In an eggshell...
- Endometriosis is when the inner lining of the uterus grows outside and spreads to nearby organs.
- Symptoms can vary from person to person, the most common one being intense period pain.
- This condition affects around 10% of women of reproductive age.
The inner lining of the uterus is known as the endometrium.
This one’s a hard worker, thickening in size with every menstrual cycle, prepping itself just in case a fertilised egg implants 🐣
And when it sheds, is when the bleeding stage of the menstrual cycle happens.
But in some cases, the endometrium goes a little overboard and starts growing beyond the uterus.
And this can unfortunately be painful. It also tags along issues such as infertility, adding to the baggage.
But is there any way around it? And what does treatment look like? We’re here with our research on all things endometriosis. Read on!
What is endometriosis?
When endometrial-like tissue grows outside the uterus, the condition is called endometriosis. It usually grows on or around the surrounding reproductive organs such as the fallopian tubes, ovaries, lining of pelvic cavity, surface of uterus and the space between the uterus and bladder.
Unlike the endometrial tissue that sheds every month during our menstrual cycles, this overgrowing tissue doesn’t shred, and instead leads to buildup, scarring and cysts 😖
What causes endometriosis?
There are several theories surrounding the causes of endometriosis:
1. Genetics
Databases have shown a familial connection between first and second-degree relatives affected by endometriosis. Additionally, changes in HOXA10 gene expression were associated with uterine structural changes and endometrial abnormalities.
2. Reverse menstruation
This is based on Samson’s theory of retrograde menstruation. In some cases, our menstrual blood, rather than being shed out, might flow back to the fallopian tubes.
Now, as our normal hormonal cycle goes on, this menstrual blood containing endometrial cells might respond to hormonal changes and grow.
And since they’re endometrial cells, they are programmed to shed and grow in response to hormones (but in the wrong place😖), and unfortunately, spread endometriosis the same way.
3. The stem cell theory
The normal human endometrial lining is subjected to cycles of growth and shedding. This ability to do so comes from resident stem cells, which behave like bone marrow stem cells.
Stem cells are a special bunch as they can self-renew and turn into different cell types. According to the theory, it is this ability that might lead to the development of endometriosis.
What are the symptoms of endometriosis?
The symptoms of endometriosis may depend on the stage and the person itself.
The most common symptoms include:
- Painful periods
- Inflammation
- Pain during sex
- Painful bowel movements
- Chronic/ongoing pelvic pain
- Tiredness
- Mood changes
- Issues with fertility
Apart from these, endometriosis can also cause cysts to form, and adhesions where the endometrial-like tissue creates a sticky impression.
What are the risk factors for endometriosis?
While there are theories around the causes, there are some things that increase your chance of developing endometriosis, such as:
- Never giving birth
- Having short monthly cycles (less than 28 days)
- Heavy and prolonged periods that last longer than seven days
- High levels of oestrogen in your body
- Having a low body mass index
- Having a structural issue with the vagina, cervix, or uterus that prevents menstruation
- A family history of endometriosis
How is endometriosis diagnosed?
Before a diagnosis, you may have an appointment with your healthcare provider to discuss the symptoms, the area of pain, and the extent of it. Further, these are some common tests that may be performed as a diagnosis:
- Pelvic exam to manually feel for cysts in the pelvic area
- Ultrasound, either abdominal or transvaginal to identify cysts
- Magnetic resonance imaging (MRI), in case surgery is planned. MRI helps retrieve detailed images of any adhesions or lesions
- Laparoscopy, an outpatient surgery done to temporarily manage by cutting lesions to manage endometriosis
Does endometriosis cause infertility?
Unfortunately, yes. Since the symptoms of endometriosis lie on a spectrum, for some people infertility is the only symptom. And for some, it may come along with other symptoms.
Endometriosis can pose a barrier when trying to conceive. Usually, an egg is released by the ovary and waits around in the fallopian tube for the sperm to fertilise.
Endometriosis, if spread to the fallopian tube can cause swelling and inflammation affecting the transport of the egg as well as the sperm. Lesions can adhere to organs as well, such as the ovaries, disrupting their function.
How is endometriosis treated?
Any form of treatment for endometriosis is based on the severity of symptoms and helps manage the symptoms.
To reduce pain, you may be prescribed painkillers such as ibuprofen and naproxen. Hormonal medication such as birth control (pill, IUD, vaginal ring, patch, implant) may also be prescribed to manage symptoms.
However, if you’re planning to conceive or preserve fertility, treatment may differ. Some options include:
1. Surgery
Surgery may be done to remove lesions, additions, and scar tissue caused by endometriosis. This is done via laparoscopic surgery.
2. Assisted reproductive technologies
Methods such as intrauterine insemination (IUI), or in vitro fertilisation (IVF) can be done with or without surgery.
3. Egg or embryo freezing
If you’re planning for endometriosis surgery later on, this is an option that is recommended. You can freeze eggs, or embryos (if you have partner or donor sperm available).
📚Also read: Should I go for egg or embryo freezing?
Where Amilis comes in
Navigating endometriosis can feel scary and uncertain.
Especially if it’s affected your fertility. Visualising the journey ahead with multiple GPs, clinic visits, tests and so on can feel confusing.
But we at Amilis are here to tell you that it doesn’t have to be.
We are here to have conversations around egg freezing as a form of treatment, offering 1-1 consultations, partnering with pre-vetted fertility clinics that treat endometriosis-related infertility, and reducing costs on the egg freezing process to make it more affordable for millions of women in the UK.
You can also book a free call with us, take our fertility test, or get started with our egg-freezing quiz to check whether it’s for you.
We are here to support you, every step of the way♥️
