Endometriosis is a painful, chronic condition with symptoms that include painful, heavy periods and pelvic pain. It can be debilitating, but often goes undiagnosed for years
Endometriosis is a long-term chronic condition that can severely affect a woman’s mental and physical health – but often goes undiagnosed for years. It is thought to affect around 10-15% of women, usually during their reproductive years. It is caused when tissue similar to the inner lining of the womb (endometrium) grows in abnormal locations, most commonly in the fallopian tubes, ovaries and pelvis, although could potentially grow anywhere in the body.
These oestrogen-regulated cells are programmed to ‘menstruate’ at the same time as a period takes place in the uterus, which means a period bleed wherever those cells are located. But if the bleed is not in the womb, there is nowhere for the blood to go.
Main symptoms
Some typical symptoms include excessive bleeding during and between periods, painful periods that aren’t relieved by painkillers, pelvic pain, and pain during or after sex, blood in the stool and feeling tired all the time. Women also describe back pain, urine and bowel problems. Because of the effect of the physical symptoms on mental health, depression is often reported, too.
Catherine Nestor, co-vice chair of the Royal College of Obstetricians and Gynaecologists Women’s Network, has suffered from endometriosis since she was a teenager, suffering from fainting spells and cold sweats, as well as being doubled over in pain before her period. During her thirties, she says, “the pain was almost unbearable, I could only manage to walk short distances, and my energy levels were shot.”
But some women don’t experience any symptoms. “For some women, symptoms can stop them from doing their normal activities and may lead to feelings of depression and relationship difficulties,” Professor Nick Raine-Fenning, a consultant gynaecologist and spokesperson for the RCOG says.
Long-term effects
As well as debilitating monthly attacks for some, endometriosis can lead to fertility problems. In women who are having fertility problems, around 50% have endometriosis. Many women don’t realise they have the condition until they start investigating their own fertility problems.
What causes endometriosis?
“Doctors don’t know why endometriosis occurs but believe it may happen when cells that line the womb are carried to the pelvis during a woman’s period” Professor Raine-Fenning says. “Unlike the cells from the womb lining, which can leave the body through the vagina during menstruation, the endometriotic cells have nowhere to escape. This leads to pain and inflammation and, in some women, damage to the pelvic organs through the formation of scar tissue and cysts”.
One factor is thought to be genetics, as it’s commonly seen in families. Interestingly, a number of studies have suggested an association between naturally red hair and increased incidence of endometriosis.
There are also indications that impaired immunity, diets low in vegetables/fruit, diets high in red meat, saturated fat and a lack of exercise could also be causes.
Other factors may be triggers and mediators for endometriosis and these include intrauterine devices (coils), endocrine disruptors, prenatal exposure to endocrine disruptors, poor liver function, dioxin, parabens, Bisphenol-A exposure and oestrogen dominance.
The importance of diagnosis
As well as taking steps to address the symptoms of endometriosis, either through lifestyle changes or medical options (read more on both in our mini-series), many women diagnosed with the condition say that the mental relief of finding out what is going on with their bodies is huge. “Too many years were lost feeling terrible and not knowing why,” Catherine says.
Laura Owen-Wright, 32, agrees. “I look back over the years and think, what could I have achieved if I had just been in balance,” she says. “No one cares about that stuff and it’s so important. How much more productive could we be if attention was given to our cycles. There’s so much wisdom in it.”
Read more from Moody Month’s endometriosis mini-series:
Endometriosis: How to get diagnosed
Endometriosis: The medical options
Endometriosis: Lifestyle factors that can help manage symptoms
Daily wellness for women, tailored to your cycle.
