Understanding Endometriosis

It's a condition that effects one in ten women- so why do we still not know a whole lot about endometriosis?

My whole thought process for this post came about a few months ago when my doctor brought it up in conversation and the only real knowledge I had on the condition had come from social media posts published by owner of fashion boutique Sabo Skirt, Thessy Kouzoukas when she would talk aboutg about how debilitating endo is for her. I'm sure that many other women are in the same boat, we've heard of endometriosis and we know it exists but we don't know all that much more about it. Which is why I wrote this post, to educate you on something that is so important for us to be educated about, we do need to know what endo is and we do need to know how too look out for any signs, not only in ourselves but in the ladies around us.

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image from here

I did a lot of research into this topic, I really wanted to give you as much information as possible and allow us all an insight into endo. I really feel that women need to be educated so much more on this than we are, so let us get right too it.

First off what is endometriosis? To understand the disease we must first have some kind of an understanding of the uterus. The lining of the uterus is called the endometrium, its tissue like layer that serves as the "wallpaper" of the uterus if you will, it is such an important part of the menstrual cycle and pregnancy. In fact, when you get your period every month, what is leaving the body is actually the endometrium. So, when endometriosis occurs- cells that are almost replicas of the endometrium have been misplaced in the body, they have occurred in places out side of the uterus (where they are not supposed to be). These cells can be misplaced to areas such as the ovaries, the bowels and sometimes even the lungs. As I said these cells are almost that of a replica of the endometrium which also means that they bleed as well, except when these cells bleed, this blood has no where to go- this causes inflammation and pain and ultimately can cause scar tissue.

The symptoms of endometriosis can often be attributed to other causes, meaning it can be difficult to come to the conclusion of endometriosis. In so many of the stories I read and YouTube videos I watched girls didn't do anything about their symptoms because they just assumed that what they were experiencing was normal. Also something that became a recurring theme in the experiences I read- girls had a hard time convincing their doctors that something was wrong, so this is the part where I jump in and say that if your gut is telling you something is wrong, but your doctor is saying different, go to a different doctor, go with your gut.

Endometriosis cause a lot of pain, in fact almost every listed symptom is pain of some kind. The first that I just quickly want to touch on is period pain. The reason I want to talk about it is because period pain isn't normal, I know that since the first time you found blood on your undies it has just been assumed that period pain just comes along with Aunt Flo, but period pain- it isn't normal, your period should not be painful to the point that you are physically sick, or that you pass out, or that you cannot move from your bed. Other pain symptoms include pain with intercourse, pelvic pain, ovulation pain, pain when using your bowels, pain when urinating, pain in the lower back and thighs, pain. pain. pain. While all these symptoms are pain. all. the. time- it is actually possible to have endo with no pain at all. Other symptoms include infertility or reduced fertility, nausea and lethargy and premenstrual symptoms.

From many of the stories I read the women cannot remember a period that wasn't extremely painful, from the early teen years when you get your period to your very last period they are painful. Many stories were very similar in the fact that birth control pills do help- but only for a certain amount of time, as soon as you come off those birth control pills that is the end of little pain. Many women also said they had shorter cycles but longer periods.

There is no definitive cause of endometriosis, meaning it is VERY hard to prevent the condition. While there is no proven cause, there is a few different ideas floating around the internet as to why endometriosis happens. Have you heard of retrograde menstruation or "backward menstruation"? No? I hadn't either until I was researching for this post. Apparently it is when you get your period and the fluid, instead of taking the nearest exit- flows back into the Fallopian tubes. From here, because the Fallopian tubes are open ended the fluid has the ability to travel into the pelvic cavity. The theory that I read basically said that endometrial tissue in this fluid that is leaking into the pelvic cavity sticks to whatever structure is lands on and well-ah cells begin to grow. The catch to this theory is that this retrograde menstruation occurs in almost all women and yet only around 10% of women actually have endometriosis.

Another theory that I read was all about the immune system- it fails women with endometriosis by allowing this endometrial tissues to grow anywhere outside of the uterus. It has also been proven that genetics and family history play a part in the development of endo- with women who have a close relative with the condition being seven to ten times more likely to also it. Exposure to toxins and pollutants is another theory as to why endometriosis develops.

There is currently no cure for endometriosis, there is ways to reduce your chances of recurrence but nothing to completely stop the condition. In mild cases of endo there is the possibility of simply observing the condition with no medical intervention. In these cases the pain is usually managed by non-steroidal anti-inflammatory medication like ibuprofen.
Hormone treatment is a method that I read up on in quite a few cases. Due to the cells being sensitive to hormones there is few different types that can be useful in having an effect on the condition, but like most things in life they do come with their side effects. Progestins are synthetic progesterone like hormones that can be used to suppress the growth of these misplaced cells. Side effects of this synthetic hormone can include wight gain, tender breasts, acne, depression, mood swings and fatigue, nausea, vomiting. Another hormone that can be used to inhibit the growth of these cells is GnRH (gonadotrophin releasing hormone) agonists. These are the brain hormones that have control over the release of other hormones throughout the body including the ovaries. The side effects of this one include menopausal symptoms (hot flushes, dry vagina, night sweats, bone thinning, loss of libido ect) However these side effects can be relieved with oestrogen.

There is only one way to really diagnose endo and that is through surgery which is my next point of discussion. Laparoscopic surgery is keyhole surgery in which a laparoscope (small telescope tool) is inserted into the abdominal cavity- this method is both used for diagnosis and for treatment. During this surgery it is possible to have any cysts and adhesion's cut or burnt out. A laparotomy is a major surgery- this is when a major cut is created in the abdomen and again cysts and adhesion's can be cut or burnt out. Should the cells occur on the wall of the bowel- bowel surgery would be required. In major cases a hysterectomy can be required- that involves the removal of the uterus. This is usually only even considered if endo is really having an impact on the persons way of life and no other treatment has taken. However the chances of recurrence without ovaries is still only at 50%, an no ovaries would mean you're straight into the hormone treatments due to menopause.

Of course there are the alternative medicine methods that have varying results from person to person, but can be quite effective in some cases. Herbal medicine, Chinese medicine, nutritional therapies and acupuncture/ physiotherapy can see some great results for women suffering with endo.

In most cases it is a combination of all the different treatments that is the most effective.

If you are getting period pain that is seriously impacting on your life- I'm talking you have to take time off school or work, your normal Panadol or Neurophen isn't working- if you are seriously suffering every time Aunt Flo comes to visit, don't let someone tell you "you just have bad periods", if you truly know that something isn't right- push further.