Endometriosis: Often a hidden disease

Endometriosis is a condition where the tissue similar to that which lines the inside of your uterine wall (called the endometrium) grows outside of your uterus like ovaries, back of uterus, ligaments of the uterus. In very rare cases it has been found on the diaphragm and in the lungs. This lining will bleed every month under the influence of female hormones and if it is in the ovary, it can form a chocolate cyst(noncancerous, fluid-filled cysts). The endometrium induces a chronic inflammatory reaction that may result in scar tissue. It is basically found on the pelvic peritoneum, ovaries, bladder, in the recto-vaginal septum and bowel.

In most cases, endometriosis is extremely painful, and a lot more in numbers than what most people have figured. Endometriosis is by far the most common cause of pelvic pain in women and can also cause infertility. It affects an average of 1 in 10 women from the age of 15 to around 49 years, which is roughly 176 million women from all over the world. Endometriosis can begin as early as a girl’s first period, and menopause may not relieve its symptoms –particularly in case the woman has scar tissue or adhesions from surgery or the disease.

Symptoms

  • Painful periods (Dysmenorrhea) – The primary symptom of endometriosis is pelvic pain and cramping which may begin before and extend several days into a menstrual period. Though in most cases menstrual periods are associated with cramping, those having endometriosis will be experiencing far worse menstrual pain than usual. They may also have lower back and abdominal pain. Pain also may increase over time.
  • Pain during passing motion especially during periods.
  • Pain during coitus – Pain during or after sex is common with endometriosis.
  • Lower abdomen pain
  • Rectal pain
  • Excessive bleeding- One may experience heavy menstrual periods or bleeding (intermenstrual bleeding) between periods.
  • Infertility – Sometimes, endometriosis is often first diagnosed in those seeking infertility treatments.
  • Other signs and symptoms- During menstrual cycles, you may experience fatigue, vomiting, constipation, bloating or nausea.

All these symptoms can impact on general physical, mental and social well-being of a woman.

Causes of Endometriosis

There is no known cause of endometriosis, but some genes are highly likely to predispose women to develop the disease. Women are also at greater risk of developing endometriosis if their mother and/or sister(s) are also affected. It is likely that when the menstrual cycle starts, other gynecological factors and environmental exposures may also influence whether a woman is affected. Whereas the evidence for exposure to dioxins (environmental pollution) has been poor, some evidence now supports exacerbation of its symptoms due to PCBs.

Risk associated with Endometriosis

  • Fertility problems may develop
  • Can have heavy menstrual periods that can extend more than seven days or short menstrual cycles that are less than 27 days.
  • Cancer: Several reports have related the existence of endometriosis to the development of ovarian cancer; however, the correlation is not conclusive and the absolute risk to a specific individual with endometriosis is exceedingly low.

Even though endometriosis is associated with inflammation and immunological dysfunctions, it has not been proven itself to be an autoimmune disease.

Endometriosis can take a toll on mental health: When a woman has endometriosis, the symptoms they go through isn’t something that they just have in their head. The condition can affect their psychological state. If you’re going through anxiety or depression, you’re not alone. Managing chronic pain, infertility and other symptoms is very stressful. Fix an appointment with a mental health counselor. They can help you work through the effects of endometriosis which may be affecting you emotionally and your health.

Nutrition tips to alleviating symptoms in Endometriosis

  • eliminate possible food allergens: dairy, gluten, corn, soy, preservatives and additives such as monosodium glutamate(MSG)
  • eat food high in antioxidants: fruits(blueberries, cherries and tomatoes) and vegetables(kale, spinach and bell pepper)
  • avoid refined foods: white bread, pasta and sugar
  • eat less red meat and more lean meat: fish, tofu and beans
  • cook with healthy oil: olive oil or vegetable oil
  • eliminate trans fatty acids: commercially baked cookies, crackers and cakes, as well as fries, onion rings, donuts, processed foods and margarines
  • avoid alcohol tobacco and caffeine
  • limit foods with high sugar salt and fat
  • drinking six to eight glasses of water each day

Treatment for Endometriosis

A general lack of understanding on the part of both patients and health care providers, due to a “normalization” of symptoms, results in a long delay from the first time a patient experiences symptoms before she is finally diagnosed and treated. False assumption that menstruation has to hurt ends up with almost 50% of women not diagnosing the issue correctly.

  • Hormonal treatment with Dienogest and oral contraceptives.
  • Laparoscopy: If endometrioma is more than 3 cm, laparoscopy is required.
  • Although endometriosis can be treated effectively with drugs, most treatments are not suitable for long term use due to side-effects
  • Gonadotropin-releasing hormone (GnRH) – these will cause the estrogen levels to fall to menopausal levels but can have side effects i.e. it causes menopausal symptoms.
  • There may be relief to some of the symptoms after pregnancy but is not a cure for the disease
  • Last-resort surgery (hysterectomy) – with surgical removal of all the disease at the same time, may relieve symptoms, but may not be a definitive cure either as success rates depend on the severity of the disease. Removal of the ovaries at the same time as a hysterectomy is performed increases the chances of pain relief but often results in premature menopause.

One cannot state that all of these treatments may provide a complete cure to the condition but it may help to provide relief to the symptoms up to a certain degree.

If you have any concerns regarding endometriosis or would want to know more about it, reach out to us by calling +971563587610.

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