If painful periods and reproductive system difficulties have you down, you’ve come to the right place. From hormonal therapies to pelvic massages, there are plenty of options available to help you find the best treatment for you. So, grab a heating pad and settle in, because we’re about to dive into the wild world of endometriosis treatment!
What is Endometriosis?
Endometriosis is a common condition, where the tissue that’s similar to the lining of the uterus develops outside the uterus.
Some common places endometriosis can develop include the:
- Exterior of your uterus
- At the back of your uterus
- Fallopian tubes
- Lining of your abdomen and pelvis (Peritoneum)
- Bladder and ureters
Endometriosis usually affects the ovaries, fallopian tubes, and pelvic lining. However, in rare cases, the endometrial-like tissue can extend beyond the pelvic organs and expand onto other parts of the body.
In order to understand what this health condition actually consists of, you need to know a bit more about the female anatomy and this tissue. The endometrial-like tissue that grows where it isn’t supposed to behaves the same way endometrial tissue does during a menstrual cycle – thickening, breaking down, and bleeding (exiting the body). However, since this tissue is growing in the wrong areas, it has no way out and gets trapped in the body. This can lead to cysts known as endometriomas, can irritate the surrounding tissue, lead to the development of scar tissue and can even cause the pelvic organs and tissues to stick together, leading to further complications. As a result, women with endometriosis typically experience intense and sometimes severe pain, as well as many additional symptoms that can disrupt their overall health and wellness, quality of life and fertility.
Unfortunately, it affects over 11% of American women aged between 15 and 44 years old. The good news: there are treatments available.
Symptoms of Endometriosis
The most common sign of endometriosis is pelvic pain, especially during menstrual periods. This pain tends to be more intense than your typical menstrual cramps (even on the worst days) and the pain can intensify overtime. However, you may also experience some additional symptoms with endometriosis, such as:
- Painful periods (also known as dysmenorrhea): experiencing intense pelvic pain and cramping before and during menstrual period, as well as lower back and abdominal pain.
- Pain with intercourse: experiencing pain during or after intercourse is common with endometriosis.
- Pain when going to the bathroom: experiencing pain with bowel movement or urination, especially during menstrual period.
- Heavy bleeding: having heavy periods or bleeding between periods (intermenstrual bleeding).
- Infertility: having difficulties getting pregnant, due to the growths blocking your fallopian tubes or forming scar tissue.
You may also experience other signs and symptoms, such as fatigue, diarrhea, constipation, bloating, nausea especially during menstrual periods.
It’s important to keep in mind that the level of pain you experience doesn’t always reflect the severity of your endometriosis. For example, you can have mild endometriosis with severe pain or advanced endometriosis with minimal or no pain.
Causes of Endometriosis
While we know that the symptoms are caused by the endometrial-like tissue growing where it shouldn’t, why that happens is still unknown. However, many healthcare experts believe that the cause may be from menstrual blood (that’s carrying endometrial cells) flowing backward into the fallopian tubes, where the cells then attach to the surfaces of your pelvic organs and on the pelvic wall. Here, the cells continue to thicken and grow with each menstrual cycle. This is formally known as retrograde menstruation.
Some other theories surrounding the cause of endometriosis are:
- Peritoneal cells transforming: when the cells lining the inside of the abdomen transform into endometrial-like cells due to hormones or immune factors.
- Embryonic cell transformation: hormones, such as estrogen, can cause embryonic cells to transform into endometrial-like cells.
- Surgical scar implantation: when endometrial cells attach themselves to the surgical incision following a surgical procedure, such as a C-section or hysterectomy.
- Endometrial cell transport: whenendometrial cells get carried to different parts of the body through the blood vessels or the lymphatic system
- Immune system disorder: when a malfunctioning immune system has problems identifying and eliminating endometrial-like tissue that is growing outside of the uterus.
There are also some additional factors that may contribute to the development of endometriosis, such as:
- Having mother, aunt or sister with the condition increases your chances of developing it.
- Getting your period at an early age
- Going through menopause at an older age
- Never giving birth
- Having menstrual cycles that are less than 27 days
- Having heavy periods that last longer than 7 days
- Having a low BMI (body mass index)
- Having higher estrogen levels
- Medical conditions that disrupt the passage of blood from the body during menstruation
- Disorders associated with the reproductive system
Potential Complications of Endometriosis
Dealing with endometriosis, in itself, can be physically, emotionally and mentally trying. Unfortunately, it can also create additional complications that can affect other areas of your health, such as your mental health, fertility, and overall quality of life. But as mentioned previously, knowledge is power and there are several treatments available to help combat the following potential risks:
Endometriosis is the number one cause of infertility, with approximately two out of five women with endometriosis having difficulties getting pregnant. This is because endometriosis can negatively affect fertility as it interferes with your reproductive organs in various ways, such as:
- Tissue surrounding the ovaries can block the release of eggs
- Blocking the fallopian tubes, preventing the sperm from getting to the egg
- Blocking a fertilized egg from getting to the uterus
- Altering hormone balance
- Triggering the immune system to attack the embryo
- Disrupt the uterine lining where the egg is implanted
Research suggests that ovarian cancer may be more common in people with endometriosis. The good news: the overall lifetime risk of developing ovarian cancer is still quite low. You may also be at higher risk of developing endometriosis-associated adenocarcinoma, a rare cancer, later in life if you have endometriosis.
Studies have also found a potential link between endometriosis and several other health issues, such as:
- Chemical sensitivities
- Autoimmune diseases, including multiple sclerosis, lupus, and certain types of hypothyroidism.
- Chronic fatigue syndrome
- Breast cancer
Ways to Treat Endometriosis
Learning about endometriosis can be quite daunting but there is light at the end of the tunnel because there are various forms of treatments available that can help with the physical and mental health symptoms. Sometimes, endometriosis can even resolve on its own without treatment.
Speaking with your doctor is important, as they can help you develop a treatment plan based on your individual circumstances, such as your fertility or plans for pregnancy, age, the severity of symptoms, etc. However, a typical treatment plan consists of managing your symptoms, alleviating pain and improving fertility issues (if you aiming for kids in the future).
To give you an idea of the different treatment options available to you, let’s take a look at some of the most common ones.
Medications are commonly used to help alleviate the symptoms of endometriosis and typically consist of a combination of pain relief medications and hormone treatments. Some common options are:
- Danazol: This medication stops the production of hormones responsible for inducing menstruation to stop painful menstrual periods altogether.
- Hormonal birth control: These types of medications combine estrogen and progesterone or use progesterone-only, and are designed to suppress hormones which can help combat heavy, painful periods. They come in different forms – from oral pills to patches, vaginal rings, shots, Nexplanon implants, and IUDs.
- Gonadotropin-releasing hormone (GnRH) medications: These medications are used to suppress the hormones responsible for menstrual cycles, thus stopping your period to help alleviate pain. You can get them in the form of injections, nasal sprays or oral pills.
- Over-the-counter pain relief: Acetaminophen (Tylenol) and NSAIDS (nonsteroidal anti-inflammatory drugs) such as Aspirin, naproxen (Aleve), and ibuprofen (Advil, Motrin) can be used to help alleviate pain.
Surgery is typically recommended for people dealing with severe endometriosis symptoms that do not respond to hormonal therapies, or for those experiencing fertility issues. There are various options to choose from but the general approach with these surgeries is to identify and remove any patches of endometriosis. Some examples of surgery types are:
- Laparoscopy: A minimally invasive procedure where a small incision is made in the abdomen and a tool is inserted to locate and remove endometriosis patches.
- Hysterectomy: A surgery that may be offered in cases of severe endometriosis where your uterus is partially or fully removed.
There are also many natural remedies you can use to help treat your symptoms and manage endometriosis. These can be used on their own or alongside other treatment options mentioned. Here are some tips to get you started:
- Heat compressions: Applying heat to the lower abdomen can help ease pain and cramping and can be done with a hot compress, by taking a warm bath, or using a heating pad or water bottle.
- Massaging your pelvic area: This simple act of self care can help alleviate pain by increasing the blood flow around the pelvic area. It can also promote relaxation.
- Low-fat diet: Some studies found that long-term exposure to certain toxins may increase the risk of developing endometriosis and make its symptoms more severe. Since many toxins are stored in animal fats and passed through food and drinks, eating a diet low in saturated fats can help reduce your risk.
- Progesterone cream: This type of cream may help stop the blood supply feeding lesions and causing pain and it may even help prevent new lesions.
- Omega-3 fatty acids: Eating more foods with omega-3 fatty acids, such as salmon, mackerel, sardines and anchovies (or taking a supplement) can help with swelling.
- Rest and relaxation: Practicing relaxation techniques such as deep breathing, taking a walk in nature, or meditating can help reduce stress, can ease endometriosis symptoms.
- Prioritizing sleep: Getting adequate sleep is essential for keeping your hormones in balance, reducing inflammation and easing pain.
- Herbal supplements: Herbs that have anti-inflammation properties, such as turmeric, may help alleviate endometriosis symptoms.
- Staying active: Committing to some light exercise each day for a minimum of 20 minutes can help combat pain, inflammation and depression.
Endometriosis can be a difficult condition to live with. The good news: there are many treatments available to help manage its symptoms. Whether it’s heating pads, pelvic massages, or medication, you can start easing your symptoms, boosting fertility (if you plan on future pregnancies) and start living life pain-free once again.