Endometriosis awareness week 4-10th March 2023, article by Joy Wisdom
Endometriosis is the second most common genealogical condition affecting women in the UK. A female health condition ‘Endometriosis’ a disorder where tissue similar to the lining of the uterus grows outside the uterus, causing pain and/or infertility. A health condition under acknowledged and under supported in today’s medical care spectrum. Globally the situation is mirrored.
World Health Authority (WHO) states Endometriosis affects 190 million females globally or approximate 10% of reproductive aged women.
1.5 million women suffer from Endometriosis in the UK Endometriosis UK. Equates to 1 in 8 individuals suffer from this complaint. Estimated waiting time for diagnosis on average is 8-years. Source: www.endometriosisuk.org
Affecting a woman’s quality of life. Involved in fertility disappointments. Emotionally and psychologically undermining and tainting life. Endometriosis has significant social, public health and economic implications. A complex disease that affects some women from the onset of their first period (menarche) through menopause regardless of ethnic origin or social status. Origins of endometriosis are thought to be multifactorial, meaning that many different factors contribute to its development.
Symptoms include: Intense pain undermining life during menstrual/premenstrual (dysmenorrhea) and around ovulation periods. Causing a chronic inflammatory reaction that may result in the formation of scar tissue (adhesions, fibrosis) within the pelvis and other parts of the body.
Painful episodes - chronic pelvic pain
Painful sexual interactions
Fatigue and chronic tiredness.
Emotionally and mentally affects women.
Changing hormonal levels can produce mood swings, affecting daily life.
Endometriosis is where uterine tissue grows outside the uterus causing pain and bleeding in women.
Infertility occurs due to the probable effects of endometriosis on the pelvic cavity, ovaries, fallopian tubes or uterus. There is little correlation between the extent of endometrial lesions and severity or duration of symptoms: some individuals with visibly large lesions have mild symptoms, and others with few lesions have severe symptoms. Symptoms often improve after menopause, but in some cases painful symptoms can persist. Source: W.H.O (1)
Retrograde menstrual flow occurs i.e.: tissue sheds during menstrual period, through fallopian tubes into other areas of the body such as pelvis giving skeletal pain.
*Retrograde menstruation meaning: when menstrual blood containing endometrial cells flows back through the fallopian tubes and into the pelvic cavity at the time that blood is flowing out of the body through the cervix and vagina during periods. Retrograde menstruation can result in endometrial-like cells being deposited outside the uterus where they can implant and grow.
Cellular metaplasia, occurs when cells change from one form to another. Cells outside the uterus change into endometrial-like cells and start to grow. Stem cells giving rise to the disease, which then spreads through the body via blood and lymphatic vessels. Source: www.worldhealthauthority.org
Hormones and Endometriosis
The disorder is known to be dependent upon Oestrogen, facilitating inflammation, growth and pain associated with the disease. Women with imbalanced Oestrogen hormones maybe more prone to this gynaecological disorder.
However, the relationship between oestrogen and endometriosis is complex since the absence of oestrogen does not preclude the presence of endometriosis. Several other factors are thought to promote the development, growth, and maintenance of endometriosis lesions. Including altered or impaired immunity, localised complex hormonal influences, genetics and potentially, environmental contaminants. ( 2-7)
Exhaustion from Endometriosis.
A 2018 study found that women with endometriosis are twice as likely to have extreme tiredness. Stating doctors may be overlooking endometriosis as a critical symptom in a women’s fatigue conditions. Source: www.everydayhealth.com
Endometriosis is a factor in infertility. Estimated to be affecting 30% of sufferers.
Science investigations are continuing around infertility and endometriosis. Endometriosis affects female reproductive apparatus, in various ways and in embryo implantation and ovary function, causing further complications in fertility outcomes. A recent Italian research found congenital origin of endometriosis andsome pollutants cause the embryonic alterations responsible for the dislocation of the endometrial cells. An exciting revelation for the first time was proved on animal models, the relationship between endometriosis and ovarian reserve; the latter is often lower in endometriosis patients, causing infertility and/or early menopause. Source: www.italianendometroisisfoundation.org
Endometriosis can affect the bowel. As endometrium tissue releases into the body it has been found to affect the bowel. Termed bowel endometriosis, endometrium tissue grows on the surface of or inside the intestines, on the rectum, or in other parts of the bowel. This may cause: constipation. bloating or gas. Source: www.weilcornell.edu
Early suspicion of endometriosis is a key factor for early diagnosis, as endometriosis can often present symptoms that mimic other conditions and contribute to diagnostic delay. At present, there is no known way to prevent endometriosis.
Medical treatments for endometriosis focus on either lowering Oestrogen or increasing Progesterone in order to alter hormonal environments that promote endometriosis. Medical therapies include, combined oral contraceptive pill, progestins, and GnRH-analogues. However, none of these treatments eradicates the disease. Wea re all unique and individuals may have side effects. Endometriosis-related symptoms can sometimes reappear after therapy discontinuation. The choice of treatment depends on effectiveness in the individual, adverse side effects, long-term safety, costs, and availability.
Surgery can remove endometriosis lesions, adhesions, and scar tissue. However, success in reducing pain symptoms and increasing pregnancy rates are often dependent on the extent of disease. In addition, lesions may recur even after successful eradication, and pelvic floor muscle abnormalities can contribute to chronic pelvic pain. Secondary changes of the pelvis, including the pelvic floor, and central sensitisation may benefit from physiotherapy and complementary treatments for sufferers. D.A.R.E Therapy helps here.
Read more out women’s health issues in my book - Pregnancy and Birth a New Generation.
Joy Wisdom www.allonus.co.uk/ www.joywisdomtrust.org
World Health Organization (WHO). International Classification of Diseases, 11th Revision (ICD-11) Geneva: WHO 2018.
Zondervan KT, Becker CM, Missmer SA. Endometriosis. N Engl J Med 2020; 382:1244-56.
Agarwal SK, Chapron C, Giudice LC, et al. Clinical diagnosis of endometriosis: a call to action. Am J Obstet Gynecol 2019(4):354-64.
Johnson NP, Hummelshoj L, World Endometriosis Society Montpellier Consortium. Consensus on current management of endometriosis. Hum Reprod 2013;28(6):1552-68.
Horne AW, Saunders PTK, Abokhrais IM, et al. Top ten endometriosis research priorities in the UK and Ireland. Lancet 2017; 389:2191-92.
Johnson NP, Hummelshoj L, Adamson GD, et al. World Endometriosis Society consensus on the classification of endometriosis. Hum Reprod 2017;32(2):315-24.
Wen X, Xiong Y, Qu X, et al. The risk of endometriosis after exposure to endocrine-disrupting chemicals: a meta-analysis of 30 epidemiology studies. Gynecol Endocrinol 2019;(35):645-50.