Endo-cation

‍What is Endometriosis?

‍Endometriosis is a chronic, whole body, inflammatory disease, where tissue similar to the lining of the uterus, is found in other parts of the body. This is most commonly within the pelvic cavity, however may extend beyond, to other parts of the body. It is also important to acknowledge what endometriosis is not, which is a menstrual disease. Endometriosis impacts the entire body, and should be thought of as a “whole body” disease.

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Symptoms of Endometriosis

‍Endometriosis can present a variety of symptoms, which can range from mild to severe. Interestingly, symptom severity does not correlate with disease severity, meaning some people have very little endometriosis disease, yet have significant symptoms.

Symptoms include:

• Pelvic Pain: This may be pain related to periods, ovulation, filling or emptying your bladder, bowel movements, or a more general pain.
• Menstrual Irregularities: Heavy periods, prolonged periods, or bleeding between periods.
• Pain During Intercourse: Discomfort or pain before, during or after sexual activity.
• Infertility: Difficulty in becoming pregnant.
• Bowel Irregularities: Fluctuating stool types (constipation or diarrhoea), bloating (endo belly), nausea
• Bladder Irregularities: Difficulties emptying your bladder (slow flow, hesitancy to start, incomplete emptying), pain with emptying your bladder, or urinary incontinence
• Fatigue

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Causes of Endometriosis: The exact cause of endometriosis is unknown. The research is limited on this topic, yet there are a few thoughts proposed:

• Immune System Disorders: Issues with the immune system may prevent the body from recognising and destroying endometrial-like tissue outside the uterus.
• Genetic Factors: Endometriosis tends to run in families, suggesting a genetic link. One statistic shares that if you have a direct relative with diagnosed endometriosis (mum, aunt, sister), you are seven times more likely to be diagnosed with endometriosis.
• Hormonal Imbalances: Estrogen, a hormone that regulates the female reproductive system, might promote endometriosis tissue growth.
• Transport systems: The circulatory and lymphatic system may take endometriosis cells around the body to new areas, highlighting, although rare, how endometriosis tissue has been found in places such as the heart and brain.

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Endometriosis is a chronic, whole body, inflammatory disease, where tissue similar to the lining of the uterus, is found in other parts of the body.

Diagnosis of Endometriosis:

‍Diagnosing endometriosis can be challenging due to the similarity of its symptoms to other conditions, for example, it is often misdiagnosed as irritable bowel syndrome or dismissed as “normal” menstrual pain.

A combination of the following methods is typically used:

• Pelvic Exam: A doctor manually checks for abnormalities in the pelvic area.
• Imaging Tests: Pelvic ultrasound, MRI, or CT scans can provide detailed images of the pelvic organs. Diagnosis can be made by a skilled sonographer or radiographer.
• Laparoscopy: A surgical procedure where a camera is inserted into the pelvic cavity to look for endometriosis tissue. This tissue can be excised and sent to pathology to confirm diagnosis.

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Treatment Options for Endometriosis:

‍While there is no cure for endometriosis, various treatments can help manage symptoms and improve quality of life:

• Hormonal Therapies: Birth control pills, hormone therapy, and other medications can reduce or eliminate menstruation, which in turn reduces the symptoms of endometriosis.
• Surgery: Surgical options like laparoscopy can remove as much endometriosis tissue as possible via excision (preferred) and ablation. It is important to find a surgeon skilled in endometriosis surgery.
• Lifestyle and Home Remedies: Regular exercise, heat therapy, dietary changes, and stress management techniques can also help manage symptoms. Matilda is designed to encompass this pillar of management, delivering this care before and after surgery.

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Conclusion:

‍Endometriosis is a complex condition that impacts many facets of an individuals life. The treatment, like any chronic disease, is also multi-faceted. Like other chronic diseases, such as diabetes or asthma, endometriosis must be managed over the course of a person’s life (reproductive). Learning about endometriosis, and sharing it with your family and friends, helps to improve the general populations understanding of this condition and opens the door for more research and discussions about optimising care.

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Call to Action: If you or someone you know is experiencing symptoms of endometriosis, seek advice from your local GP.

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Author: Joanna Morris (Pelvic Health Physiotherapist and Co-founder of Matilda)