Endometriosis 101

The basic 101 on Endometriosis: what is it, how it develops, and how it affects women’s health

Did you know that March is Endometriosis month?

If you did then give yourself a pat on the back.

If you didn’t and are wondering why there’s an awareness month then let us explain:

Endometriosis is a disorder or condition that affects about 1 in 10 women between the ages of 15-49.  

And while yes there’s research that sheds light on this condition, many women who have it are often left in the dark without a whole of direction.

The awareness month allows us women to talk about it, connect, and help each other out.

 In this article, we’ll do just that by sharing what this condition is and how it affects women’s health.

What is Endometriosis? 

To explain what this condition is we'll first have to briefly go over some anatomy.

So in the female reproductive tract, you have the uterus and the oviducts or fallopian tubes extending from the uterus.

And the uterus is covered by 3 different tissue layers. You have an outermost layer, a middle layer, and an innermost layer.

That innermost layer? That’s called endometrium.

This is the bloody lining that thickens during your menstrual cycle (as your body prepares for a possible pregnancy) and then sheds during menstruation.

And in endometriosis, that endometrial tissue breaks off of the uterus and travels through the oviduct and attaches to the ovaries and other structures.

During menstruation, the lining on your uterus sheds.

But what about the endometrium tissue that goes rogue and attaches to ovaries and other structures?

It gets stuck in the tube and irritates the surrounding structures leading to the pelvic or back pain that’s commonly experienced in endometriosis.

Other symptoms commonly experienced with endometriosis are:

  • Pain can be experienced during sexual intercourse
  • Pain experienced during bowel movements or urination (especially during menstruation)
  • Pain at times other than menstruation, as the rogue tissue can send signals through the nervous system
  • Bleeding or spotting outside of menstruation
  • Nausea or fatigue
  • Gastrointestinal symptoms like: bloating, constipation, diarrhoea
  • Infertility

How does this condition affect women’s health?

As mentioned previously, endometriosis affects many aspects of women’s health from their sex hormones to their fertility.

But the more obvious and apparent effect of endometriosis is on women’s quality of life. Endometriosis reduces quality of Life

The pain that majority of women with endometriosis experience is quite severe.

While we all experience cramps or pain during our periods, the pain for women with endometriosis is magnified.

For many, it interferes with their daily functioning and prevents them from socialising, working, or other day to day tasks.

In fact, the pain can be so bad that you can’t even walk. Or that you wake up crying from how much it hurts.

It can and does seriously affect your quality of life. Not being able to work or walk only adds to the pain, frustration, and, well, agony, that women with endometriosis experience.   

Endometriosis affects fertility  

We mentioned that one of the other symptoms of endometriosis is infertility.

So you may be wondering: how does endometriosis lead to infertility?

Remember how we said that the endometrial lining that’s attached to the ovaries or other structures irritates the tissue there?

Well, that irritation scars the oviduct or fallopian tube.

And the oviduct or fallopian tube are a really important part of fertility or pregnancy.

The ovaries send the reproductive cells to the ends of the fallopian tube.

During an uncomplicated pregnancy, the sperm would swim to that end of the fallopian tube and fertilise the reproductive cells there.

The now fertilised egg would travel back down the tube towards the uterus and plant itself on the uterine walls.

In endometriosis, however, that scarring reduces the size of the oviduct or fallopian tube.

 Think about it: a scarred tissue is not as elastic and doesn’t hold up as well.

And that makes it way harder for the sperm to actually get to the egg and can prevent fertilisation of the egg.

And if the sperm does get to the egg and fertilise it, well, the fertilised egg has to travel back down the same way.

And again, the scar tissue makes it harder for the fertilised egg to do that. In some cases, the fertilised egg can actually implant in the fallopian tube, which is not the proper place for a foetus to grow.

Endometriosis affects hormones and menstrual cycles

Endometriosis is usually associated with hormonal imbalances and menstrual cycle irregularities.

And if we’re talking specifics, it’s estrogen that affects women with this condition the most.  

Research shows that women with endometriosis experience estrogen dominance. The excess estrogen is what stimulates the rogue endometrial cells. The stimulation causes these cells to grow and irritate the oviduct and surrounding structures even more.

What’s even more interesting is that these rogue cells can actually start to secrete estrogen themselves. And that further imbalances estrogen levels.

Imbalanced estrogen levels like in the case of estrogen dominance can lead to menstrual cycle irregularities.

Excess estrogen can delay menstrual cycles, and is often what leads to those PMS symptoms. In endometriosis, PMS symptoms such as pelvic and back pain are further magnified because of the excess estrogen.

The trouble with being diagnosed with endometriosis

Getting diagnosed with endometriosis is tricky.

But the the spark notes version is this:

If you experience Endometriosis symptoms, you should visit your doctor and they should do either one of these tests (or maybe a combo):

  • Ultrasound to look for growths, lesions, or scars
  • Pelvic examination to feel for growths
  • Blood test
  • Laparoscopy

However, in reality, it isn’t that easy. Many women’s pain and concerns are dismissed as normal period pain. Or being sensitive to hormones.  

And many women have done these tests for the doctor to say everything is normal but for the women to be diagnosed with endometriosis years later anyway. 

Yep, that’s right. In some cases, women don’t get diagnosed properly until years or a decade later (maybe more). In other cases, they’re misdiagnosed with having ovarian cysts (which is completely different).

So what can you do?

If you or someone you know experiences these symptoms or thinks that they have endometriosis, get them in to see a specialised doctor.

An OB/GYN with experience in endometriosis or a specialist who keeps up with the latest research can often diagnose more accurately.

High quality healthcare makes a world of a difference here.

And while, yes, your doctor should advocate for you, don’t forget to advocate for yourself. Don’t take no for an answer if you continue to experience debilitating pain. And if you feel like your doctor isn’t listening to you, keep searching for a doctor who does.

And don’t give up hope!

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