For those who have never heard of it: endometriosis is a chronic disease that affects more than one in ten women. It exists in various forms and can range from mild to severe. Unfortunately, it is often diagnosed too late, and there are only a few treatment options available to combat it. Given the severity of this disease, the blog of the Sisters has taken the issue very seriously. Find out here everything you need to know about this still unknown gynecological condition.
Endometriosis, what is that?
Endometriosis is a disease that is closely related to menstruation. This is because the uterine lining, known as the endometrium, thickens during the menstrual cycle due to estrogens. This thickening of the uterine tissue occurs in preparation for a possible pregnancy. If fertilization does not take place, the lining breaks down and is eliminated through menstruation.
In endometriosis, however, this tissue thickens in an irregular manner. It can develop in other organs, including the ovaries and the peritoneum. It often also reaches the vagina, the digestive tract (rectum, sigmoid colon, and small and large intestines), the urinary tract (sacrouterine ligament and bladder), and sometimes even the lungs. These endometrial cells that grow outside the uterus develop into adhesions, internal injuries, or ovarian cysts.
All women of childbearing age are susceptible to this disease. Today, doctors estimate that about one in ten women is affected by endometriosis. This is a rather alarming number, especially since this estimate does not take into account the undiagnosed cases and the disease actually affects more women.
The disease can take on different forms depending on the woman. The severity also varies from woman to woman, depending on the amount of abnormal tissue and the associated organ damage.
Causes of Endometriosis
But where does this disease come from? First of all, endometriosis is characterized by the presence of tissue that resembles the uterine lining and is found in other organs. This is due to the migration of the tissue upwards and through the fallopian tubes to other parts of the pelvis and abdominal cavity. The factors that trigger or promote this migration are still quite unexplored, but the pathways of the uterine tissue have already been identified.
It may be a case of retrograde menstruation. In this case, a part of the menstruation that contains endometrial cells flows upward into the fallopian tube. Cell transplantation can also occur via lymphatic or vascular pathways or "mechanically" during a surgical procedure in the pelvic area (cesarean section, laparotomy, episiotomy, etc.).
Endometriosis can also be caused by a so-called metaplasia. In this case, normal tissue changes to abnormal tissue. This occurs either spontaneously, for reasons still unknown, or due to hormonal disorders.
This disease is mainly diagnosed in industrialized countries, but that does not mean that its existence is limited to these countries. Many women may suffer from the corresponding ailments in other parts of the world without receiving a correct diagnosis.
Experts estimate that 90% of women have "retrograde" menstrual bleeding (bleeding that does not flow out in the normal way). Officially, however, only 10% suffer from this condition. There are still unknown individual factors that, according to the hypothesis, could be related to genetics.
Symptoms that should alarm you
"If it does not proceed asymptomatically, this disease mainly manifests through pain:"
- Pain in the pelvic area: Women with endometriosis often experience pain in the lower abdomen. If you are suffering from this pain, you should see a doctor.
- Pain during menstruation: "In addition to the pelvic area, the pain can also occur in areas affected by endometrial cells. In a very rare case observed in 1993, the woman even had epileptic seizures on the first day of her period because the endometrial cells had reached the brain."
- Pain during bowel movements and urination: "If you have difficulty with bowel movements and pain when urinating, that is not a good sign. It means that the endometrial cells have reached the urinary and digestive tracts."
- Pain during sex or dyspareuniaIt is not normal to have pain in the lower abdomen or vagina during sex.
- Pain in the lower back area and sciatica complaints: The pain can also affect the lower back, the pelvis, and the navel. Sometimes it radiates down into the legs.
These chronic pains vary in intensity depending on the case. Sometimes a woman with endometriosis is able to continue her daily activities, while in other cases, the severe pain can even prevent her from standing. The pain may also be accompanied by vomiting.
"If you are suffering from one or more of these symptoms, it is strongly recommended to consult a gynecologist. This also applies if you notice the following symptoms:"
- Uncontrolled bleeding: "You have spotting or bleeding from the rectum or uterus. This often occurs in the premenstrual phase."
- Digestive and urinary problems: This can involve constipation or diarrhea. With urinary problems, you may often feel the urge to go to the bathroom. Sometimes there is blood in the urine, and it burns when urinating.
- Chronic Fatigue: You suffer from great fatigue during the premenstrual period or menstruation that affects your daily life and quality of life.
Women with endometriosis often have difficulty becoming pregnant. In fact, many women do not know the cause of endometriosis and only discover it by chance after tests conducted due to fertility issues.
In France, the disease is diagnosed on average with a delay of 5 years. This can lead to significant damage to the affected organs. It is therefore important to see a doctor as soon as the first suspicious signs appear.
The diagnosis is made using an ultrasound examination. An MRI may also be necessary to confirm the results of an initial gynecological examination. Sometimes a laparoscopy is also required, a surgical technique in which a tiny camera is used to look inside the organs. This is usually performed for curative purposes.
What treatment methods are available for the cure of endometriosis?
Endometriosis is a chronic recurring disease that unfortunately cannot yet be completely cured. Usually, hormonal and palliative treatment is applied. It aims to "block" the menstrual cycle. In this way, the bleeding and pain caused by the lesions that occur during menstruation are stopped. As a hormonal treatment, the continuous intake of a contraceptive pill or the insertion of a spiral that continuously releases hormones may be considered.
It was also found that endometriosis decreases and eventually disappears in most cases with menopause. There are various methods to induce artificial menopause in patients to reduce or eliminate their suffering. GnRH analogs are injected, usually combined with a small dose of estrogen, to minimize the side effects of menopause (hot flashes, dry skin, etc.).
Finally, an operation can also be planned if contraceptives and other hormonal treatments do not work. This involves the removal of the lesions using laser or electrical methods. Although the pain disappears afterwards, most patients experience recurrences. Therefore, it is often sensible to continue hormone treatment to prevent the reappearance of abnormal tissue. As a last resort, a hysterectomy can be performed on women over 45 years old who have already undergone all treatments and surgeries unsuccessfully.
