What is Endometriosis?
2021 Edit - This post is originally from 2017. Even though I used cited sources, what we know about and how we define endometriosis changes all the time. Please consider this brief overview but if you want to know more, check out the latest from the medical and chronically ill communities. If you suspect you have endometriosis, please find a specialist in your area for proper diagnosis.
• Pain (usually pelvic) that usually occurs just before menstruation and lessens after menstruation
• Painful sexual intercourse
• Cramping during intercourse
• Cramping or pain during bowel movements or urination
• Infertility
• Pain with pelvic examinations
The intensity of the pain can vary from month to month, and can vary greatly among affected individuals. Some women experience progressive worsening of symptoms, while others can have resolution of pain without treatment.
Pelvic pain in women with endometriosis depends partly on where endometrial implants of endometriosis are located.
• Deeper implants and implants in areas of high nerve density are more apt to produce pain.
• The implants may also release substances into the bloodstream which are capable of eliciting pain.
• Pain can result when endometriotic implants incite scarring of surrounding tissues. There appears to be no relationship between severity of pain and the amount of anatomical disease which is present.
Endometriosis can be one of the reasons for infertility for otherwise healthy couples. When laparoscopic examinations are performed during evaluations for infertility, implants are often found in individuals who are totally asymptomatic. The reasons diminished fertility in many patients with endometriosis are not understood. Endometriosis may incite scar tissue formation within the pelvis. If the ovaries and Fallopian tubes are involved, the mechanical processes involved in the transfer of fertilized eggs into the tubes may be altered. Alternatively, the endometriotic lesions may produce inflammatory substances which adversely affect ovulation, fertilization, and implantation.
Other symptoms that can be related to endometriosis include
• lower abdominal pain,
• diarrhea and/or constipation,
• low back pain,
• chronic fatigue
• irregular or heavy menstruation,
• painful urination, or
• bloody urine (particularly during menstruation).
Rare symptoms of endometriosis include chest pain or coughing blood due to endometriosis in the lungs and headache and/or seizures due to endometriosis in the brain.
The reasons for the association between endometriosis and ovarian epithelial cancer are not clearly understood. One theory is that the endometriosis implants themselves undergo malignant transformation to cancer. Another possibility is that the presence of endometriosis may be related to other genetic or environmental factors that serve to increase a women's risk of developing ovarian cancer.
Another possibility is that areas lining the pelvic organs possess primitive cells that are able to develop into other forms of tissue, such as endometrium. (This process is termed coelomic metaplasia.)
It is also likely the direct transfer of endometrial tissues at the time of surgery may be responsible for the endometriosis implants occasionally found in surgical scars (for example, episiotomy or Cesarean section scars). Transfer of endometrial cells via the bloodstream or lymphatic system is the most plausible explanation for the rare cases of endometriosis that are found in the brain and other organs remote from the pelvis.
Finally, there is evidence that some women with endometriosis have an altered immune response in women with endometriosis, which may affect the body's natural ability to recognize ectopic endometrial tissue.
The reasons for a decrease in fertility when endometriosis is present are not completely understood. It is likely that both anatomical and hormonal factors are contributory to diminished fertility. The presence of endometriosis may incite significant scar (adhesion) formation within the pelvis which can distort normal anatomical structures. Alternatively, endometriosis may affect fertility through the production of inflammatory substances that have a negative effect on ovulation, fertilization of the egg, and/or implantation of the embryo. Infertility associated with endometriosis is more common in women with anatomically severe forms of the disease.
Treatment options for infertility associated with endometriosis are varied, but most doctors believe that surgery is superior to medical treatment for endometriosis. When appropriate, assisted reproductive technology may also be used as an adjunct or an alternative to surgical therapy.
From https://www.medicinenet.com/endometriosis/article.htm
What is Endometriosis?
Endometriosis is the abnormal growth of endometrial tissue similar to that which lines the interior of the uterus, but in a location outside of the uterus. Endometrial tissue is shed each month during menstruation. Areas of endometrial tissue found in ectopic locations are called endometrial implants. These lesions are most commonly found on the ovaries, the Fallopian tubes, the surface of the uterus, the bowel, and on the membrane lining of the pelvic cavity (i.e. the peritoneum). They are less commonly found to involve the vagina, cervix, and bladder. Rarely, endometriosis can occur outside the pelvis. Endometriosis has been reported in the liver, brain, lung, and old surgical scars. Endometrial implants, while they may become problematic, are usually benign (i.e. non-cancerous).What are the stages of endometriosis?
Endometriosis is classified into one of four stages (I-minimal, II-mild, III-moderate, and IV-severe) based upon the exact location, extent, and depth of the endometriosis implants as well as the presence and severity of scar tissue and the presence and size of endometrial implants in the ovaries. Most cases of endometriosis are classified as minimal or mild, which means there are superficial implants and mild scarring. Moderate and severe endometriosis typically result in cysts and more severe scarring. The stage of endometriosis is not related to the degree of symptoms a woman experiences, but infertility is common with stage IV endometriosis.Symptoms
Most women who have endometriosis, in fact, do not have symptoms. Of those who do, the most common include:• Pain (usually pelvic) that usually occurs just before menstruation and lessens after menstruation
• Painful sexual intercourse
• Cramping during intercourse
• Cramping or pain during bowel movements or urination
• Infertility
• Pain with pelvic examinations
The intensity of the pain can vary from month to month, and can vary greatly among affected individuals. Some women experience progressive worsening of symptoms, while others can have resolution of pain without treatment.
Pelvic pain in women with endometriosis depends partly on where endometrial implants of endometriosis are located.
• Deeper implants and implants in areas of high nerve density are more apt to produce pain.
• The implants may also release substances into the bloodstream which are capable of eliciting pain.
• Pain can result when endometriotic implants incite scarring of surrounding tissues. There appears to be no relationship between severity of pain and the amount of anatomical disease which is present.
Endometriosis can be one of the reasons for infertility for otherwise healthy couples. When laparoscopic examinations are performed during evaluations for infertility, implants are often found in individuals who are totally asymptomatic. The reasons diminished fertility in many patients with endometriosis are not understood. Endometriosis may incite scar tissue formation within the pelvis. If the ovaries and Fallopian tubes are involved, the mechanical processes involved in the transfer of fertilized eggs into the tubes may be altered. Alternatively, the endometriotic lesions may produce inflammatory substances which adversely affect ovulation, fertilization, and implantation.
Other symptoms that can be related to endometriosis include
• lower abdominal pain,
• diarrhea and/or constipation,
• low back pain,
• chronic fatigue
• irregular or heavy menstruation,
• painful urination, or
• bloody urine (particularly during menstruation).
Rare symptoms of endometriosis include chest pain or coughing blood due to endometriosis in the lungs and headache and/or seizures due to endometriosis in the brain.
What about endometriosis and cancer risk?
Some studies have postulated that women with endometriosis have an increased risk for development of certain types of ovarian cancer, known as epithelial ovarian cancer (EOC). This risk is highest in women with both endometriosis and primary infertility (those who have never conceived a pregnancy). The use of combination oral contraceptive pills (OCPs), which are sometimes used in the treatment of endometriosis, appears to significantly reduce this risk.The reasons for the association between endometriosis and ovarian epithelial cancer are not clearly understood. One theory is that the endometriosis implants themselves undergo malignant transformation to cancer. Another possibility is that the presence of endometriosis may be related to other genetic or environmental factors that serve to increase a women's risk of developing ovarian cancer.
What causes endometriosis?
The cause of endometriosis is unknown. One theory is that the endometrial tissue is deposited in unusual locations by the retrograde flow of menstrual debris through the Fallopian tubes into the pelvic and abdominal cavities. The cause of this retrograde menstruation is not clearly understood. It is clear that retrograde menstruation is not the only cause of endometriosis, as many women who have retrograde menstruation do not develop the condition.Another possibility is that areas lining the pelvic organs possess primitive cells that are able to develop into other forms of tissue, such as endometrium. (This process is termed coelomic metaplasia.)
It is also likely the direct transfer of endometrial tissues at the time of surgery may be responsible for the endometriosis implants occasionally found in surgical scars (for example, episiotomy or Cesarean section scars). Transfer of endometrial cells via the bloodstream or lymphatic system is the most plausible explanation for the rare cases of endometriosis that are found in the brain and other organs remote from the pelvis.
Finally, there is evidence that some women with endometriosis have an altered immune response in women with endometriosis, which may affect the body's natural ability to recognize ectopic endometrial tissue.
What about endometriosis and infertility?
Endometriosis is more common in infertile women, as opposed to those who have conceived a pregnancy. However, many women with confirmed endometriosis are able to conceive without difficulty, particularly if the disease is mild or moderate. It is estimated that up to 70% of women with mild or moderate endometriosis will conceive within three years without any specific treatment.The reasons for a decrease in fertility when endometriosis is present are not completely understood. It is likely that both anatomical and hormonal factors are contributory to diminished fertility. The presence of endometriosis may incite significant scar (adhesion) formation within the pelvis which can distort normal anatomical structures. Alternatively, endometriosis may affect fertility through the production of inflammatory substances that have a negative effect on ovulation, fertilization of the egg, and/or implantation of the embryo. Infertility associated with endometriosis is more common in women with anatomically severe forms of the disease.
Treatment options for infertility associated with endometriosis are varied, but most doctors believe that surgery is superior to medical treatment for endometriosis. When appropriate, assisted reproductive technology may also be used as an adjunct or an alternative to surgical therapy.
From https://www.medicinenet.com/endometriosis/article.htm
Autoimmune Diseases and How They Relate to Endometriosis
Is endometriosis an autoimmune disease? As of right now, the medical community says no, however there are some newer studies that state it is. Some studies say it is all hormonal while others say the blood markers and auto-antibodies are there. Whether you agree that it is or isn't, all studies have pointed to an increase in autoimmune diseases in women with endometriosis, meaning be mindful of what is going on in your body, what you put in your body and how you treat your body. At the end of the day, if you are taking care of yourself to heal your endometriosis naturally, most of what you do will be helpful in caring for yourself if you have an additional autoimmune issue. However, if you suspect that you have an additionally autoimmune issue, talk to a medical professional. You don't want to make one issue worse trying to treat another issue.Until next time my lovelies!
-M
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