Endometriosis is a condition that affects so many people with uteruses — yet, very few are aware of the condition and its symptoms until themselves or someone close to them is diagnosed. Since March marks Endometriosis Awareness Month, our team wants to highlight and raise awareness by breaking down the symptoms & causes, how it can affect fertility, and why it's important to be aware of Endometriosis. We do the best with the knowledge we have and it's important to learn and be proactive about our health.
What is Endometriosis?
Endometriosis is a disorder that causes the tissue that normally lines the inside of your uterus to grow on the outside. This tissue can be found covering the ovaries, fallopian tubes, or anything lining your pelvis — in rare cases, it can cover the intestines. Because of this, Endometriosis can be painful to experience, especially during the menstrual cycle.
33% of people with uteruses aren't familiar with Endometriosis while 45% know, generally, what the condition is, but can’t name the symptoms. So many people with uteruses (especially those with irregular periods) who experience severe pain don’t even realize that they could be experiencing symptoms that point to the early stages of Endometriosis.
As it currently stands, there is no known cure for Endometriosis — however, there are a litany of treatments, depending on stage and severity of symptoms, such as surgery, medications, and other procedures that can weaken the symptoms of the condition.
How Do I Know I Have Endometriosis?
We want to note: if you believe you could be experiencing symptoms of Endometriosis, the first step is to get in contact with your Primary Care Physician, your Gynecologist, or your OB-GYN to run tests.
- Painful periods (dysmenorrhea). Pelvic pain and cramping may begin before and extend several days into a menstrual period. You may also have lower back and abdominal pain.
- Pain with intercourse. Pain during or after sex is common with Endometriosis.
- Pain with bowel movements or urination. You're most likely to experience these symptoms during a menstrual period.
- Excessive bleeding. You may experience occasional heavy menstrual periods or bleeding between periods (intermenstrual bleeding).
- Infertility. Sometimes, Endometriosis is first diagnosed in those seeking treatment for infertility.
- Other signs and symptoms: you may experience fatigue, diarrhea, constipation, and bloating or nausea -- especially during menstrual periods.
While pain is clearly a major symptom, it may not be a clear indicator for how advanced your endometriosis is — some patients with advanced Endometriosis experience mild pain, and conversely, some with mild Endometriosis may experience severe pain.
This is just one of the reasons it's highly recommended that you visit your Gynecologist or Primary Care Physician if you are experiencing any of these symptoms. An early diagnosis can make a huge difference in your treatment process.
It’s still not clear what exactly causes Endometriosis, however, these are some phenomenons that medical professionals believe may be linked to an Endometriosis diagnosis.
- Retrograde menstruation. In retrograde menstruation, menstrual blood containing Endometrial cells flows back through the fallopian tubes and into the pelvic cavity instead of out of the body. These endometrial cells stick to the pelvic walls and surfaces of pelvic organs, where they grow and continue to thicken and bleed over the course of each menstrual cycle.
- Transformation of peritoneal cells. In what's known as the "induction theory," experts propose that hormones or immune factors promote transformation of peritoneal cells — cells that line the inner side of your abdomen — into Endometrial-like cells.
- Embryonic cell transformation. Hormones such as estrogen may transform embryonic cells — cells in the earliest stages of development — into Endometrial-like cell implants during puberty.
- Surgical scar implantation. After a surgery, such as a hysterectomy or C-section, Endometrial cells may attach to a surgical incision.
- Endometrial cell transport. The blood vessels or tissue fluid (lymphatic) system may transport Endometrial cells to other parts of the body.
- Immune system disorder. A problem with the immune system may make the body unable to recognize and destroy Endometrial-like tissue that's growing outside the uterus.
There are a few risk factors when it comes to untreated Endometriosis. Out of the list, the two most often referenced are infertility and cancer.
As we know, pregnancy occurs when the egg travels down the fallopian tube to get fertilized by sperm in the uterus. With Endometriosis, the condition could block the fallopian tube with the extra tissue growth around the lining — therefore, preventing the egg from reaching the sperm waiting in the uterus. It’s important to note that this only occurs in the very late stages of Endometriosis — many with Endometriosis, especially when caught earlier, are fully able to carry a baby to term.
Doctors advise that women with mild Endometriosis have a talk with their fertility team (Gynecologist, OB-GYN, Midwife, etc.) about family planning. Some many recommend that those who wish to have children think about starting the "trying to conceive" process earlier, as their Endometriosis can cut their child-bearing years shorter than average.
Another risk factor associated with untreated Endometriosis is the potential to develop ovarian cancer. While normally, the risk of getting ovarian cancer in a lifetime is pretty low, studies may suggest that Endometriosis can increase chances of developing ovarian cancer when left untreated. It's so important to be proactive about your health, and to bring up any concerns (including pertinent family medical history) with your health care team.
The purpose of Endometriosis Awareness Month is to educate the general public on what the condition is and what to look out for — not to stoke anxiety surrounding Endometrosis. Your health care team can answer further questions or concerns you many have — they're your best resource when it comes to proactivity and information.