Endometriosis is an often painful disorder in which tissue similar to the tissue that usually lines the inside of your uterus—the endometrium—grows outside your uterus. Endometriosis most often involves the ovaries, fallopian tubes, and tissue surrounding the pelvis.
ENDOMETRIOSIS: General about endometriosis | Symptoms | Causes | Treatment | Risk Factors | Questions and Answers | Sources/references
Endometriosis, endometrial-like tissue, acts like endometrial tissue - it thickens, breaks down, and bleeds with each menstrual cycle.
But because this tissue cannot escape your body, it gets trapped. When endometriosis affects the ovaries, cysts called endometriomas can form.
Image: Endometriosis is the cause of 30 to 40% of female infertility.
.jpg)
Surrounding tissue may become irritated, and scarring and adhesions may eventually develop.
There are several types:
- superficial endometriosis, which is located mainly on the peritoneum of the pelvis
- cystic ovarian endometriosis (endometrioma) found in the ovaries
- Deep endometriosis in the recto-vaginal septum, bladder, and intestines
- in rare cases, endometriosis has also been found outside the pelvis
Under normal conditions, the tissue that covers the inside of the uterus called the endometrium, is only in the uterus. In women with endometriosis, microscopically, small pieces of this tissue also migrate from the uterus, are implanted in other organs and tissues, and grow there.
These defects or areas of abnormal tissue are usually in the abdominal cavity - they often spread to other parts of the body, such as the ovaries or the muscular wall of the uterus - but in sporadic cases, they can also affect other organs, such as the lungs.
Image: Endometriosis often involves the ovaries, fallopian tubes, and tissue surrounding the pelvis.
.jpg)
Like the endometrium, the transplanted tissue also responds to estrogen and progesterone hormones. Every month, it first thickens and then bleeds. However, since the transplanted tissue is placed in other tissues, the blood produced cannot flow out and irritates the surrounding tissue, causing cysts, scars, and growths. These can finally bind the births together, moving as one big mass under the doctor's hands.
Cases of endometriosis are classified as minimal, mild, moderate, and severe, depending on the size of the defects and the depth to which the tissue has penetrated the host organ. Symptoms can be very different; around 10% of patients have no symptoms. Others have weighty and painful periods and deep abdominal pain during intercourse.
Endometriosis is the cause of 30 to 40% of female infertility. In women who can conceive, symptoms may decrease or even disappear during pregnancy but return after a year or two. Endometriosis most often affects women between the ages of thirty and forty and usually stops at menopause, when estrogen production drops sharply.
A particular tissue called the endometrium is shed from the uterus every time during menstruation as part of a natural process; if pieces of endometrial tissue get implanted in other organs in the small pelvis, they can grow there, become troublesome and cause pain and abnormal bleeding. If this is not treated, the tissue grows and eventually creates cysts that interfere with the function of the uterus.
Symptoms
The primary symptom of endometriosis is pelvic pain, often associated with menstruation. Although many women experience cramping during their periods, those with endometriosis typically describe menstrual pains much worse than usual.
Video content: 5 warning signs of endometriosis.
Common signs and symptoms include:
- sharp abdominal pains before, during, and immediately after menstruation
- sharp pain in the abdomen during sexual intercourse
- abnormally heavy menstrual bleeding, especially if a large number of clots form and last longer than seven days
- infertility
Consult your doctor if you suspect you have endometriosis; correct diagnosis is essential for treatment.
Causes
Researchers don't know precisely how endometrial tissue gets to other body parts. One possibility is a condition called retrograde menstruation. During menstruation, parts of the normal sloughed-off uterine lining are expelled from the uterus through the cervix and vagina.
In retrograde menstruation, particles of the endometrium float back into the fallopian tubes, from where they can enter the abdominal cavity and cause endometriosis. Doctors have noticed that endometriosis occurs more often in women with a body structure that increases the possibility of retrograde menstruation. For example, these women have various blockages in the vagina and cervix.
Image: Endometriosis occurs more often in women who have various blockages in the vagina and cervix.
.jpg)
There is still considerable disagreement about whether tampons promote retrograde flow. The evidence contradicts this, but some women with endometriosis still prefer to avoid tampons.
In the rare cases of endometriosis that affects the lungs or other tissues far from the uterus, researchers hypothesize that stray pieces of endometrium reach them via the bloodstream or lymphatic system. However, no one knows precisely how this happens.
Another theory holds that endometrial tissue moves outside the uterus quite often. Still, endometriosis only occurs in women with problems with their immune system, preventing the body from destroying the stray pieces.
Despite the lack of clarity regarding the specific mechanisms of endometriosis, researchers can point to some connections. The fact that the disease occurs in certain families speaks in favor of the possible role of genetic influences. Studies have also shown that endometriosis occurs more often in women with shorter-than-usual menstrual cycles or in those whose cycles last longer.
Women who have less than 25 days between periods, or those whose periods last longer than seven days, are twice as likely to develop endometriosis. However, recent evidence suggests that exposure to dioxin, an industrial chemical, is also a possible cause.
Video content: What is endometriosis?
There seems to be no real connection between the size of the defects and the pain level in the small pelvis. Some women with minor changes complain of excruciating pain, while some women with a widespread defect have no symptoms. The pain probably comes from scarring and irritability caused by bleeding or when endometrial tissue encroaches on or grows on a nerve.
It is also not entirely clear how the disease causes infertility, but it does not appear to be related to the degree of endometriosis; many women with minor changes are infertile. Some researchers believe that endometrial implants interfere with the ovulation process. Inserts can also hinder the egg's passage through the fallopian tubes by interfering with the cilia that are supposed to move the egg. Still, other researchers say that the inserts secrete chemical substances that create an unfavorable environment for fertilization.
HEALING
Endometriosis can be treated conventionally or with everything from hormone pills and surgery to herbal remedies. However, this only tames the course of the disease but does not cure it. When treatment is stopped, symptoms often return. Symptoms usually stop with menopause, but symptoms continue in women who take estrogen during and after menopause.
Image: Doctors can only make a diagnosis with laparoscopy.
As endometriosis often recurs and causes infertility, you may want to join a support society for women with endometriosis, which they can tell you about at the hospital.
Conventional medicine
The doctor will probably perform a gynecological examination to rule out other possible causes of your symptoms. However, they can only be diagnosed with a laparoscopy - an examination in which a thin instrument equipped with a light is inserted through the abdominal cavity through a small incision. The procedure is usually performed under general anesthesia; many doctors also take a biopsy to confirm the diagnosis.
Most doctors believe that pregnancy is a good treatment option for many women who can conceive and would like to have a child. Pregnancy alleviates symptoms, probably because it temporarily stops menstruation. In some women, endometriosis does not come back after giving birth. Another option is for the doctor to prescribe birth control pills for nine months or longer, creating a false pregnancy that stops menstrual cycles and bleeding from endometrial defects. This treatment can be effective but not as successful as a natural pregnancy.
If there is no success after taking pills continuously, doctors recommend treatment with androgens - male hormones. Medicines that have hormonal effects, such as danazol and nafarelin, stop the menstrual cycle and make it impossible for the uterine tissue to bleed. However, danazol has masculinizing side effects that sometimes do not go away after stopping the drug; these are excessive hairiness and - although rarely - a lower voice, which makes it impossible to take it for a long time.
Video content: 7 natural remedies for endometriosis that work.
With all these treatment methods, a complete cure is impossible because the implants remain on the organs, and when the treatment stops, they start to bleed again regularly every month. Analgesics such as ibuprofen and naproxen can relieve the discomfort of cramping, but they do not alter the cyclic changes of the implants. So these, too, only affect the symptoms but do not treat the underlying cause.
Yoga
"Bow" increases the flexibility of the spine. Lie on your stomach and hold your ankles. While breathing, squeeze your buttocks and slowly lift your head, chest, and thighs off the floor. Hold this for 15 seconds while breathing slowly. Exhale and relax. Exercise once or twice a day.
Image: Bow (yoga position).
.jpeg)
"Locust" increases tone in the muscles of the small pelvis. Lie on your stomach and place your arms by your body. Squeeze your buttocks, - while pressing with your hands on the floor. As you inhale, raise your legs and keep them straight, pressing outwards with your toes and heels. Hold this position for 15 seconds, then exhale and relax. Do the exercise once or twice a day.
Image: Locust (yoga position).
"Boat" strengthens the spine and the area in the small pelvis. While lying on your stomach, inhale and lift your head, chest, arms, and legs off the floor. Clasp your hands behind you and stay in this position for 15 to 20 seconds, then exhale and relax. Run the boat once or twice a day.
Image: Boat (yoga position).
Yoga offers several healing benefits that can help reduce endometriosis symptoms such as stress, tension, and pain. It promotes relaxation, which helps relieve discomfort and calms your mind. Yoga and breathing techniques can help relieve pelvic pain in women with endometriosis.
Operation
When the tissue growth is extensive and medical treatment is ineffective, the doctor may advise surgery. If it removes all the transplanted tissue, your symptoms will go away. However, some pieces of tissue can remain and start to grow back and cause symptoms, even after the uterus is completely removed (hysterectomy). The doctor may, therefore, decide on a combination of surgery and ongoing drug treatment.
Alternative ways
Most alternative medicines are aimed at relieving symptoms. However, since such treatment does not directly affect the defect, it is often less effective than conventional treatment.
Acupressure
Cramps can be alleviated by pressing on the Spleen 6 point on the inside of the legs, 5 cm above the ankle. Pregnant women should not use this method.
Herbs
Some herbal formulas can relieve pain. Scutellaria lateriflora, black cohosh (Cimicifuga racemosa), and wild yam (Dioscorea vil-losa) can affect underlying hormonal problems. Valerian (Valeriana officinalis) can contribute to relaxation, but you should not take it for longer than one month.
Image: Herbs are characterized by high levels of bioactive compounds.
The root of life (Senecio aureus) and black cohosh strengthen the health of the organs in the small pelvis. Consult a herbalist about unique herbal formulas.
Nutrition
The body contains hormone-like substances called prostaglandins. These, among other things, play an essential role in muscle contraction and contribute to menstrual cramps. Your symptoms may improve if you eat foods rich in natural anti-prostaglandins - including mackerel, sardines, salmon, and tuna. Alternatively, you may take fish oil supplements instead of feeding these fish.
To help create a balance between estrogens and prostaglandins and to reduce menstrual cramps, you can take a daily multivitamin and multimineral supplement that should contain B vitamins (50 to 100 mg), vitamin E (400 to 600 IU), calcium (1000 mg) and magnesium (400 to 600 mg).
Home remedies
In addition to taking analgesics to relieve pain, place a hot water bottle or moist heat on the abdomen and drink warm drinks to relax and alleviate cramps. Get moderate exercise to boost endorphins, the body's natural painkillers. Drink soothing herbal teas from herbs such as hops and valerian to reduce tension.
Image: Drink soothing herbal teas made from herbs to reduce tension.
.jpg)
Tea may be a promising alternative to over-the-counter medications to help manage menstrual cramps. Chamomile, fennel, or ginger tea is a simple and natural way to relieve these pains.
Prevention
Avoid exposure to dioxin, which is recent evidence that it may cause endometriosis in some cases. Change them often when using tampons, especially if you're bleeding profusely, and try replacing them with pads or templates occasionally. By doing this, you prevent menstrual blood from flowing backward, which is the cause of endometriosis, according to one theory.
Risk Factors
Several factors are associated with an increased risk of endometriosis. Be aware that you are more likely to get endometriosis if:
- you have a close relative with endometriosis, especially if it is your mother or sister
- you regularly have a short menstrual cycle - shorter than 25 days
- you bleed for a long time during menstruation - longer than a week
- bleed profusely during periods
- you use tampons and change them less often than every eight hours
- you are using an intrauterine device
- you have a medical problem that closes or obstructs access to the cervix or vagina
- you have a congenital abnormality of the uterus, such as bicornuate uterus or double cervix
- you have been exposed to dioxin
Questions and answers
How common is endometriosis?
Endometriosis affects approximately 10% (190 million) of women and girls of reproductive age worldwide[1].
Is endometriosis dangerous?
Endometriosis has significant social, public health, and economic consequences. It can reduce the quality of life due to severe pain, fatigue, depression, anxiety, and infertility. Some women with endometriosis experience debilitating pain that prevents them from going to work or school[1].
How is endometriosis treated?
Medications range from pain relievers to hormonal drugs that suppress ovulation and menstruation. Surgery may be used to remove or destroy endometriosis. The most common surgical approach is laparoscopy[2].
With all these treatment methods, a complete cure is impossible because the implants remain on the organs, and when the treatment stops, they start to bleed again regularly every month. Analgesics such as ibuprofen and naproxen can relieve the discomfort of cramping but do not alter the cyclic changes of the implant metal. So these, too, only affect the symptoms but do not treat the underlying cause[3].
Sources and references
Source: Family Health Guide. Conventional and alternative treatment, Dr. Jaro Lajovic, Publishing House Mladinska knjiga
- Endometriosis - https://www.who.int
- Treating endometriosis - https://www.thewomens.org.au
- Encyclopedia - Endometriosis, p. 238, 239, 240, 241
