Endometriosis | Symptoms | Effects | Causes | Factors | Seriousness | Diagnosis | Is it Curable? | Life with Endometriosis
A woman’s reproductive organs are sensitive enough to cause several painful and complex medical issues. The system, that mainly involves uterus, ovaries, eggs and menstrual blood, requires following the adequate natural procedure in which everything remains in its place to function properly.
When tissues that form the lining of the uterus also happen to grow in parts outside the uterus then it results in endometriosis. It might not cause pain or discomfort initially but the addition of tissues placed in inappropriate places intensely disturbs the menstrual cycle. Not only this, but endometriosis also causes infertility problems in some cases due to the added tissues between uterus and ovaries.
What is endometriosis?
Endometriosis is the result of the disturbance caused when the tissues similar to the lining of the uterus grow on the outside of it. The tissue can form on the ovaries, pelvis lining, and bowel.
The lining of the uterus is known as endometrium and hence, when the endometrial tissues grow outside of the uterus, the condition is called endometriosis. Endometriosis is often quite painful in later stages, especially during menstruation. The reason for this is that when the tissues grow in the passage between the uterus and cervix, it stops the menstruation blood to flow out of the vagina.
As a result, the blood sometimes makes its way through the fallopian tube to the ovaries. Also, during menstruation, the endometrium tissues thicken and break down due to the pressure which causes immense pain in the abdominal area.
Although the symptoms of endometriosis are common for women to experience during menstruation, the only difference is that the pain and discomfort in endometriosis are much severe. However, if a woman is suffering from endometriosis then it is almost impossible to not consult a specialist because the pain becomes unbearable at some point. This is probably the only way to self-diagnose endometriosis by analyzing the symptoms and its severity. Therefore, it is vital to visit a doctor who will run some tests and prescribe medicines.
Immense period pain
Period pain is very common that starts from the back to the abdominal area and for some women, it is normally very harsh. However, in endometriosis, the intensity of the same pain grows to an extent that it causes hindrance in doing routine work. Also, the abdominal cramps and lower back pain make eating, sitting, and standing quite difficult for women with endometriosis.
Unbearable pre-menstruation pain
Pre-menstrual syndrome is considered to be an ordinary type of disorder as a lot of the women commonly suffer from it. At the same time, in endometriosis, pre-menstrual cramps start a week or two before the actual date of periods and are very much severe. Normally, women with endometriosis find it very hard to function properly for a major part of the month i.e. around 2-3 weeks. The cramps, pain, abnormal bowel movements, and rapidly changing hormones combine and cause greater problems like not being able to perform routine tasks.
Heavy menstrual bleeding
Menstrual bleeding is light for some women while for some, it is usually much heavier. In endometriosis, women might experience
A) Heavy bleeding
B) Intermenstrual bleeding
We all know what heavy bleeding looks like and the effects it has on a woman’s body like pain, weakness, shivering, and head spinning. Intermenstrual bleeding is the condition in which a woman experiences mild bleeding or spotting in between the periods. This happens when the uterus or cervix outgrows its usual size but is mainly pain-free. Whereas in endometriosis, intermenstrual bleeding occurs due to the growth and breaking down of endometrium tissues.
Painful sexual intercourse
A shooting pain during or after sexual intercourse is also one of the symptoms of endometriosis. The reason for this is the presence of endometrium tissues outside of the uterus that causes a great deal of discomfort.
What happens when you have endometriosis?
The effects of endometriosis are quite harsh. As the disorder itself is not easy to bear, the impact that it has, especially on younger women/girls, is highly risky. Some of the risks related to endometriosis include:
- Becoming infertile for the time being or the rest of their lives
- Start of periods at an early age from around 8-10
- Delay in menopause
- Brief duration of the menstrual cycle i.e. less than 27 days
- Heavy menstrual bleeding lasting for more than 10 days
- Lower BMI due to the abnormal functioning in the body
- Passing it on to coming generations like daughter or granddaughter
- Abnormal menstruation flow
- Temporary or permanent defects in the reproductive organs
Causes of endometriosis are not known yet, however, there are some theories that doctors have suggested for it. The reason why it is still unidentified is probably the consequences that women face due to endometriosis. For example:
- Some women with endometriosis are unable to give birth for life while some’s fertility remains uninfluenced by it.
- Some women experience heavy bleeding because of endometriosis while some have normal menstrual flow.
Below are mentioned are some of the theories that doctors have expressed as possible causes of endometriosis.
Retrograde menstruation is the case when the menstrual blood consisting of endometrial tissues flows back into the fallopian tubes instead of escaping through the vagina. The blood either stays on the pelvic organs or its walls. This results in the growing and thickening of the cells which eventually leads to additional bleeding during menstruation.
Immune system disorder
The purpose of the immune system is to prevent the body from all types of infections and abnormalities that are a result of irregular functioning. However, whenever there is an immune system disorder in a woman’s body, it does not let the immunity perform effectively. This means that the immune system, that should destroy the tissue similar to endometrial, is unable to do it. As a result of this, the cells grow, thicken, break down, and eventually bleed.
Factors leading to endometriosis
According to a recent study in the US, women of ages around 25-40, that are also in the stages of child-bearing, are mostly like to have endometriosis. This proves that the condition usually occurs some years after the start of the menstrual cycle. In addition to this, some factors are commonly known for triggering endometriosis, some of which include:
Women who are in their late 20s to those who have reached their early 40s have greater chances of developing this condition. However, in some cases, girls who have just hit puberty might also experience endometriosis.
A family history of one or more women, like a sister, mother or aunt, with endometriosis is one of the leading factors of causing endometriosis.
- Delayed pregnancy:
Women who have never gotten pregnant at all or those who bear their first child in the late 30s or early 40s might experience endometriosis because of the disturbed natural hormonal system.
- Abnormal menstrual history:
Young girls who have had a history of abnormal periods like heavy bleeding or short menstrual cycles might develop endometriosis in later years.
How serious is endometriosis?
Endometriosis is a very sensitive condition that holds the capability of damaging a normal lifestyle to creating some highly risky problems for women like the inability to conceive. If ignored or left untreated, it can turn into something as dangerous as cancer because the abnormal hormonal changes and formation of endometrial-like-tissues in the pelvis together make it difficult for a woman to happily survive with the condition.
Although a severe case of endometriosis might lead to ovarian cancer in some rare cases, the chances of its occurrences are still very low. Ovarian cancer is not a common type of cancer which is the reason why the risk of having it, because of endometriosis, is poor. Also, endometriosis-associated adenocarcinoma is another form of cancer that endometriosis might lead to but then again, it is quite rare to happen.
Infertility is not life-threatening but it is as damaging as any other critical medical condition. Women with infertility not only go through immense emotional, mental, and physical pain but also suffer from complexities caused by it, like endometriosis. For someone with the condition, it might be either too difficult to conceive at all or require some painful and expensive treatments. However, there are a lot of women who naturally conceive while having mild endometriosis but it all depends on every individual’s hormones and menstrual history.
The diagnosis of endometriosis holds no less importance than treating a fatal condition. As stated earlier, the symptoms of endometriosis are also common to occur in other cases like an ovarian cyst or pelvic disorders. However, when all of the mentioned factors combine like symptoms, age, and family history, etc. then it is important to visit a specialist. A doctor runs some tests and physical examination to observe the severity of the condition and prescribe treatment accordingly.
The first thing a doctor does for the diagnosis of endometriosis is taking the family history while also noting down the symptoms. This way, it helps a lot in deciding if there is a need for some tests or just the meds will treat the problem.
Most women dread the physical examination as it involves performing the pelvic exam that is slightly painful or uncomfortable, to be precise. The doctor feels the inside of the cervix and uterus to know if there are endometrial tissues present that are causing the endometriosis symptoms.
For endometriosis, either transvaginal or abdominal ultrasound is done to check for the additional tissues in the pelvis area. Because of this, the doctor can see a clear picture of what is happening inside the vagina or behind the uterus. Whether it is a cyst or the presence of endometrial tissues, the ultrasound helps identify the main cause of the symptoms.
Laparoscopy is more of a treatment than a diagnosis. It is a method of diagnosing endometriosis with total conformation while also removing the tissues in the same procedure. It is a minor and pain-free surgery but a doctor uses it after the patient goes through all the other practices that do not lead to anything significantly benefitting.
Can endometriosis be cured?
If someone is looking for safer options for the treatment of endometriosis then it is not getting rid of it completely but managing the symptoms. The condition is incurable but its intensity gets more and more severe if left untreated. Other than this, it is also possible to eliminate this condition from the body but the consequences are much harder to survive with.
This is the safest way to opt for if a woman with endometriosis wants to avoid complicated medical procedures. The over-the-counter pain meds are easily available anywhere but those might not work for some due to the greater intensity and frequency of the disorder.
Hormonal therapy is taking the medication that plays with your naturally abnormal hormonal activities. The purpose of these medicines is to regulate the hormonal changes and stop endometrial tissues from forming or growing outside of the uterus.
The contraceptives used for hormones to function in a certain way that prevents pregnancy is also another possible treatment for endometriosis. Whether it is the pills, chip, or vaginal ring, the purpose of contraceptives for endometriosis is to keep a check and balance on the formation and progression of endometrial tissues.
Doctors prescribe a medicine named Danazol, a hormonal drug that works in 2 ways
- Shrinking the endometrium tissues in the pelvis area
- Stopping the menstruation for a month or two to reduce the symptoms
However, danazol does not completely treat endometriosis, instead, it just helps to manage the symptoms for the time being.
The main purpose of surgery for treating endometriosis is to remove the endometrial tissues via a safe procedure known as laparoscopy. It is a minor surgery with effects of laser and usually used in cases when all the other methods fail for women who are trying to conceive.
Hysterectomy is the latter option when all the other ways of treatment fail. Doctors don’t usually prefer using this method unless the severity of the disease becomes uncontrollable. In this surgery, they remove the uterus, cervix, and ovaries to stop the production of estrogen which is responsible for the growth of endometrial tissues.
How tough is it to live with endometriosis?
Endometriosis cannot be seen; it is rather felt. The pain, depression, discomfort, crankiness, weight gain on the abdominal area, heavy bleeding, weakness, shivering, less control on the bladder, all of these issues combined make it a lot more difficult to live a normal life. Most women also tend to neglect the symptoms considering them to be normal pre and post menstruation.
Nevertheless, it only complicates the issues and these women are left with no other option later than opting for major surgery. Not being able to function properly for 2-3 weeks a month not only disturbs personal but professional life also.
What happens if endometriosis is left untreated?
If left untreated, endometriosis can result in permanent infertility or reduced chances of fertility. Also, the pelvic and abdominal pain might not leave even after menstruation as the tissues remain on the cervix and bowel. Moreover, things might complicate in later years to the extent that there is no other option left other than a hysterectomy.
Can endometriosis cause weight gain?
Yes, endometriosis might cause weight gain but it does not necessarily happen to every woman. The weight gain is usually on the abdominal area because of the added tissues as they first grow and thicken and then break down. Also, most of the medicines for endometriosis are hormonal which further explains the reasons for weight gain because disturbed hormones do that to the body.
Can you have a baby if you have endometriosis?
Yes, women with mild to moderate endometriosis can have a baby but they may have difficulty conceiving as compared to women without the condition. Moreover, women who conceive with endometriosis are at higher risks during pregnancy because of the abnormal activity in the pelvic area. For some women, the condition might get worse in pregnancy because of the uterus expansion. For this reason, a strict medical check and balance are required to be kept to carry a full-term baby and deliver without complications.
Can endometriosis turn into cancer?
There is no proof as of now that endometriosis puts women at higher risks of developing cancer. Yes, there have been cases in which women with endometriosis are diagnosed with ovarian or endometrioid ovarian but that very rare to happen as the condition is directly not related to the causes of cancer. Still, doctors suggest examining women with endometriosis every once in a while, for cancer to remain proactive.