What is Endometriosis?
Endometriosis is a disease that affects a woman's period but it has the ability to impact schooling, careers, finances, daily activities, relationships, fertility and one's overall wellbeing. Tissue that is similar to the lining of the uterus (the endometrium) is found outside of the uterus.Most endometriosis is found in the pelvic cavity, attaching itself to reproductive organs but it can also be found on the bladder, bowel, intestines, appendix and/or rectum (Endometriosis Foundation of America, 2018).
Once outside the uterus, the endometriosis tissue continues to act like its still inside the uterus. Like your period, the endometriosis tissue is also going to bleed except now there's nowhere for this blood to go. The blood comes in contact with other organs, causing inflammation and irritation which leads to pain. Eventually, scar tissue and endometrial adhesions, which are like super glue, form between organs putting pressure onto nerves and tissue in that area. When organs become fused together by these adhesions, they cannot function to their full capacity. For example, constriction of the bowel can lead to constipation (EFA, 2018).
How does it occur?
It was believed that retrograde menustration (backwards flow of the period through the fallopian tubes) was one of the main causes of endometriosis but currently, there is no one theory that explains why this disease occurs. There is thought to be a genetic component to endometriosis alongside other theories but more research is needed to determine this link (EFA, 2018).
The most common symptom is pelvic pain, which usually occurs at the same time as a period, but this pain can continue throughout a woman’s entire cycle. Painful cramps that are not relieved with NSAIDS and interfere with daily life, heavy and longer cycles, nausea, vomiting, chronic fatigue, bowel and urinary issues, infertility and pain during sex are just a few of the signs and symptoms of Endometriosis. Each woman’s experience with Endometriosis is different as well the severity and pain associated with it (EFA, 2018).
Who gets it?
It's disappointing that not many people know about Endometriosis as 176 million women worldwide are affected. Women of all ages, races, ethnicity, or socioeconomic backgrounds in their reproductive years can be impacted by this disease (EFA, 2018).
In Canada, it takes an average of 9 years from the onset of symptoms to receive a diagnosis of Endometriosis which most likely is due to a lack of knowledge among the public and medical community. Misdiagnosis frequently occurs which leads to incorrect treatments (The Endometriosis Network Canada, 2014).
There is no test for Endometriosis and even CTs, MRIs or Ultrasounds cannot confirm it. The only way to confirm and treat it is laparscopic excision surgery and test the biopsies (EFA, 2018).
While there is no cure, there are treatment options. As mentioned before, laparscopic excision surgery is known as the gold standard treatment. This involves having a surgeon, who is well versed in this method, cut and remove the entire lesion, including tissue beneath the surface of the growth (EFA, 2018).
Cautery and ablation are also surgical methods used but it only removes the tissue on the surface and leaves behind what is growing beneath. This is not effective for long term management of this condition as the Endometriosis is not completely removed, excess scar tissue can form and at times, inflammation can follow adding to pain (EFA, 2018).
Hysterectomy is not a definitive cure for Endometriosis as growths can occur outside the uterus on other organs; for best results, a surgeon well versed in deep excision would have to remove the uterus and excise all lesions found outside of the uterus as well. If this is an option you are considering, it should be seriously discussed with your surgeon as there are different types of hysterectomies such as partial, total, etc. (Seckin Endometriosis Center, 2018).
Low-Dose Oral Contraceptives, or Birth Control Pills, are one method for symptom management. Hormonal therapies, such as the IUD and GnRH Therapy (Lupron) are also options as well as pain killers, such as Advil, Toradol, etc. (EFA, 2018).
Acupuncture, naturopathy cannabis, diet changes, massage, pelvic physio and yoga are a few other alternates to look into for symptom management. Always remember to discuss therapies with your doctor and know that each of these will work differently for each individual as there is no one treatment route for Endometriosis.
Please check the following websites below for more information about Endometriosis.
Endometriosis Foundation of America. 2018. What is endometriosis? Causes, Symptoms and Treatments. https://www.endofound.org/endometriosis