Endometriosis has remained a relatively unknown, yet very serious condition. When compared to heart disease or cancer, the two leading causes of death in the United States, it’s almost unheard of. However, endometriosis is quite common, affecting an estimate of one in 10 women between the ages of 15 to 49 — approximately 176 million women globally.
Now, what endometriosis is and how it develops are both complex topics, which we do our best to explain in the paragraphs below. What’s important while answering both of these questions is also recognizing the symptoms of endometriosis and knowing what to do when experiencing each.
In a Nutshell
Simply put, endometriosis is the “development of uterine-lining tissue outside the uterus,” according to WebMD. During endometriosis, this uterine-lining tissue, called the endometrium, grows not only outside the uterus, but can also grow onto other organs within the body. When this happens, although the endometrium continues to function normally (other than growing outside the uterus, of course), certain symptoms can occur, but not always …
The fact that the endometrium continues to function normally — meaning it continues to break down each menstrual cycle — during endometriosis, is part of the problem. Since the endometrium has grown outside of the uterus, the blood that usually leaves the body through menstruation becomes trapped within the abdominal cavity. This abnormality can sometimes affect the ovaries, Fallopian tubes, and the tissue inside of the pelvis.
When endometriosis finds its way into the ovaries it can be even very painful. Cysts known as endometriomas can form and the tissue surrounding them can often become irritated. This, in turn, forms scar tissue and abnormal bands of fibrous tissue called adhesions. These adhesions can sometimes cause pelvic organs and tissues to stick to one another.
Instead of a symptom as apparent as searing pain within the abdomen, oftentimes women will go to the doctor’s office in search of infertility treatment not knowing that there’s much more going on. This, in general, is how most women find out they have endometriosis. And as the condition increasingly affects more and more women, it’s something gynecologists regularly look for when asked to treat infertility.
The primary symptom of endometriosis is closely associated with pain in and around the pelvic region. Normally, this pain is simply associated with a menstrual period and is simply chalked up to dysmenorrhea (painful periods). Those suffering from endometriosis, however, experience a different kind of cramping than usual.
The pain and cramping from endometriosis may actually begin prior to the menstrual cycle and then extend for several days afterward. This pain might even extend up the lower back or around to the abdominal muscles. It tends to be much worse than other menstrual pain and can be situated differently depending on where the endometrial growths reside.
Endometriosis can also result in excessive bleeding during a menstrual period as well. Women who have the disorder may experience much heavier periods, called menorrhagia. Those with endometriosis might also experience menometrorrhagia or bleeding between periods. This condition, called intermenstrual bleeding, but more commonly referred to as “spotting,” in and of itself can be worrisome enough. It can also be a symptom of endometriosis.
Those who suffer from endometriosis have also reported that the painful cramping can also increase with time. Pain is generally relative of course, so the severity of it isn’t exactly a reliable indicator as to the true extent of the condition. This is particularly true when you see that some women find the pain to be intense, while advanced cases may have little or no pain at all.
As if the pain before, during, and following a menstrual cycle isn’t bad enough, endometriosis can also cause sexual intercourse to become extremely painful. This should, of course, be obvious based on the other symptoms, but it is not uncommon for someone suffering from this condition to feel pain following or even while having sex.
Women suffering from endometriosis can also experience pain during bowel movements or urination. This pain is most commonly felt during the menstrual cycle, which may not be as noticeable if the pain isn’t overly severe. The condition can also cause bouts of diarrhea, constipation, and bleeding during urination — also during the menstrual period.
Painful … Everything
Pain can also be experienced in the pelvic area, bladder, bowels, and lower back. As a result of myriad pain, sufferers can also experience chronic fatigue. Think about how it would feel to be in constant pain — exhausting. Therefore, if experiencing both pain and exhaustion, it may be time to consult a physician.
Pain in the abdomen and fatigue are the most common symptoms of the condition. Some endometriosis sufferers have also had additional symptoms like chest discomfort or coughing blood, both due to endometriosis in the lungs. There have even been reports of endometriosis in the brain, which causes headaches or worse.
Many doctors might misdiagnose the symptoms of endometriosis as evidence of some other condition. The pelvic pain associated with it might be construed as ovarian cysts or pelvic inflammatory disease. The abdominal pain and painful bowel movements could be assumed to be irritable bowel syndrome (IBS).
The presence of IBS symptoms or potential ovarian cysts could most definitely complicate a proper diagnosis. It’s important to understand that in most cases, endometriosis is usually detected based on the pattern of the symptoms, coupled with a physical examination. Unfortunately, the only definite diagnosis involves laparoscopic surgery.
Although the exact cause of endometriosis is not certain, there are a number of possible explanations for the disorder. One of these causes is something called retrograde menstruation. This means that menstrual blood, containing endometrial cells, ends up flowing back through the Fallopian tubes rather than leaving the body.
There are other potential causes of the disorder as well. One of the current explanations involves a possible autoimmune disorder. In this scenario, the body’s immune system may be unable to recognize and destroy endometrial tissue growing unchecked outside of the uterus in the pelvic cavity.
Causes and Complications
The list of other potential causes of the condition includes the transformation of peritoneal or embryonic cells into endometrial cells and surgical scar implantation. Whatever the reason, endometriosis can come with a number of complications. Chief among them is a fertility impairment. Approximately one-third to one-half of the women suffering from endometriosis have trouble getting pregnant.
Holding it Back
For pregnancy to occur, an egg is released from an ovary where it travels through the adjoining Fallopian tube and becomes fertilized by a sperm cell. After that, it attaches itself to the uterine wall and begins development. However, if endometrial cells obstruct the tube, they might separate the sperm and the egg, or else damage one or either of the two in the bargain.
The ‘C’ Word
Perhaps the most severe complication associated with endometriosis is that it can result in ovarian cancer. Though it is not directly linked, this type of cancer does occur at a higher rate in women with endometriosis than those without. It even has its own rare form of cancer called endometriosis-associated adenocarcinoma.
There is Hope
There is no cure for endometriosis at this point, but all hope is not lost. In fact, many women who suffer from moderate or mild endometriosis can still conceive and carry a child to term. Cancer is not a foregone conclusion by any means, and the pain can be treated with medication and surgery if it gets to that point.