Endometriosis is one of the least understood female conditions.
Despite the fact that roughly 1 in 10 women of reproductive age suffers from endometriosis (equivalent to 5 million women in the United States and 176 million women worldwide) very little is known about the condition (1,2).
Worse yet, about three-quarters of these women experience pelvic pain and/or painful periods as typical symptoms of endometriosis.
What is Endometriosis?
According to WebMD: “Endometriosis occurs when tissue that should line the inside of your uterus, the endometrium, grows outside of it instead. Even though the tissue is outside of your uterus, it still acts like it should during your menstrual cycles. That means at the end of your period, this tissue will break apart and bleed.”
“However, the blood from this tissue has no place to go. Surrounding areas may become inflamed or swollen, and scar tissue and lesions can develop. The most common site for endometriosis is on your ovaries.”(3)
Doesn’t sound good, does it? And yet, millions of women suffer from the condition every day.
The Mystery of Endometriosis
Endometriosis is incredibly frustrating for women because many doctors have a hard time diagnosing it.
It’s even been called a “silent epidemic” since it takes on average 7-10 years for women to get a proper diagnosis. That’s because some symptoms can easily be mistaken for other conditions and others are more subjective (such as pain) (4).
Pelvic Pain Foundation of Australia director Dr. Susan Evans explains: “There is no area of medicine that feels completely trained to cover all the aspects of a woman with endometriosis’s care.”
Many women also believe that their symptoms are just a part of being a woman and many doctors fail to recognize them as related to endometriosis. Many patients aren’t believed by their doctors either, who often think that their patients are exaggerating or dramatizing their symptoms. This leads not only to more pain and discomfort for these women but also plenty of embarrassment and fear.
“They do the standard things to try and check that there’s not something life-threatening, they find nothing much, and unfortunately she goes home none the wiser,” Dr. Evans said.
Endometriosis isn’t straightforward, and it’s not a medical priority for researchers, leaving thousands of women and their doctors in the dark.
Researchers aren’t quite sure why endometriosis occurs, but they do have some possible causes (5):
Retrograde menstruation: when menstrual blood containing endometrial cells flows back through the fallopian tubes and into the pelvic cavity instead of out of the body. These cells then stick to the pelvic walls and pelvic organs. Every menstrual cycle, they thicken and bleed.
Hormones imbalance during puberty: estrogen especially may transform embryonic cells into abnormal endometrial cells. Other hormones can transform peritoneal cells — cells that line the inner side of your abdomen — into endometrial cells.
Surgical scar implantation: some surgeries, such as a hysterectomy or C-section can cause endometrial cells to attach themselves to the surgical incision.
Endometrial cells transport: occurs when the circulatory or lymphatic system accidentally transports endometrial cells to other parts of the body.
Immune system disorder: if your immune system doesn’t work properly, your body can’t recognize and destroy endometrial tissue growing where it shouldn’t.
On the other hand, risk factors include:
Never giving birth
Having your first pregnancy at an older age
Starting your period at an early age (before 11 yrs of age)
Going through menopause at an older age
Short menstrual cycles (less than 27 days)
Having higher levels of estrogen in your body or a greater lifetime
Low body mass index
High alcohol consumption
Family history of endometriosis
Any medical condition that prevents the normal passage of menstrual flow out of the body
8 Symptoms of Endometriosis
The following symptoms of endometriosis are typical for sufferers of endometriosis, but some women don’t experience any symptoms at all (6).
1. Severe Menstrual Cramps
While cramping is normal during menstruation, women suffering from endometriosis experience severe abdominal pain that gets worse over time. The pain may be dull, persistent, deep, burning, stabbing, grinding or gnawing. It may also be accompanied by nausea, intestinal cramping, vomiting, diarrhea, constipation or dizziness (7).
The pain may also occur in between periods as the endometrial cells swell and grow. To relieve pain, apply a heated pad, take a nice hot bath, drink dandelion tea, and reduce your salt intake.
2. Heavy Bleeding During Periods
Women all experience bleeding in different ways during their time of the month. Some may experience light spotting for a few days while other can pass clots for a full week. According to Web MD “Periods are considered heavy if there is enough blood to soak a pad or tampon every hour for several consecutive hours.” (8)
If your period lasts longer than seven days or interferes with everyday activities, it’s a good idea to talk to your doctor. You want to look into increasing your iron intake too.
3. Chronic Low Back Pain
Low back pain and abdominal cramps that worsen during menstruation are classic symptoms of endometriosis. Treat with heat when possible and stretch regularly to relax your muscles and relieve cramping.
Excessive inflammation and swelling caused by misplaced abnormal endometrial cells can manifest itself as severe bloating and abdominal tenderness. In addition to normal period-induced water retention, the swelling can be very uncomfortable. In some sufferers, the swelling can be so severe that they gain a dress size or two during menstruation.
5. Painful Sex
Painful sex is one of the most noticeable symptoms of endometriosis and other gynecological issues. Specifically, pain from endometriosis is described as a “deep” pain that occurs during and after penetration.
Because of the excessive blood lost during menstruation in women with endometriosis, fatigue is a common symptom of endometriosis. It can be caused by both inflammation and bleeding-related anemia. Plus, cramps caused by the condition make it hard to get a good night’s sleep during menstruation (9).
Endometriosis can cause endometrial cells and menstrual blood to migrate up the fallopian tubes. Over time, this may cause extensive scarring to the fallopian tubes and ovaries, which effectively blocks sperm from reaching the egg and prevent the release and migration of the egg.
In fact, most often, endometriosis often diagnosed during infertility treatments.
8. Painful Bowel Movements
Painful bowel movements or urination, especially during menstruation, is a token symptom of endometriosis. This can be caused by endometrial cells latching onto your bladder or large intestine. In more severe cases, you may also find blood in your stool or urine.
Endometriosis can typically be diagnosed with a pelvic exam, ultrasound, MRI, laparoscopy or a biopsy.
Endometriosis is classified in four stages, from minimal to severe, from superficial implants and mild scarring to cysts and severe scarring. Unfortunately, science has yet to find a cure for endometriosis, but some women manage their condition by rebalancing hormones, managing pain, and, in some cases, surgery (10).
If you suspect you may be experiencing symptoms of endometriosis, don’t give up hope and look for an endometriosis specialist that can understand your condition and begin a proper course of treatment.