Endometriosis What is endometriosis? Endometriosis (say “en-doh-mee-tree-OH-sus”) is a problem many women have during their child-bearing years. It is estimated that endometriosis affects between 10 and 15 percent of all women of reproductive age. It means that a type of tissue that lines your uterus is also growing outside your uterus. It is a benign condition (not linked to cancer), but is a progressive, debilitating disease. It may significantly impair health and reduce fertility. The clumps of tissue that grow outside your uterus are called implants. They usually grow on the ovaries, the fallopian tubes, the outer wall of the uterus, the intestines, or other organs in the belly. In rare cases, they spread to areas beyond the belly. Endometriosis isn't usually life-threatening but it can cause severe pain that may affect a woman's health and other areas of her life, including relationships with her partner, family, and friends. How does endometriosis cause problems? Your uterus is lined with a type of tissue called endometrium. It is like a soft nest where a fertilized egg can grow. Each month, your body releases hormones that cause the endometrium to thicken and get ready for an egg. If you get pregnant, the fertilized egg attaches to the endometrium and starts to grow. If you do not get pregnant, the endometrium breaks down, and your body sheds it as blood. This is your menstrual period. When you have endometriosis, the implants of tissue outside your uterus act just like the tissue lining your uterus. During your menstrual cycle, they get thicker, then break down and bleed. But the implants are outside your uterus, so the blood cannot flow out of your body. The implants can get irritated and painful. Sometimes they form scar tissue or fluid-filled sacs (cysts). Scar tissue may make it hard to get pregnant. What causes endometriosis? Experts do not know what causes endometrial tissue to grow outside your uterus. But they do know that the female hormone estrogen makes the problem worse. Another theory is that endometrial cells are transported through the blood. Environmental causes, such as exposure to dioxins, are also being investigated. What are the symptoms? The most common symptoms are: # Abnormal bleeding. Some women have heavy or non stop periods, spotting or bleeding between periods, bleeding after sex, or blood in their urine or stool. # pain between periods; # lower abdominal pain; # lower back pain; # painful intercourse especially with deep penetration (dyspareunia); # menstrual irregularity; # infertility; # nausea, vomiting, dizziness and fainting; and # pain with bowel movements and/or urination. # fatigue # rectal bleeding # tenderness around the kidneys. # allergies and other immune system-related problems. # inability to sleep due to pain. # problems with circulation - e.g. cold feet and hands. # large dark clots during a period. # waking in the night because of pain. # Intense pain which leaves you doubled up in pain and/or unable to get out of bed. The severity of pain does not appear to be linked exclusively to how severe and extensive your endometriosis is. You may have a few tiny spots and suffer excruciating pain, while another woman with severe endometriosis can be entirely pain free. The pain felt with endometriosis can be mild, moderate or severe. Words used by women to describe their painful periods are:- # constant # deep inside # sharp # stabbing # knife-like # nagging # aching # burning # throbbing # dull # boring # cramping This pain can be felt mid-line, around the uterus, or on one or both sides of the pelvis. Women with endometriosis sometimes complain of pain that radiates around their pelvis, and that they can feel pain in other places, such as: # the lower back # the hips # the vulva # the pubic bone # the rectum # the buttocks # the groin # the thighs Most women who suffer from bad pain with their endo tend to find that they're unable to do anything, except stay in bed curled up with a hot water bottle and some decent pain relief. In fact, most women with endo, tend to completely withdraw into themselve because to get out of bed and actually do something, is virtually impossible! Some women only experience this during their regular time of the month, but other women, however, aren't so lucky. Sometimes the pain can continue throughout the entire month, only letting up for a few days at a time. Some women are unable to live a “normal” day-to-day life because of exhaustion and pain. It's not really clear why so many women suffer from so much pain. There are various reasons and theories, and these include the following: # The bleeding from the endometrial implants can cause irritation to the surrounding tissue and organs. # Pressure resulting from the swelling of the implants and chocolate cysts can cause pain in the immediate area, much in the same way that a boil causes pain. # Endometrial implants release inflammatory chemicals known as prostaglandins. This can cause a spasm of blood vessels and may trigger pain through a lack of oxygen to the surrounding tissue. # The release of extra prostaglandins from the implants and cysts can also cause increased cramping contractions of the uterus, which means that women can suffer from very intense cramps. # If the endometrial lesions invade tissue or organs, such as the bladder or bowel, then they will cause pain. If they leak blood this can cause yet more irritation and thus even more pain. As with other pain that women feel, there are different types of pain experienced with sexual intercourse such as: # a deep, aching pain # a sharp, stabbing pain # a deep, burning pain # an intense, jabbing pain Some women say that it feels as though they can feel something being knocked against and that they feel bruised and sore afterwards. Other women have complained of pain after an orgasm, to the point where they suffer from intense cramp like pains. Sometimes the pain may only be felt at certain times of the month, or in certain positions. However, sadly this isn't the case with other women. They're not so lucky and find that it doesn't matter what time of the month it is, or what position they try. No matter what, it still hurts and it becomes easier to avoid sex altogether. What are the stages of Endometriosis? Endometriosis is categorized in four stages based on the severity, location, amount, depth and size of growths. Stage 1 - minimal disease, superficial and filmy adhesions Stage 2 - mild disease, superficial and deep endometriosis Stage 3 - moderate disease, deep endometriosis and adhesions Stage 4 - severe disease, deep endometriosis, dense adhesions **ME** How is endometriosis diagnosed? There is no simple, accurate, noninvasive way to diagnose endometriosis. The only way to be sure you have endometriosis is to have a type of surgery called laparoscopy (say “lap-uh-ROS-cuh-pee”). During this surgery, the doctor puts a thin, lighted tube through a small cut in your belly. This lets the doctor see what is inside your belly. If the doctor finds implants, scar tissue, or cysts, he or she can remove them (or most of them) if it is safe to do so during the same surgery. How is it treated? There is no cure for endometriosis, but there are some good treatments. You may need to try several treatments to find what works best for you. With any treatment, there is a chance that your symptoms could come back. Treatment choices depend on whether you want to control pain or you want to get pregnant. For pain and bleeding, you can try medicines or surgery. If you want to get pregnant, you may need surgery to remove the implants. As a last resort for severe pain, some women have their uterus and ovaries removed (hysterectomy and oophorectomy). Can a woman still get pregnant if she has endometriosis? About 30 to 40 percent of women with endometriosis experience infertility. --------------------------------------------- So now ya's know what it is I suffer from, and hopefully understand it (and me) a bit better! Got any questions? Feel free to ask! I'll try to answer them as best as I can.