Endometriosis

In the past two weeks, I cannot tell you how many times I have heard someone mention in conversation “endometriosis.” I have several friends and family members who have endometriosis, so it is not an altogether unfamiliar subject to me. However, I have never given much thought to endometriosis.   So, in writing this blog entry I hope to educate both myself and my readers a bit.

To start with the root, the word endometriosis comes from the Greek words meaning “inside” and “womb.”  Remember that the endometrium is the layer lining the uterus.  Here is a diagram:

The endometrium is where the embryo implants after it has been fertilized, so it is an integral part of reproducing.  Without a healthy endometrium, an embryo is not likely to implant successfully.

Interestingly, too many endometrial cells are a bad thing, and this is what endometriosis is:  the proliferation (spread) of endometrial cells outside of the uterus, especially common on the ovaries.  These cells respond as the endometrium does to hormonal changes over the course of a menstrual cycle.  So, imagine that you have endometrial cells throughout your pelvis and not just in your uterus.  Menstrual cramps would be amplified–the pain difficult to bear.  So, if you have particularly unmanageable menstrual pain during your period, please visit your doctor.  You may have a disorder such as endometriosis.  Only investigation by a medical professional can determine the source of the pain.

It is estimated that between 5-10 percent of women are affected by endometriosis.  Its effects generally do not manifest until menarche (first menstrual cycle) and usually diminish following menopause, though not always.  A large number of women who are infertile are infertile because of endometriosis (about 20-50%).  The proportion of women with chronic pelvic pain who suffer from endometriosis is much higher (about 80%).  There seems to be an increase in incidence of endometriosis in families that affected by it.  Women with an immediate relative with endometriosis has a higher risk of having endometriosis.  There is some association between endometriosis and certain types of cancer (especially ovarian), so it is important to know if you have endometriosis or if you have another malady with similar symptoms.

Endometriosis usually appears in patches within the pelvis that are often visible to the human eye during surgery because they can appear as darkened bluish-black spots.  Here is a diagram example of endometriosis:

Not all endometriosis appears as darkened spots, so it is necessary sometime to perform biopsies to be certain.  Endometriosis causes an inflammatory response that often causes scar tissue.  This scar tissue is frequently problematic in a variety of ways, including being the cause of infertility.  The cause of endometriosis is, so far, unknown but it is believed that there is more than one possible cause.  Hopefully, further research will uncover causes that can help in management and treatment of the disease.  Symptoms, too, can vary widely across endometriosis sufferers.  Abdominal pain being the most common symptom, others include:

  • nausea, vomiting, fainting, dizzy spells
  • frequent or constant menstrual flow
  • chronic fatigue
  • heavy or long uncontrollable menstrual periods with small or large blood clots
  • mood swings
  • pain in legs and thighs
  • back pain
  • mild to extreme pain during intercourse
  • mild to severe fever
  • headaches
  • depression
  • Again, it is important to remember that other disorders can have similar symptoms to endometriosis.  It is crucial to consult a doctor if you are experiencing problems in order to accurately determine what you have.  Never rely on an “Internet diagnosis.”  This article is just scratching the surface of this topic (maybe I will write “Endometriosis:  Part 2”), so please feel free to leave comments and questions!

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    3 thoughts on “Endometriosis

    1. Something that is often overlooked about endometriosis is that sometimes the errant tissue attaches in places OTHER than the ovaries or outside of the uterus, and can, in fact, land pretty much anywhere inside the abdominal cavity, including on the intestines (which can cause symptoms like IBS) and even, as in my case, on the inside of the rib cage, very high up in the abdominal cavity, causing pain that most doctors are quick to assume was something else entirely.

      Most general practitioners (and many ob/gyns) have very little understanding of endometriosis, and when a person comes in reporting acute abdominal pain, make the rapid assumption that it MUST be something related to the digestive tract (acid reflux, ulcers, kidney stones, etc.) and when they can’t substantiate this, presume it MUST be the gallbladder, and offer to take it out when nothing else seems to account for the pain (first AND second opinion.)

      It is my advice to any female who experiences any of the symptoms of endometriosis listed above, even if the pain does not seem to be located near the reproductive organs, to get it checked out by a reputable gynecologist first, and possibly save yourself MONTHS of frustrating, often painful tests, and quite possibly unnecessary surgery and organ removal(!), as well.

    2. This is a very good point. Always remember, you are your own best advocate in the health care system. If you get a diagnosis and treatment for one thing and it isn’t improving, keep going until you get the right diagnosis. Any good physician will tell you that the medical profession is an art, not a science. Otherwise, we could all pee on a stick in our own homes to find out what is wrong. So, if you think you might have endometriosis, make sure you find out for sure and don’t just a let a doctor right you off as having something else. (It might be something else, but it might be endometriosis. The distinction is important!)

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