What is Endometriosis? Symptoms, Causes & Treatment

Endometriosis is a disorder that affects many women; however, little is understood about it. In fact, endometriosis is so little spoken about that it takes time for most women to discover that they have it. Here, we will discuss what endometriosis is, how to test for it, what the symptoms of endometriosis are, how common the disease is, and more.

What is endometriosis?

Endometriosis is characterized as an often painful disorder when the type of tissue that lines the uterus begins growing outside of the uterus. This tissue will most often grow over the ovaries, fallopian tubes, and tissue lining the pelvis.

Endometrial tissue responds to estrogen and progesterone by thickening and bleeding with every menstrual cycle. However, as this tissue cannot exit the body, it gets trapped and most often causes cysts, or ‘endometriomas.’

In severe cases, the endometrial tissue can spread to other organs in the body. When this happens, scar tissue, adhesions, and fibrous tissue can develop, which causes organs and pelvic tissue to fuse together. Eventually, this can lead to infertility and inevitable surgery for many women.

The stages of endometriosis

There are four stages of endometriosis with symptoms including the following:

Stage I

Characterized by small lesions or wounds and thin endometrial tissue growing on the ovaries as well as inflammation in the pelvic area.

Stage II

More ‘implants’ are formed in this stage covering the ovaries and pelvic lining, and some scar tissue may begin to develop.

Stage III

At this stage, there are many deep implants, and cysts may begin to form on the ovaries. The scar tissue will have also thickened at this point and formed adhesions.

Stage IV

This stage is categorized as ‘severe.’ At this point, there are deep implants on the pelvic lining and ovaries. There will also be extensive scar tissue and lesions on the fallopian tubes and perhaps even other organs at this stage.

Bear in mind that endometriosis may look different for each individual at different stages. The severity of endometrial tissue and the rate of change will depend on the individual.

What causes endometriosis?

The precise cause of endometriosis is currently unknown. However, there are several theories on what may cause the disorder:

Retrograde menstruation

This is one of the oldest theories regarding what causes endometriosis. It’s the theory that endometriosis develops when menstrual blood flows back out the fallopian tubes into the abdominal cavity instead of the normal way through the vagina. While many women will experience retrograde menstruation, only a few will have endometriosis. Some theorize this comes from differences in immune systems.

It’s hormones

Another idea is that the hormone changes in the body can sometimes transform the cells outside the uterus to produce cells and tissues similar to those inside the uterus. These are labeled ‘endometrial cells.’

Spreads from surgery

It is thought that sometimes endometriosis can spread because of surgery. For instance, in the case of a c-section, endometriosis cells can attach to the incision site.

It’s the lymphatic system

Another theory is that endometriosis occurs due to an immune deficiency which causes endometrial cells to be transported out of the uterus through the lymphatic system.

Mullerian Theory

Also known as ‘uterovaginal embryogenesis,’ this is the theory that endometriosis starts in the unborn fetus. It states that as the fetus develops, cell tissue meant to respond to puberty hormones gets misplaced.

Environmental toxins/genetics

It has been theorized that genetics, environmental toxins, or both may be linked to the cause of endometriosis.

Many of these theories are highly debated, and up to date, none have been scientifically proven.

What are the symptoms of Endometriosis?

Endometriosis will vary from woman to woman. Some will experience intense pain during their menstrual cycle, and others may not experience any abnormal period pain nor typical symptoms. Here are the common symptoms of endometriosis you should know about:

• Lower abdominal pain
• Intense pain with periods
• Pain during intercourse
• Difficulty becoming pregnant
• Bowel and bladder issues
• Blood in the urine
• Abnormal vaginal bleeding
• Bloating and/or constipation

The most common symptom women with endometriosis report is the high level of pain surrounding their monthly menstrual cycle. Scar tissue can also develop in the pelvic area, causing cysts and irritation which further contribute to the pain.

If you’re experiencing one or two of these symptoms or even if you aren’t experiencing symptoms but something doesn’t seem right to you, consult your gynecologist right away. Be sure to voice your concerns about endometriosis.

How common is Endometriosis?

It’s estimated that endometriosis affects 3%-10% of reproductive-aged women, therefore this condition is common. If you do have this disorder, you’re not alone. There are even support groups for women with endometriosis.

How to test for Endometriosis

It is extremely hard to diagnose endometriosis; that’s why it’s an ‘invisible disease’. Those who have it can seem perfectly healthy but can be suffering from so much internal pain. Currently, the only sure way to know if someone has it is by opening up the stomach through surgery. Here are ways to test for endometriosis:

Laparoscopy

This is surgery where a doctor looks in the abdomen through an incision in the belly button. A camera is inserted for the doctor to check if the body has developed endometriosis. During this procedure, samples are taken of any abnormalities and lesions the doctor finds. Endometriosis lesions are often described by medical professionals as looking like cigarette burns, however, there are many ways a lesion can look inside the abdomen.

Annual physical

During your annual gynecological exam (or primary care exam), the doctor conducts a pelvic exam where they can feel for large cysts or scar tissue around the uterus.

Ultrasound

To test for endometriosis, the doctor may conduct either a vaginal or abdominal ultrasound to take photos of reproductive organs. This helps to identify if there are any cysts on those organs that may be the result of endometriosis.

MRI

An MRI or magnetic resonance imaging is another way to take images of reproductive organs and look for cysts or lesions.

Hormones

Particularly in women suffering from intense pain, a doctor may prescribe birth control pills or medicine that lowers hormone levels in the body. After taking these, if the pain substantially subsides, it could mean the woman has endometriosis (as endometrial tissue responds to hormones).

Family history

Genetics may be an indicator as to whether someone has endometriosis. Doctors might want to look at family history records or ask questions about whether any relatives had similar issues to detect if you have endometriosis.

It’s important to note that endometriosis symptoms look very similar to other health issues like ovarian cysts and pelvic inflammatory disease. Ensuring you get the correct diagnosis is important for treating endometriosis properly.

How to treat Endometriosis

Treatment for endometriosis will largely depend on how far along a woman is with the disease. Earlier stages may only require medication, while later stages could mean surgery. Here are the common ways to treat endometriosis:

Medication

Endometriosis can be treated and symptoms alleviated with the use of medications such as:

• Ibuprofen
• Non-steroidal anti-inflammatory medicine
• Birth control pills and other contraceptives

Surgery

In addition to helping diagnose endometriosis, through surgery, doctors can go in and remove some of the built-up endometrial tissue and scar tissue on the ovaries and uterus. They can also burn off any lesions. This is said to alleviate much of the pain caused by endometriosis and is a good option for women hoping to become pregnant.

Hormone therapy

Supplemental hormones prescribed by a doctor can aid in relieving pain from endometriosis and slow down its progression in the body. Contraceptives such as birth control, patches, and vaginal rings also fall into this category.

Gonadotropin releasing hormone (GnRH)

This is a medication that blocks the production of estrogen which helps cut down on the creation of endometrial tissue in the female body. However, the side effect with this is that it halts menstruation—creating an artificial menopause. It also can induce vaginal dryness and hot flashes, but taking small, controlled doses of estrogen and progesterone can help to prevent these symptoms.

Danazol

This is another type of medicine that stops menstruation in order to reduce endometriosis symptoms. Its side effects include acne and abnormal hair growth on the face and body.

Hysterectomy

As a last resort, the doctor may recommend a hysterectomy, which is the removal of the uterus. When all other treatment options have failed, the doctor may resort to surgically removing the uterus, cervix, and ovaries. Any implant lesions found growing will also be removed.

A hysterectomy will render a woman unfertile afterward. So, before agreeing to such a surgery be sure to get a second opinion from other doctors if this is the first option presented to you.

No cure has been found yet for endometriosis, but it can be treated with the above options.

Can you get pregnant with Endometriosis?

The short answer to this question is yes. However, it’s important to note that for some women, endometriosis may render them infertile. Between 20% and 40% of women with infertility have endometriosis. Here are some theories on how endometriosis affects fertility:

• Distorting the fallopian tubes so the egg can’t properly pass through after ovulation.
• Creating so much inflammation that the ovary, egg, fallopian tubes, uterus, or a combination of these organs can’t carry out its reproductive functioning.
• Endometriosis tissue distorts the shape of reproductive organs so the sperm can’t find the egg as easily.
• The uterine lining where implantation happens doesn’t develop properly
• Causes the immune system to attack the embryo

Despite these complications, many women with endometriosis are able to become pregnant. If you have been diagnosed with endometriosis or if you think you exhibit the symptoms and you are trying to get pregnant then speak to your doctor right away about treatment options.

We hope this article on what is endometriosis has been educational for you in helping understand this invisible disease better and how to treat endometriosis and how to test for endometriosis. If you’re interested in MagView and Mammogram technology, please contact us here.