Endometriosis is one of the leading causes of pelvic pain in women.
It’s usually diagnosed when women suffer painful, heavy or irregular periods but sometimes there are no symptoms and it is only discovered when a woman seeks treatment for infertility.
What is endometriosis?
Endometriosis is a condition where cells similar to those that normally lines the uterus (the endometrium) grow outside the uterus and stick to various pelvic organs such as the ovaries, bowel, rectum, bladder and the lining of the pelvis. Occasionally, this tissue can stray even further and can be found outside the pelvic region in other areas of the body.
This endometrial tissue behaves just like the uterine lining in that it responds to hormones during the menstrual cycle. Consequently, at the time of every ‘menstrual bleed’ the endometrial tissue, wherever it is, sloughs off. For regular endometrial tissue in the uterus the majority exits via the vagina during the period. However endometrial-like tissue elsewhere in the body cannot be discharged and over time it builds up and can form masses and lesions which can affect organ function.
What are the symptoms of endometriosis?
The primary symptom is pelvic pain – during period, during ovulation, during or after sex, during bowel movement or urination. Other symptoms can include; fatigue, migraines, nausea, diarrhoea, weight gain, vomiting, bloating and all of these can often lead to depression, anxiety or just feelings of low self esteem.
What are the main causes of endometriosis?
- Genetics: women who have a close relative with the condition are up to 7-10 times more likely to get endometriosis.
- Retrograde (backwards) menstruation: When a woman has a period, the blood flows out of the vagina, but also backwards along the fallopian tubes into the pelvis. In 90% of women, the blood, which will contain endometrial cells is absorbed or broken down and causes no symptoms; however, in some women this endometrial tissue starts to grow causing endometriosis.
- Conversion of normal pelvic tissue into endometriosis.
There are other possible lifestyle and environmental factors that can play a role in causing endometriosis and these can be discussed during a consultation with one of our practitioners.
Cessation of periods?
It is generally considered that the single most effective treatment of endometriosis is the cessation of the menstrual cycle. This is because the endometrium tissue responds to the fertility hormones that dictate our menses. When women stop having periods naturally at menopause (around 45-55) it’s because oestrogen has declined. No messages from oestrogen – no endometrial growth and no bleed.
However, for many good reasons, many women do not want to go through menopause early. It can entail other health risks and unwelcome changes to the body.
Nor is menopause necessary the cure. For women with advanced endometriosis, scarring or/and cysts, women may still suffer symptoms and long term pain.
Likewise, women that go on HRT will maintain oestrogen levels that continue endometrial growth and therefore continue to have the pain and symptoms associated with endometriosis.
Conventional treatment methods range from taking painkillers, the oral contraceptive pill, laparoscopy, endomyometrial resection, ablation, combinations of these and other surgeries through to full hysterectomy. The unfortunate aspect of all this intervention is that if there are still hormones and there is still endometrial tissue remaining, and there are no other changes made, the body will respond and the endometrial tissue will continue to grow.