Understanding Endometriosis

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What is Endometriosis?

To many, endometriosis seems like an unfamiliar word. However in reality, this medical condition affects 10% of reproductive age women and girls globally (1). Endometriosis is a condition where the tissue lining of the uterus grows outside of the uterus in places such as the ovaries, pelvic lining, or even the fallopian tubes(1). As a result, this tissue lining that is misplaced cannot shed like normal during the menstrual cycle and accumulate in the body and can result in bleeding, inflammation, and pain(1).

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Common Symptoms

Endometriosis can result in varying symptoms, with the more common ones being as follows:

1. Chronic pelvic pain

   1. Before and during menstruation

2. Fatigue, bloating, and gastrointestinal issues

3. Painful bowel movements or urination

   1. Especially during menstruation

4. Excessive menstrual bleeding

   1. Heavy bleeding during and/or between periods

5. Infertility

   1. Difficulty getting pregnant

6. Pain during intercourse

   1. Discomfort or pain during sexual activity

Causes and Diagnosis

Currently the precise cause of endometriosis is undetermined however there are many proposed theories for the cause of this medical condition such as genetic predisposition, hormonal imbalances, retrograde menstruation, and immune system dysfunction.

Furthermore, the diagnosis of this medical condition is also challenging due to many overlapping symptoms endometriosis shares with other conditions. However, two common diagnostic methods include receiving a laparoscopy or a biopsy, both of which examine the endometrial tissue itself to make a diagnosis(2).

Treatment Options

There are several treatment options for endometriosis to help manage symptoms:

1. Pain medication

   1. Common painkillers such as ibuprofen(2) or non-steroidal anti-inflammatory drugs (NSAIDs) such as naproxen(1) are often used to alleviate pain symptoms.

2. Hormone therapy

   1. As estrogen is related to endometriosis tissue growth and shedding, hormone therapy aims to limit and stop the production of this hormone to shrink endometrial tissue and subsequently reduce pain symptoms(3). Common hormone therapy treatments include the combined oral contraceptive pill, progestogens, and gonadotropin-releasing hormone (GnRH) analogues(3).

1. Surgery

   1. In some cases, surgery is recommended which is most commonly done through a laparotomy or a hysterectomy(3). A laparotomy involves the removal of endometrial tissue whereas a hysterectomy involves the removal of the uterus(3).

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Conclusion

Endometriosis is not a well known condition however it still affects millions of women worldwide. Through raising awareness and creating discussion of this condition, we can support those with endometriosis and pave the way towards improving diagnosis and treatment.

References:

1. Treatment Endometriosis [Internet]. Available from: https://www.nhs.uk/conditions/endometriosis/treatment/

2. Endometriosis [Internet]. Available from: https://www.hopkinsmedicine.org/health/conditions-and-diseases/endometriosis

3. Endometriosis [Internet]. World Health Organization. Available from: https://www.who.int/news-room/fact-sheets/detail/endometriosis