March is National Endometriosis Awareness Month
March is Endometriosis Awareness Month. Endometriosis, often referred to as “endo,” is a condition that happens when tissue similar to the lining of a woman’s uterus (womb) grows outside of the uterus, according to the Office on Women's Health. It can cause painful periods, pain during sex, irregular bleeding, digestive problems, infertility, and other symptoms, notes Mayo Clinic.
It is estimated that 1 in 10 women have endometriosis. Endometriosis frequently presents with the symptom of pain including dysmenorrhoea (painful periods), dyspareunia (pain during sexual intercourse), and chronic pelvic or abdominal pain. Endometriosis can cause infertility and for women with subfertility, the prevalence rate ranges from 25% to 40%. Yet the disease is often misdiagnosed or missed altogether, says the Endometriosis Foundation of America (EndoFound). Lack of education and public awareness is part of the reason that endometriosis goes undetected.
History of National Endometriosis Awareness Month
National Endometriosis Awareness Month was an initiation taken by The Endometriosis Association in 1993. This month is observed worldwide through various activities that involve educating people about the condition, fundraising, and marches. Yellow ribbons and brochures are distributed worldwide to honor National Endometriosis Awareness Month.
Endometriosis is a disorder where the endometrial tissue migrates to areas outside the uterus. The endometrial tissue (inner lining of the uterus) is the same tissue that thickens during the menstrual cycle. When the endometrial tissue sheds it is discharged along with blood causing menstruation. In Endometriosis this process occurs outside the uterus, where the blood has nowhere to go, causing pain in the pelvic region.
The symptoms include pelvic pain, heavy periods, bleeding between menstruation, and infertility. Endometriosis is often difficult to diagnose because there are many other conditions that can cause these symptoms. In a few cases, endometriosis remains undiagnosed because it is mistaken for other conditions or women do not experience any symptoms at all.
The causes of endometriosis are uncertain, but several factors such as genetics, retrograde period flow, (where blood flows back into the pelvis instead of out of the body,) immune system disorders, and hormones are possible influencers.
Treatment ranges from symptom management with pain medication and hormone therapy such as oral contraceptives to surgical treatment. Conservative surgery involves removing the misplaced endometrial tissue while preserving the uterus, though in severe cases a hysterectomy may be performed.
Endometriosis can have a devastating effect on the quality of life of individuals suffering from this disorder and can have a huge impact on their physical, mental, and social well-being.
What Is Endometriosis?
Endometriosis is a hormonal and immune system disease in which tissue (endometrium) similar to the inside lining of the uterus is also found in other areas of the body. It develops into growths that cause pain, bleeding, formation of scar tissue, and other medical problems. Symptoms include:
- Painful periods
- Chronic pelvic pain
- Pain with sex
- Heavy or irregular bleeding
- Diarrhea and/or painful bowel movements during periods
- Infertility
The uterus, or womb, is the place where a baby grows when a person is pregnant. The uterus is lined with tissue (endometrium). Endometriosis is a disease in which tissue that is similar to the lining of the uterus grows in other places in your body. These patches of tissue are called "implants," "nodules," or "lesions." They are most often found:
- On or under the ovaries
- On the fallopian tubes, which carry egg cells from the ovaries to the uterus
- Behind the uterus
- On the tissues that hold the uterus in place
- On the bowels or bladder
- In rare cases, the tissue may grow in your lungs or in other parts of your body.
Endometriosis cannot be confirmed in routine gynecological exams. Diagnosis is considered uncertain until proven by laparoscopy, a surgical procedure done under anesthesia. A laparoscopy usually shows the location, size, and extent of the growths and can help the doctor and patient make better treatment choices. (Non-surgical diagnostic tests are in development.)
What Causes Endometriosis?
Endometriosis is a puzzling hormonal and immune disease affecting girls and women from as young as eight years old through postmenopause. The cause of endometriosis is still unknown, though there are some theories of its causes:
- One theory suggests that endometrial tissue is distributed from the uterus to other parts of the body through the lymph or blood systems.
- A genetic theory suggests that certain families have predisposing factors for the disease.
- Surgical transplantation has also been cited in many cases where endometriosis is found in abdominal scars, although it has also been found in such scars when accidental implantation seems unlikely.
- Another theory suggests that remnants of tissue from when the woman was an embryo may later develop into endo or that some adult tissues retain the ability they had in the embryo stage to transform under certain circumstances.
- The retrograde menstruation theory (transtubal migration theory) suggests that during menstruation some of the menstrual tissue backs up through the fallopian tubes, implants in the abdomen, and grows. Some experts believe that all women experience some menstrual tissue backup and that an immune system problem or a hormonal problem allows this tissue to grow in the women who develop endometriosis.
Who Are At Risk For Endometriosis?
Endometriosis can affect anyone who menstruates. Certain factors can raise or lower your risk of getting it.
You are at higher risk if:
- You have a mother, sister, or daughter with endometriosis
- Your period started before age 11
- Your monthly cycles are short (less than 27 days)
- Your menstrual cycles are heavy and last more than 7 days
You have a lower risk if:
- You have been pregnant before
- Your periods started late in adolescence
- You breastfeed your babies
What Are the Symptoms of Endometriosis?
The main symptoms of endometriosis are:
- Pelvic pain, which often happens during your period.
- Infertility
Other possible symptoms include:
- Painful menstrual cramps, which may get worse over time
- Pain during or after sex
- Pain in the intestine or lower abdomen
- Pain with bowel movements or urination, usually during your period
- Heavy periods
- Spotting or bleeding between periods
- Digestive or gastrointestinal symptoms
- Fatigue or lack of energy
How is Endometriosis Diagnosed?
Surgery is the only way to know for sure that you have endometriosis. First, however, your health care provider will ask about your symptoms and medical history. You will have a pelvic exam and may have some imaging tests.
The most common surgery to diagnose endometriosis is a laparoscopy. This is a type of surgery that uses a laparoscope, a thin tube with a camera and light. The surgeon inserts the laparoscope through a small cut in the skin. Your provider can make a diagnosis based on how the patches of endometriosis look. He or she may also do a biopsy to get a tissue sample.
Though endometriosis is a painful condition that can affect your quality of life, it’s not a fatal disease. In extremely rare cases, however, endometriosis-related complications can cause potentially life-threatening problems.
What Are The Treatments for Endometriosis?
There is no cure for endometriosis, but there are treatments for the symptoms. Your provider will work with you to decide which treatments would be best for you.
Treatments for endometriosis pain include:
- Pain relievers, including nonsteroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen and a prescription medicine specifically for endometriosis. Providers may sometimes prescribe opioids for severe pain.
- Hormone therapy, including birth control pills, progestin therapy, and gonadotropin-releasing hormone (GnRH) agonists. GnRH agonists cause temporary menopause, but also help control the growth of endometriosis.
- Surgical treatments for severe pain, including procedures to remove the endometriosis patches or cut some nerves in the pelvis. The surgery may be a laparoscopy or major surgery.
Treatments for infertility caused by endometriosis include laparoscopy to remove the endometriosis patches, or in vitro fertilization.
Facts About Endometriosis
It is one of the most common gynecological conditions. It is estimated that one in 10 women have endometriosis.
Endometriosis is difficult to diagnose. The average diagnosis can take up to seven and a half years.
Endometriosis and fertility. Endometriosis adversely affects women’s reproductive systems.
Natural cures. Lifestyle changes and natural remedies can help relieve some of the symptoms, such as exercise, a healthy and well-balanced diet.
It is a chronic disorder. Endometriosis is a long-term condition.
Observing National Endometriosis Awareness Month
Spread awareness about endometriosis
It is time to get comfortable with discussing women's health. A painful period is not normal and the more we talk about it the sooner an endo patient can receive the treatment and support she deserves. National Endometriosis Awareness Month helps to break the taboo and stigma surrounding menstruation by educating and creating a platform for the discussion of women’s health.
Educate yourself and others
Lack of awareness and the normalization of symptoms of menstrual pain contributes to delayed diagnoses for many women. Education and awareness help with the early diagnosis of this disorder.
Awareness can help detect this disorder early on. You can participate in many awareness conferences or virtual events being organized during this month.
Lend your support
Many organizations offer volunteer opportunities for people who want to help women affected by endometriosis. Endometriosis can have a devastating effect on the quality of life of women who suffer from this condition. Having to live with painful physical symptoms have harmful effects on the emotional wellbeing of women too. This month recognizes their suffering.
Sources:
https://www.cochrane.org/news/endometriosis-awareness-month-2022
https://www.everydayhealth.com/endometriosis/awareness-month/
https://endometriosisassn.org/endometriosis-awareness-month
https://nationaltoday.com/national-endometriosis-awareness-month/
https://endometriosisassn.org/
https://medlineplus.gov/endometriosis.html