What is Endometriosis?
Endometriosis is a painful condition in which the endometrium tissue grows outside of the uterus instead of inside it. The condition most commonly affects the ovaries, the tissue lining the pelvis and the Fallopian tubes. In rare cases, endometrial tissue can spread outside the pelvic organs. The dislodged endometrial tissue continues to thicken, fall apart and shed with every monthly cycle. However, the displaced tissue can’t find a way to leave the body, so it gets trapped. When endometriosis affects the ovaries, cysts called endometriomas can develop. Surrounding tissue can become irritated, eventually developing adhesions and scar tissue.
Stages of Endometriosis
There are four types or stages of endometriosis, ranging from minimal to severe. There are various factors that classify each stage, including the number, size, depth and location of the endometrial implants.
Minimal (Stage 1) – a few endometrial implants on the membrane that lines the abdomen
Mild (Stage 2) – implants and cysts on the ovaries, which can break and spread to the pelvic cavity
Moderate (Stage 3) – implants are deep within the pelvic lining, potentially involving the uterus
Severe (Stage 4) – deep implants in the pelvic cavity as well as outside of it. It may spread to the bowels, the appendix, the diaphragm, the heart and lungs. The implants may even spread to the patient’s brain
Symptoms of Endometriosis
Irregular Menstrual Cycles
Complications from Endometriosis
Unfortunately, infertility is a potential complication. After ovulation, the fallopian tubes pick up the egg, but endometriosis distorts the tubes so they are unable to. The condition also causes inflammation that affect the reproductive organs.
Risk Factors for Endometriosis
However, there are other possible conditions that physicians have identified that may also contribute. Endometriosis can affect anyone, but there are some factors that can make some people more likely to develop it than others. For example, age is a risk factor. Most commonly, patients are diagnosed in their 30s or 40s.
If a patient has retrograde menstruation, some of the menstrual blood and tissue enters the fallopian tubes and into the pelvis, instead of leaving the body.
Estrogen is the hormone that may cause endometriosis. Researchers suggest that patients with endometriosis may have a hormonal imbalance that causes the endometrium tissues to grow outside the uterus.
According to studies, a developing fetus can have endometriosis. However, researchers think that the symptoms do not activate until puberty, triggered by shifting estrogen levels.
Embryonic Cell Growth
There are two different types of stem cells: adult and embryonic. According to studies, there are embryonic stem cells in the endometrium that turn into endometrial tissue if a patient has retrograde menstruation.
Abdominal wall endometriosis is a rare form of the condition. But researchers hypothesize that a patient can develop endometriosis after a surgical procedure, such as a C-section.
According to research, issues with immune system function can cause menstrual tissue to become displaced and fail to produce anti inflammatory substances to stop the inflammation.
There could be a hereditary factor. A woman is more likely to have endometriosis if a relative also has the condition.
Physicians conclude that if a patient has less than 27 days between each menstrual period or if the period lasts for more than seven days, the cycle is labeled abnormal. Each menstruation increases the risk for endometriosis, so an abnormal menstruation puts the patient at a higher risk.
Endometriosis symptoms may be similar to other disorders, such as pelvic inflammatory disease and ovarian cysts. Patients will need an accurate medical diagnosis to treat the symptoms. First, the physician will take note of the patient’s family or personal history of endometriosis and their symptoms. The doctor may perform a general health evaluation to find out if the patient has signs of another disorder. If the symptoms do not match with any other condition, the doctor will perform a diagnostic test.
The best way to identify endometriosis is by looking at it directly, using a minor procedure called laparoscopy. A laparoscopy allows the doctor to insert a camera into the stomach through the belly button to observe the abdomen. Then the doctor can collect a sample of tissue.
Imaging exams, such as an ultrasound or transvaginal ultrasound, can also help a doctor identify signs of endometriosis. Both methods produce pictures of the reproductive system. They may help the doctor detect cysts linked to endometriosis.
Treatment for Endometriosis Symptoms
Currently, there is no cure for this condition. However, there are various treatments that may help relieve the symptoms and manage pain.
Patients can try prescription medications for treating painful menses or over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs).
A doctor may also prescribe medications that reduce the amount of estrogen the body produces. There are hormonal treatments that can stop or significantly reduce menstruation. This can reduce inflammation and decrease the risk of developing ovarian cysts and scars. For example, oral contraceptives that contain progestin and estrogen can help manage pain. A doctor may also prescribe GnRH agonists that induce the patient to a temporary state similar to menopause.
This is a more recent form of hormone therapy treatment. Aromatase inhibitors block aromatase, a chemical that increases estrogen production in the body. As opposed to oral contraceptives and GnRH medication, aromatase inhibitors do not suppress ovarian estrogen. Rather, they only suppress extra-ovarian estrogen synthesis. According to research, this makes the medication particularly useful for postmenopausal women.
If a patient suffers from severe symptoms, a doctor may recommend surgery to remove or eliminate endometrial growths without destroying the reproductive organs.
This diagnostic procedure can also double as a surgical treatment. After the doctor diagnoses the condition, they can get rid of the endometrial tissue in the same procedure. The surgeon makes small incisions in the abdomen to remove the growths or destroy them with heat and reseal the blood vessels.
Home Remedies for Endometriosis
There are several different alternative and complementary treatment options, including acupuncture, herbal medicine and chiropractic methods. However, there is limited evidence to prove that these treatments work and to what extent. Patients must work to finding a pain management system that works for them.
In a 2010 study, researchers discovered that gently massaging the pelvic region—the abdomen, back and sides—helped reduce menstrual pain linked to endometriosis. Massaging this area immediately before menstruation starts may help make it a lot more comfortable.
Regular exercise releases endorphins, “feel good” hormones that can relieve pain. It may also help reduce the body’s estrogen levels and improve symptoms. Stretching before and after every workout can help, as well as support the body in exercise.
Supplements for Pain and Reproductive Health
Supplements, including herbal ones, may be able to help relieve symptoms and promote reproductive health. However, research is scarce so it’s essential to talk to a doctor before using herbal supplements. They are not an acceptable medicinal treatment, although they can benefit a patient’s health.
N-Acetyl L-Cysteine (NAC)
Pine Bark Extract
The Bottom Line
Endometriosis is a painful condition that causes the tissue that normally grows within the uterus to form outside of it. Because this excess tissue still responds to hormonal triggers, during the menstrual cycle it builds up and sheds as uterine lining is supposed to. However, because it forms outside of the uterus, it gets trapped and causes extremely severe pain. Those who have not experienced the condition commonly misunderstand the pain and assume it is just “bad cramps.” However, endometriosis pain can be very intense . If you are experiencing severe pain around the menstrual cycle seek medical advice to express any concerns.
The condition may also cause irregular menstrual cycles, digestive problems and even infertility in some cases. There is no identifiable cause for endometriosis, but risk factors include genetics, surgical scarring and embryonic stem cell growth. Thankfully, there are several forms of treatment, including simple home remedies such as exercise, massage therapy, stress management or heat for pain management. Patients may also find relief from pain medication and hormone therapy. However, the only way to completely prevent symptoms from returning is a hysterectomy, a procedure that removes the uterus. It is a very common and safe procedure.
Patients can also try supplements that can support overall female reproductive health and reduce inflammation in the body. Before trying any supplement, speak to a doctor and consider the potential side effects and drug interactions if the patient has any underlying or untreated medical conditions. Supplements are not a replacement for any medical condition, although they may have a positive effect on overall health.