Understanding and Managing Endometriosis In Women

Over 10% of women and adolescents within the reproductive age (15 to 49) have endometriosis. It is higher in women with infertility (30-50%) and pelvic pain (40%). Endometriosis develops during the adolescence stage and is commonly diagnosed before age 30. These statistics prove the importance of endometriosis education and awareness in our society. Endometrial tissue normally lines the uterus, but in endometriosis, it is found outside the uterus. Often, women don’t recognize the symptoms of endometriosis and could confuse it with painful cramps. This contributes to late diagnosis, early detection, prevention, and management of the condition. This blog will discuss the types, diagnosis, treatment options, and how to live with it.

What is Endometriosis

Endometriosis is a chronic inflammation whereby the tissues found in the uterus are located outside of the uterus. It causes severe menstrual cramps and pelvic pain. It is associated with infertility in women. In the woman’s cycle, estrogen and other hormones cause the endometrium to thicken in preparation for fertilization. When that does not happen, it breaks down during menstruation. Women with endometriosis have endometrial-like lesions, nodules, or tumor-like growth in the following:

• Ovaries
• Fallopian tubes
• Peritoneum
• Urethra
• Bladder
• Ligaments supporting the uterus

In rare cases:

• Pericardium
• Lungs
• Brain
• Cervix
• Vulva

The endometrial tissue located in any of the above sites functions like the normal endometrial tissue during the menstrual cycle. This means that the implant or tissues may bleed before and during menstruation, causing severe pain. The intensity of the pain, symptoms, and its effects on fertility and other organs differ from woman to woman. As time progresses, the tissue grows and spreads to other body parts. In some cases, it invades deep into organs to form nodules. For instance, the tissue is located on the surface of the fallopian tubes,  and as time progresses, it begins to invade deeper into the organ, leading to nodule formation.

Types of Endometriosis

There are three common types of endometriosis, and they are based on the location of the growth.

1. Superficial peritoneal endometriosis

Superficial peritoneal endometriosis is the most common of all three. These lesions are small and do not invade the tissues at a depth of more than 5 mm. Depending on the phase of inflammation, they can be red, brown, black, or white.

2. Ovarian endometriomas

This hemorrhagic lesion is located under the ovarian parenchyma and grows to displace the ovaries over time. The lesions vary from several millimeters to centimeters. Compared to other types of ovarian cysts, ovarian endometriomas are not fully intra-ovarian cysts. They form as a result of the in-depth invagination of the lesion that was originally located on the surface of the ovary. You can describe it as a millipede invading a mango. Surgeries for this type of endometriosis are usually very risky because of the close relationship between the endometrioma and the ovary.

3. Deep subperitoneal endometriosis

In deep sub-peritoneal endometriosis, the lesions have become hard and fibrous. Like a tumor, it infiltrates deep and rapidly into the peritoneal cavity and its surrounding organs. Deep sub-peritoneal endometriosis infiltrates deeper into organs and tissues than the others. It is considered more severe and difficult to remove. This type of endometriosis is seen in post-menopausal women because amenorrhea influences and stabilizes the lesions.

Symptoms of Endometriosis

25-30% of women with endometriosis don’t show symptoms, while others do. Here are some classic symptoms commonly seen in most cases:

• Painful periods
• Pain during and after intercourse
• Infertility
• Abnormal menstrual flow
• Chronic pelvic pain
• Painful urination
• Painful bowel movement
• Endometriomas

Other symptoms include:

• Depression
• Underweight
• Fatigue
• Central pain sensitization

Diagnosis

• Pelvic exam
• Ultrasound
• Laparoscopy
• Magnetic Resonance Imaging

Treatment and Management

There is no definite cure for endometriosis. Nonetheless, the symptoms can be managed. The treatment regimen depends on the severity and type of endometriosis.

Medications

Non-steroidal anti-inflammatory drugs (NSAIDs) and analgesics like ibuprofen and naproxen can reduce pain. Contraceptives and hormonal medicines can relieve symptoms of pain, and they include:

• Implants
• Hormonal intrauterine devices (IUDs)
• Injections
• Pills
• Vaginal rings

Note: This method is not for you if you are trying to get pregnant. Endometriosis can lead to infertility. Your specialist would recommend fertility medicines to you.

Surgery

Sometimes, surgery is required to remove the tissues or nodules from their attachments. A surgeon performs a laparoscopy, which is non-invasive and limits incisions to the minimum. Other treatment options and methods are available. However, we recommend that you seek medical counsel from your doctor to get the one that is best suited to your needs. This post raises awareness and informs women about endometriosis and the importance of early diagnosis. When a problem is diagnosed early, and treatment commences immediately, it’s easy to treat or halt the development. It also prevents long-term complications. READ ALSO: The Digital Advantage: Female Entrepreneurs Thriving In The Online Space Endometriosis can take a toll on your mental health, self-esteem, and confidence and ruin you emotionally. Therefore, in addition to seeking medical care, you should seek help from emotional support groups. Most emotional support groups are formed by patients who meet in hospitals and are suffering from the same situation. Look up emotional groups in your vicinity, and don’t be scared to open up about your struggles. .