Endometriosis: Causes, Symptoms, Diagnosis, Complications, Treatment, Diet & More

Endometriosis occurs when the tissue lining a woman’s uterus also starts growing within the uterus. This tissue acts similarly to the uterine tissue during menstruation. It tears apart, passes through your body, and leaves your body along with your period blood every month. However, the tissue that accumulates in your uterus from the in-growth of the tissue lining your uterus has nowhere to go. This results in inflammation of your uterus, along with lesions and scarred tissue. In certain cases, PCOS and endometriosis may co-exist, although this is not always the case.

8 Possible Endometriosis Symptoms

Not every woman with health conditions experiences all the symptoms. Is endometriosis painful, you ask? The answer is that the pain varies among individuals. The degree of pain does not define the severity or stage of the condition. For instance, there are instances when women have experienced bearable pain despite the condition being severe and in its advanced stages, and the signs of endometriosis like pain are agonising among those where endometriosis is in its early stages. Not just that, endometriosis symptoms may not manifest at all among some women. 

Some of the most common endometriosis symptoms are as below:

1. Painful menstruation
2. Heavy menstrual bleeding
3. Bleeding between periods
4. Cramps for 1 to weeks around the time of periods
5. Pain during bowel movements
6. Pain while having sex
7. Infertility
8. Lower back pain during your menstrual cycle

The health condition generally develops several years after the onset of menstruation. Symptoms may improve temporarily during pregnancy and after menopause, unless you are taking oestrogen.

12 Risk Factors Of Endometriosis

1. Family history of the medical condition
2. The onset of periods before 11 years of age
3. Shorter period cycles of less than 27 days
4. Heavy menstrual bleeding exceeding 7 days
5. Duration of menstruation every month
6. Complications in the uterus or fallopian tubes
7. Never giving birth
8. Experiencing menopause at an earlier age
9. Higher oestrogen levels in your body
10. Higher lifetime exposure to oestrogen your body produces
11. Being underweight
12. Any health condition that prevents the smooth passage of blood from the body during periods

What Causes Of Endometriosis?

Although the root cause of the health condition is yet to be confirmed, possible endometriosis causes may be as below:

1. Retrograde Menstruation

In this case, the period blood comprising endometrial cells flows back through the fallopian tubes, back into the pelvic cavity, rather than leave the body. These cells stick to the walls of your pelvis, where they thicken and get passed out with period blood every menstrual cycle. 

2. Embryonic Cell Transformation

Hormones like oestrogen may transform cells that are in the earliest stages of development, known as embryonic cells, into endometrial-like cell implants when you hit puberty.

3. Endometrial Cell Transport

Endometrial cells may get transported by blood vessels or tissue fluid (lymphatic) to other parts of the body.

4. Surgical Scar Implantation

Endometrial cells may attach themselves to surgical incisions post-surgeries like C-sections or hysterectomy.

5. Immune System Disorder

A malfunction of the immune system may cause the body to not recognise and destroy endometrial-like tissue growing inside the uterus.

6. Transformation Of Peritoneal Cells

Healthcare researchers believe that immune factors or hormones transform peritoneal cells into endometrial-like cells.

How Is Endometriosis Diagnosed?

If your doctor suspects endometriosis, he/she may recommend all or some of the following medical tests for effective endometriosis diagnosis.

1. Pelvic Exam

This test enables healthcare practitioners to feel scars and cysts behind the uterus that may be the cause behind your medical condition.

2. Imaging Tests

CT Scan, MRI, or ultrasound generates detailed pictures of your organs, which may give your doctor an idea about the root cause of the symptoms you’re experiencing.

3. Laparoscopy

This is an insertive procedure wherein the doctor makes a small cut in your stomach to insert a thin tube connected to a camera, called laparoscopy, on one end. This enables the doctor to give a close look at the lesions in your stomach if any, as well as their size and location. This is the only test that confirms the presence of endometriosis. 

4. Biopsy

Often conducted during a laparoscopy, the doctor collects a sample of tissue from your stomach. This is examined under the microscope by a specialist for diagnosis.

5 Potential Complications Of Endometriosis

Can endometriosis cause cancer? Let’s check out what are the most common complications of the condition:

1. Infertility
2. Blockage of the urinary tract or bowel
3. Chronic pelvic pain
4. Ovarian cancer, in rare cases 
5. Rupture (in the case of endometriomas, which manifests through symptoms like bleeding, dizziness, sudden abdominal pain, fever, vomiting, etc.)

5 Possible Treatment Options For Endometriosis

Treatment includes surgery or medication. However, there is no cure for this medical condition. The doctor may recommend a combination of endometriosis treatments to observe what works best for you.

1. Pain Medications

The doctor may prescribe an over-the-counter (OTC) pain reliever like anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen, although it isn’t effective for all. 

2. Hormone Therapy

This may be recommended to aid in lowering the amount of oestrogen that your body produces, thus, stopping the progression of endometriosis. This, in turn, might be effective in controlling bleeding from your lesions to some extent, ensuring it does not leave scars, inflammation, and cyst formation. These medications include danazol. The side effects of this drug include acne breakouts and hirsutism (excessive hair growth on your face and body.

3. Hormonal Contraceptives

This treatment aims to keep your condition under check by preventing the monthly growth and buildup of tissues that resemble endometrial tissues. These medications include vaginal rings, patches, and birth control pills, which help in reducing or even eliminating pain in cases that are not severe. Apart from oral drugs, there are also injections that your doctor may prescribe to stop menstruation, thereby, putting an end to the growth of endometrial implants. On the flip side, contraceptives may lead to weight gain, decreased bone production, and even depression in certain extreme cases. 

4. Conservative Surgery

This is usually recommended to those who experience severe pain or in cases where hormonal treatments have been ineffective, or when you want to get pregnant. The objective of this surgery is to remove or destroy endometrial growths without damaging your reproductive organs.

Laparoscopy is a minimally invasive surgery effective in visualising and diagnosing endometriosis. It is also used to remove abnormal or displaced endometrial-like tissue. A surgeon makes small incisions in the abdomen to remove growth surgically or to vaporise or burn them. Lasers are usually the most common method used for this purpose nowadays.

5. Hysterectomy

Often considered a last-resort surgery, it is recommended only when no other treatments ensure improvements in the medical condition. Here, the surgeon removes the ovaries that make oestrogen, which causes the growth of endometrial-like tissues. Visible implant lesions are also removed, if any, at the time of this surgery. As a result, endometriosis and fertility are closely connected. 

There are two types of hysterectomy:

• Subtotal hysterectomy: This involves removing the upper part of the uterus, barring the cervix.
• Radical hysterectomy: Typically recommended in the case of cancer, this involves removing the entire cervix, uterus, and the upper part of the vagina. 

5 Pain-Relieving Tips & Lifestyle Changes For Those With Endometriosis

1. Pain-Relieving Treatments

Warm, hot water bottles and heating pads are a saviour for those experiencing pain due to endometriosis. 

2. Watch Over Your Diet

Lack of intake of fruits and vegetables and excessive consumption of red meat is believed to be linked to endometriosis. Red meat may make your body produce chemicals like prostaglandins, which may cause increased production of oestrogen. This could be the reason behind the excessive growth of endometrial tissue. An endometriosis diet should include fresh fruits and vegetables, along with omega-3 fatty acids available in walnuts and fish like salmon. 

3. Avoid Caffeine & Alcohol

Drinking these beverages is believed to raise the chances of developing endometriosis, although the cause hasn’t been established yet. Alcohol is considered to create a higher risk of developing the health condition than caffeine.

4. Follow A Regular Fitness Routine

Working out improves the circulation of blood from the heart to all the organs, helping in the smooth flow of oxygen and nutrients throughout your body.

Endometriosis has been on the rise more than ever before and there are multiple factors that are responsible for this trend. Although not curable yet,  there are some lifestyle changes that you should strictly follow to keep the symptoms under check. Make a note of the list of lifestyle changes you must undertake, and the pain and other symptoms of the condition will become bearable for you.

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