A few weeks ago, I published a book review of The Fifth Vital Sign and I'm thankful for all the positive feedback I got. I also received a request from Marie, a little sister. She asked me to talk deeply about endometriosis that I briefly mentioned in this previous post. She also told me the moving story of a young girl who died during surgery, shortly after being diagnosed with endometriosis. Though sad, this is unfortunately not an isolated case. So today, we're going to talk about this silent killer, which we need to be aware of, endometriosis. I'm glad you join me.
What is endometriosis?
Simply put, endometriosis is a condition where tissue similar to the lining of the uterus (which should only be located inside the uterus) is found elsewhere in the body. This tissue grows outside of the uterus and acts like regular uterine tissue does during your period: it will break apart and bleed at the end of the cycle. Even if they share a lot of similarities, endometriosis differs slightly from adenomyosis in which the endometrial-like cells grow within the muscles of the uterus. Note that a person can have one or both of these disorders. In endometriosis, the endometrial-like cells grow outside the uterus. Lesions are most common on the ovaries, but they can also be found anywhere in the pelvic cavity such as the fallopian tubes, the peritoneum, the uterosacral ligaments, the Pouch of Douglas.. And in even more rare cases, endometriosis lesions can be found in caesarian-section scars, on the bowel, on the intestines, colon, inside the vagina, inside the bladder, on the skin, in the lung, spine, and also brain.
Endometriosis affects 1/10 (about 176+ million) women of childbearing age worldwide, making it the third most common gynecological condition after ovarian cysts and pelvic pain.
Causes & Symptoms:
Among the stereotypes about women's period and menstrual cycle, the most popular is perhaps the one who said that period = pain. As Lisa Hendrickson-Jack said in her book, «The Fifth Vital Sign», many women suffer in silence instead of reaching out for support. Her thought on it was:
"Though common, moderate-to-severe pain with menstruation is not normal or healthy. Pain that requires the use of painkillers — or is so severe that you’re unable to go about your normal daily activities — is a universal sign that something is wrong."
The most common symptoms of endometriosis are:
Pelvic pain: In some cases, the pain doesn’t always end when your period does. You may experience pain in your lower abdomen or lower back at any time of the month.
Severe menstrual cramps, which can keep you from your daily activities and on which pain relievers have no or little effect.
Heavy bleeding: It may be a sign of endometriosis or another treatable gynecological condition. You may have abnormal heavy menstrual bleeding if you experience: bleeding lasting longer than seven days, soaking pads or tampons in an hour or less, needing to change pads or tampons during the night, passing blood clots larger than a quarter.
Irregular period and unusual bleeding: If you have endometriosis, you may experience irregular menstrual periods or bleeding between periods. Bleeding may be light, which is also referred to as 'spotting.' However, bleeding could be heavy and look like a menstrual period, even when it’s not that time of the month.
Dyspareunia or pain (after or during) sex.
There are also other symptoms like pain when pooping or peeing, especially during your period; blood in your stool or urine; diarrhea or constipation, constant fatigue, etc. Though not common, endometriosis can also cause scar tissue and adhesions to develop and distort a woman’s internal anatomy. In advanced stages, internal organs may fuse together, causing a condition known as a 'frozen pelvis.' Infertility can also be a symptom of endometriosis, but note that having endometriosis does not automatically mean that you will never have children. Rather, it means that you may have more problems getting pregnant.
PS: Many women with endometriosis have children without difficulty, and many others become pregnant eventually with medical help.
At that point, you may probably ask yourself what are the causes of this condition? And you are not alone. There are different hypotheses to what cause endometriosis, but unfortunately, none of these theories have ever been entirely proven, nor do they fully explain all the mechanisms associated with the development of the disease. However, here are the most plausible kept by the scientists:
Hormones transform the cells outside the uterus into cells similar to those lining the inside of the uterus;
Areas of your abdomen convert into endometrial tissue for reasons not yet known. These continue to grow and bleed in response to the hormones of your menstrual cycle;
Menstrual blood leaks into the pelvic cavity through a surgical scar, such as after a cesarean section;
The lymphatic system transports endometrial cells out of the uterus, spreading through the body and giving rise to the disease;
A problem with the immune system that makes the body unable to recognize and, hence, destroy endometrial cells as they grow;
Retrograde menstruation: This is when menstrual blood flows back through your fallopian tubes into your pelvic cavity instead of leaving your body through the vagina during your period;
Genetics—Endometriosis is more common among women who have a family history of the disease.
Environmental toxins.
Diagnosis & Treatments:
Thanks to the observation of the different symptoms and the fact that tongues are gradually loosened about endometriosis, more and more women are able to auto-diagnose themselves. But this is not sufficient. And because endometriosis manifests itself in a variety of ways and shares symptoms with other conditions, diagnosis can be difficult and often delayed. Indeed, it takes about 8-10 years for patients to receive a firm medical diagnosis. Checking for physical clues of endometriosis include pelvic exam, (abdominal/transvaginal) ultrasound, magnetic and resonance imaging (MRI), but the only definitive way to diagnose endometriosis is by laparoscopy. Laparoscopy is an operation in which a camera (a laparoscope) is inserted into the pelvis via a slight cut near the navel. The surgeon uses the camera to see the pelvic organs and look for any signs of endometriosis.
Once the diagnosis is posed, it's generally the end of a long period of errancy and frustration, but it's also where the real journey starts. There is currently no cure for endometriosis, but there are various treatment options, such as pain relievers, hormonal treatment, fertility treatment, and surgery. The approach you and your doctor choose will depend on how severe your signs and symptoms are and whether you hope to become pregnant. Living with endometriosis can be hard, but with treatments and lifestyle changes, it can be more manageable.
Adjusting your diet: Research has shown that eating certain types of foods such as (fresh fruits and vegetables, whole grains, nuts and seeds, fatty fish) while avoiding others (high-FODMAP foods, such as dairy, beans, and onions, red meat or foods that contain: saturated and trans fats, gluten, caffeine, alcohol) may help reduce inflammation and pain because of endometriosis.
Reduce stress: By getting exercise, doing yoga, engaging in a hobby that you enjoy, reading a book, listening to calming music, trying meditation, breathing techniques, or aromatherapy.
Complementary and alternative medicine (CAM) like acupuncture, massage, or herbs and supplements.
Want to learn more about endometriosis? See,
3 books recommendations:
Private Parts: How To Really Live With Endometriosis by Eleanor Thom,
Outsmart Endometriosis by Dr. Jessica Drummond,
Recipes & Diet Advice for Endometriosis by BA Levett NT Carolyn.
3 podcast channels to follow:
Heal Endometriosis Naturally by Wendy K Laidlaw,
Endometriosis Podcast by The Cycle.
Sources:
For many years, endometriosis has been an unknown topic for me too. It was just at the end of 2018 that I first heard about it through an acquaintance. Thankfully, it's something that more and more people talk about, allowing women who suffer from it to be more easily diagnosed and to receive adequate treatment. I think we must continue to liberate speech and break the taboo around female health and sexuality. And I encourage women to trust their bodies. If you think something is wrong, feel free to seek support. Thanks again to Marie for this request since I too have learned a lot by the time I wrote this post. And thank you, dear reader. May God bless you, take care!
To all the #endowarriors 💛
Really thank you very much for sharing. May the deceased rest in peace.