Because knowledge is power when it comes to our reproductive health.
According to the World Endometriosis Society, the condition affects around one in ten women of reproductive age. That’s 176 million worldwide! With a difficult diagnosis and symptoms including abdominal pain, painful periods, pain during sex and difficulties falling pregnant, we thought it was time to call in the experts to give you the lowdown on endometriosis.
What is it?
In some women, the endometrium (the lining of the uterus) sheds in an excessive amount and can cause “backward bleeding” where the blood travels up through the fallopian tubes. This blood can even get into the stomach cavity or the peritoneum (the membrane forming the lining of the abdominal cavity). In some women, these parts of the endometrium become trapped and attached to other body parts, which can create endometrial lesions. During menstruation, the endometrial lesions end up responding to the same messages from the prostaglandins (needed to contract and release blood) that are being sent to the uterus. The lesions can then create very painful contractions in these areas outside the uterus.
Why does it happen?
There are several theories about why endometriosis occurs. The main understanding is that endometriosis is an “estrogen-dependent chronic inflammatory process”. So basically our bodies have high estrogen, which encourages the inflammatory process. These estrogens can be from outside the body and/or from an imbalance within.
The inflammatory process creates a tissue called fibrin. During an inflammation sequence, the body triggers its defence systems and this creates added fibrin for repair (it is needed in order to stop you from bleeding, e.g., after normal things like scraping your knee or cutting your finger). Yet, some women cannot break down the fibrin and end up with an overgrowth, thus creating the adhesions between endometrial tissue and the peritoneum.
Research has found that most women with endometriosis are unable to break down fibrin once the repair work is complete and are found to have low PA-1 in the blood. The PA-1 is involved in stopping the fibrin from accumulating. Some theories about why this occurs include exposure to toxic shock syndrome toxin (TSST), exposure to other toxins and – you guessed it – hormones in our environment.
How is it diagnosed and treated?
Internal sonars or ultrasounds scans (transvaginal) can be used to find if any of the tissues from the uterus have ended up on the ovaries. At this point, the final diagnosis of endometriosis requires an internal laparoscopic exam. This test will show whether there are endometrial bits stuck to any of the organs in the peritoneum (stomach, intestines, liver, gallbladder, pancreas or spleen). During this exam the surgeon will often attempt to remove or burn these remnants.
Burning the tissues has been one of the main treatments until recently. However, this often results in more scarring. And ultimately women do not always gain relief from this treatment. Oral birth control is used to suppress ovulation, yet the long term effects of these hormones can result in other diseases and exacerbate the problem. It’s also believed that making some dietary changes, such as reducing sugar and cutting out caffeine and alcohol, can reduce symptoms.
Can I prevent endometriosis?
Endometriosis cannot exist without an estrogen-dominant environment. So, reducing exposure to estrogen is important. However, the tendency to develop endometriosis could be due to several reasons, including:
- possibly a genetic tendency to have low fibrinolysis (ability to break down fibrin – PA-1 deficiency) and immune dysfunction
- exposure to toxic shock syndrome toxin (may be the cause of the backward flow of menses)
- toxins in the environment; and
- low progesterone
Unfortunately, there is no medical cure for endometriosis at this time. Managing your symptoms and finding a diagnosis is the key to getting the support you need for endometriosis. There are some natural options that you can talk about with your doctor. Do your research and pick a doctor who you are comfortable with, and are able to communicate freely with, to best manage this condition.