like C-sections can attract endometrial cells, and inflammation after childbirth may play a role. Problems with the immune system might prevent the body from clearing misplaced endometrial tissue.

This misplaced tissue can continue to respond to hormonal changes, causing inflammation, pain, and sometimes the fusion of pelvic organs. Estrogen plays a key role in the growth and maintenance of endometrial tissue. Symptoms of endometriosis may lessen after menopause but could return if hormone replacement therapy (HRT) is used.

How Do You Treat It?

There is no cure, but it can be treated with

Anti-inflammatory meds

Painkillers

Hormone medication

Ablation (burning of tissue)

Hysterectomy (removing the uterus) 

Ablation

A superficial treatment of burning the lesions to remove them. It’s less invasive than cutting them out, but it might mean that the root isn’t removed, which can lead to them coming back. 

Laparoscopic Excision Surgery

Surgery where the lesions are cut out at the root, to avoid them coming back. It also allows for a pathological diagnosis of tissue to confirm Endometriosis. 

Hysterectomy & Oophorectomy

In some cases medicine isn’t enough, so the uterus & ovaries are surgically removed, but it should be a last resort if all else fails.

Having the ovaries removed, also called oophorectomy, causes early menopause. The lack of hormones made by the ovaries may improve endometriosis pain for some. But for others, endometriosis that remains after surgery continues to cause symptoms. Early menopause also carries a risk of heart and blood vessel diseases, certain metabolic conditions and early death.

What Works For Some To Alleviate The Pain?

Soaking in a Warm bath

Using Heat pads or bottles

Light movement such as yoga or a walk

Rub Castor oil on the areas that hurt, before going to bed. If you’re not bothered by the thickness, rub it on multiple times a day. 

Gentle massage on the areas that hurt. Use hands or different types of massage tools to get the circulation going.   

Sources

@the_endo_space

praktisk medicin.se

mayocilinic.org

myclevelandclinic.org

draxe.com