What is Endometriosis?

 What is endometriosis? Endometriosis or “endo” is a common women’s health issue when the tissue similar to the uterus’ tissue grows outside of the uterus and other areas of your body where it doesn’t belong. It can affect more than 11% of women in the United States between 15 and 44. That’s 6.5 million women! Endometriosis is typically found on your ovaries, fallopian tubes, on the tissues that hold your uterus in place, and the outer surface of your uterus, vagina, cervix, or bladder.

You are more likely to get endometriosis if you have: never had children, menstrual periods that last longer than a week, short menstrual cycles (27 days or shorter), a family member that has endometriosis since it is genetic, high estrogen levels, or a health problem that blocks the normal flow of menstrual blood during your period.

The endo growths growing outside of your uterus where they don’t belong can swell and bleed similar to period bleeding. This continues to build up and bleed in areas where it can’t easily get out and flow from your body. These endo growths can block your fallopian tubes, cause ovarian cysts, inflammation, form scar tissue around your ovaries and pelvis, making it difficult to get pregnant, and issues in your intestines and bladder. This means that every cycle that your menstrual cycle doesn’t work and all of the lining is shed correctly, that the endo growths can increase and continue growing. So, every period cycle, your endometriosis just gets worse and worse, in a downward spiral.

Endometriosis Symptoms:

There can be many symptoms of endometriosis, but some of the most common ones are:

Pain: Extremely painful cramps, chronic lower back and pelvic pain, pain during or after sex, intestinal pain, or painful bowel movements when urinating or during menstrual periods. Like, doubling over in pain, barely walk, or curled up in a ball in agony level of pain. No amount of Tylenol or Advil will help.

Bleeding or Spotting: You can experience bleeding or spotting between menstrual periods.

Infertility: Infertility, or not being able to get pregnant.

Digestive Problems: You can experience diarrhea, constipation, nausea, or bloating, especially during your period.

Endometriosis Causes:

No one can quite pinpoint the exact cause of endometriosis, but some of the potential causes are problems with menstrual flow, like retrograde menstrual flow, where some of the tissues shed during your period week instead flow back into the fallopian tube and into other parts of the body, like your pelvis. Genetic factors, an excess of estrogen (like with PCOS), and immune system problems can also cause endometriosis. During surgery in the abdominal area, like a C-section or hysterectomy, endometrial tissue can move to the wrong place by mistake.

Endometriosis Diagnosis:

If you are worried that you have endometriosis, a doctor can do several tests to discover if you have endo or not:

Pelvic exam: During the exam, your doctor will feel for large cysts or scars behind your uterus. They won’t be able to feel smaller areas of endo this way though.

Ultrasound or MRI: Your doctor could also do an ultrasound or MRI to check for ovarian cysts caused by endometriosis and get a clearer picture of the inside of your body.

Laparoscopic surgery: However, the only way the doctors can be 100% certain that you have endometriosis is to do surgery to look inside your pelvic area to see all of the growths and do a biopsy of the tissue to confirm endo. Side note, when I had laparoscopic surgery over a year ago in September to remove ovarian cysts, fibroids, and polyps from PCOS, they also did a biopsy to see if I also have endo due to extremely painful periods. Thankfully, I didn’t have endometriosis, but I know plenty of friends and loved ones that struggle with endo.

Endometriosis Treatments:

While there isn’t a cure for endo, there are several treatments to help you relieve the pain and some of the symptoms and causes.

Medicine/Hormone Treatments: if you’re NOT trying to get pregnant, your doctor may prescribe hormonal birth control or an IUD to help reduce your bleeding and pain. If you ARE trying to get pregnant, your doctor may give you a gonadotropin-releasing hormone (GnRH) agonist. This medicine stops your body from creating the hormones responsible for ovulation, menstruating, and the resulting growth of endometriosis. You will do these treatments for a short amount of time to cause temporary menopause, which will help control the growth of endo and stop the vicious cycle. Once you stop taking medicine, your menstrual cycle will return. You have a better chance of getting pregnant since everything should be functioning correctly right after going off the medicine.

Surgery: For severe endometriosis cases, where medicine isn’t providing any relief, or if you’re having fertility issues, your doctor may want to do surgery to remove the endo growths and give you and your uterus a clean slate. That way, you have a fresh start and anywhere from a few months to several years, or, ideally, not at all, before the harmful endometrial tissue returns.

Endometriosis Prevention:

While there isn’t a cure for endometriosis, you can reduce your chances of developing endo or reduce the endo that is already there by lowering estrogen levels. You can do this by avoiding large amounts of caffeine or alcohol, exercising regularly, using hormonal birth control or progesterone hormone cream.

Endometriosis can be quite painful. Know that you are not alone. It’s important to normalize talking about women’s health issues and not be afraid to speak up and be an advocate for yourself, both at the doctor’s office and in your life. What have YOU done to help manage endometriosis?

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