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Endometriosis Awareness – What You Need to Know About This Common Gynecological Condition
- Endometriosis awareness is important both for women who suffer, and for healthcare professionals alike. The more knowledge that can be gained around this topic, the better we can become as a healthcare system in diagnosing, treating, and supporting this common gynecological condition.
- Endometriosis is a condition where the tissue of the endometrium grows outside of the uterus. This condition therefore only affects those who have a uterus.
- Increasing endometriosis awareness lets others know they are not alone, and shows others that their concerns, pain, and suffering are valid and heard in the medical community.
Sadia Arshad
MPH, MSN, WHNP-BC
Raising Endometriosis Awareness
What is it? What is endometriosis?
When thinking about periods and cramps, learning about the endometrium (the scientific name for the lining of your uterus) might not be what you’re in the mood for. This innermost lining of the uterus and helps maintain the shape of the uterus!
Endometriosis is a health condition where tissue of the endometrium (the lining of your uterus), also known as endometrial tissue, grows outside of the uterus. Some places endometrial tissue can grow include the fallopian tubes, ovaries, bladder, and further outside of the pelvic region.
In rare cases, endometrial tissue can be found in the colon and lungs as well.
When this extra endometrial tissue is outside of the uterus, it behaves like how it would inside of the uterus. During a menstrual cycle endometrial tissue naturally thickens, breaks down, and bleeds out of the uterus and out of a vagina.
However, the additional endometrial tissue outside of the uterus cannot leave the body during a menstrual cycle. As a result, the remaining endometrial tissue stays stuck in the body and can cause adhesions, lesions, or cysts to develop.
Endometriosis can be severely painful, particularly during menstruation because of the adhesions, cysts, and pelvic pressure from un-released endometrial tissue. As a result, this causes severe chronic pelvic inflammation and can be a significant influence on someone’s life.
How Common is Endometriosis?
It is estimated that 1 in 10 people with a uterus have endometriosis worldwide. This is only an estimation as many people with uteri often do not discuss their pain or menstrual history, causing endometriosis to underdiagnosed and underreported.
If endometriosis is left untreated, it can lead to infertility, chronic pelvic pain, decreased quality of life, and perpetual heavy menstrual cycles.
Because of lack of funding, lack of research, and lack of awareness surrounding endometriosis, there is still so much more to learn about this common health condition.
Signs & Symptoms of Endometriosis
Common signs and symptoms of endometriosis include:
- Heavy menstrual bleeding
- Heavy menstrual cramping
- Pain during vaginal or anal sex
- Pain during urination
- Pain during defecation
- Nausea
- Fatigue
- Pelvic pain
While there are common signs and symptoms of endometriosis, some other less common signs are constipation, diarrhea, and lower back pain.
How is Endometriosis Treated?
The definite standard for an endometriosis diagnosis is examining a lesion obtained during surgery. The most common surgery to determine if someone has endometriosis is laparoscopy. Laparoscopy is a procedure used to examine the pelvic region.
Unfortunately, there is no single non-invasive test that can provide an endometriosis diagnosis. With the nature of surgery, such as cost and scheduling, some people with suspected endometriosis might not be able to obtain a laparoscopy.
Knowing the constraints of surgery, a combination of symptoms, health history, and ultrasound findings could be used to make a suspected diagnosis of endometriosis.
What Are the Stages of Endometriosis?
Determining someone’s stage (or severeness) of endometriosis can only occur during a laparoscopy by a surgeon. Endometriosis is staged according to American Society for Reproductive Medicine scoring system.
- Stage I – Minimal disease is characterized by isolated implants and no significant adhesions.
- Stage II – Mild endometriosis consists of superficial implants that are less than 5 cm in aggregate and are scattered on the peritoneum and ovaries. No significant adhesions are present.
- Stage III – Moderate disease exhibits multiple implants, both superficial and deeply invasive. Peritubal and periovarian adhesions may be evident.
- Stage IV – Severe disease is characterized by multiple superficial and deep implants, including large ovarian endometriomas. Filmy and dense adhesions are usually present.
After receiving a laparoscopy, the surgeon discusses the stage with the patient and can explain next steps and management.
It is important to note that leaving endometriosis untreated can cause progression from one stage to another over time. But, in some people, endometriosis never progresses. There is no known reason why some people have more or less severe stages than others, so it is important to keep in contact with your surgeon regarding next steps.
What Causes Endometriosis?
Unfortunately, there is no known cause for endometriosis. There are several theories on endometriosis’ cause, but no definite answer. Therefore, it is important to raise endometriosis awareness.
Women feel their concerns are dismissed and they feel ashamed. A study has even shown that those who experience endometriosis have higher levels of depression and anxiety compared to their healthy counterparts.
Who Is at Risk?
Some risk factors for endometriosis include:
- Never giving birth
- Having an early menarche (having a period before age 11-13)
- Going through menopause at an older age
- Experiencing short menstrual cycles — for instance, less than 27 days
- Heavy menstrual periods that last longer than seven days
- Having higher levels of estrogen in your body
- Having a low body mass index
- Having a One or more relatives (mother, aunt or sister) with endometriosis
- Having a medical condition that prevents the passage of blood from the body during menstrual periods
- Having a health condition of the reproductive tract
- Being exposed to diethylstilbestrol in utero
- Being exposed to severe physical and/or sexual abuse in childhood or adolescence
There is still so much to learn about endometriosis, so this list of risk factors is not final!
How is Endometriosis Treated?
Now that you’ve heard all the concerning stuff with endometriosis, you must be so eager to learn about treatment options!
In terms of medication, some health care providers might recommend hormonal contraception, such as the pill or intrauterine device to manage menstrual bleeding. Some health care providers might recommend Orilissa, a prescription used to manage moderate to severe pain from endometriosis.
If someone has had a laparoscopy, the surgeon might recommend removing adhesions and cysts to alleviate pain and improve quality of life.
Unfortunately, there is no one pill or one surgery to treat endometriosis. Endometriosis is a chronic health condition with no cure, only options to manage it. Knowing that there is no cure and that it can present so differently in people, managing endometriosis is best done under the guidance of a trusted and accredited health care provider.
If you are concerned about pelvic pain, menstrual health, or anything else regarding the pelvis, consider reaching out to your health care provider for more information.
The Bottom Line About Endometriosis Awareness
The time is now to raise endometriosis awareness. Women have been suffering for years. Not only physically with pain and discomfort, but mentally and emotionally.
Raising awareness brings knowledge and education to the conversation. The more we can learn about this common gynecological condition, the better more compassionate providers we can be to those who are suffering.
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