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What is Endometriosis?
Endometriosis is defined as "a systemic, inflammatory disease characterized by the presence of endometrial-like tissue found in extrauterine sites" (Kennedy et al., 2005; Klemmt et al., 2018; Saunders et al., 2021).
It is a whole body disease. It has the ability to impact schooling, careers, finances, daily activities, relationships, fertility and one's overall well-being. Tissue that is similar to the lining of the uterus (the endometrium), but not the same, is found outside of the uterus. Endometriosis has know been found every organ in the body including muscles, arteries and nerves as well
Endometriosis lesions have been found to function independently, meaning pain & other symptoms can occur at any time of the month. These lesions produce their own hormone and behave independent of the menstrual cycle (www.endogirlsblog.com, 2020)
How does it occur?
It was once believed that retrograde menstruation (backwards flow of the period through the fallopian tubes) was one of main causes of endometriosis but currently, that theory doesn't hold as Endo has been found in individuals who do not menstruate. Another one of the theories indicates there is most likely a genetic component to Endometriosis.as it has been found in fetuses
Signs/Symptoms
The most common symptom is pelvic pain, which usually occurs at the same time as a period. But this pain can continue throughout the 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 person’s experience with Endometriosis is different as well the severity and pain associated with it (CEC, 2022).
Who gets it?
It's disappointing that not many people know about Endometriosis as 200 million people worldwide are affected. People of all ages, races, ethnicity, or socioeconomic backgrounds can be impacted by this disease (CEC, 2022).
Diagnosis
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 always confirm it. The only way to confirm and treat it is laparscopic excision surgery and test the biopsies (CEC, 2022).
Treatment
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 an Endometriosis excision specialist (not an obgyn), who is well versed in this method, cut and remove the entire lesion, including tissue beneath the surface of the growth.
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 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.
Hysterectomy is not a cure for Endometriosis but it is a cure for Adenomyosis. If hysterectomy is an option you are considering, discuss it with your specialist as there are different types of hysterectomies. A surgeon well versed in deep excision would have to remove the uterus and excise all endo lesions for the best outcome (CEC, 2022).
Alternative Therapies
The birth control pill or visanne is commonly prescribed to manage symptoms of endometriosis. A progesterone only pill is best if the pill is an option. The IUD is another option as well as pain killers, such as Tylenol #3, Toradol, hydromorphone, etc. NSAIDS, such as Advil, or buscopan are some over the counter options
Acupuncture (in combination with low level laser therapy), naturopathy cannabis, diet changes (anti-inflammatory), supplements, massage, pelvic floor physio and physical movement (pilates, swimming, walking, weight lifting, etc) are a few other alternates that can help with symptom management
While these are some alternatives to excision surgery, remember that they are not a cure. These therapies can help with symptom management, some for short term and some for the long term but can also come with side effects
**Always remember to discuss therapies or supplements with your doctor before starting and know that each of these may work differently for each person
Please check the following websites below for more information about Endometriosis.
Center for Endometriosis Care. 2022. Endometriosis: A complex disease. https://centerforendo.com/endometriosis-understanding-a-complex-disease
EndoGirlsBlog. 2020. Endometriosis is not a menstrual disease. http://endogirlsblog.com/endometriosis-is-not-a-mentsrual-disease/
The Endometriosis Network Canada. 2014. Diagnosis. http://endometriosisnetwork.com/information/diagnosis/
The Endometriosis Network Canada. 2014. Finding a specialist. http://endometriosisnetwork.com/information/finding-a-specialist-3/
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