What is endometriosis or “endo”?
Endometriosis is a disease where tissue similar to the lining of the uterus is found outside the uterus, on other parts of the body such as: bowel, bladder, tubes, appendix, diaphragm and even the lungs. This creates lesions that bleed causing inflammation, adhesions and pain. Organs are often fused together and moved into unnatural places by these tough, fibrous scar tissue bands. For example, the bowel and an ovary may be “glued” together.
Endometriosis affects over 176 million (1 in 10) women worldwide. The average diagnosis for endometriosis takes ten years. There is no known cure for the disease.
What causes endometriosis?
The cause of endo is unknown, but some research shows it to be an autoimmune disorder caused by environmental toxins and epigenetics.
What are endometriosis symptoms?
Chronic pelvic pain, debilitating periods, difficulty with bladder/bowel function, vaginal pain, pain with intercourse, ovarian cysts, infertility, severe bloating, back pain, vomiting & more. Endometriosis is the leading cause of infertility.
There are five stages of endometriosis, which are measured by the depth of endometrial implants. Oddly, the stage of the disease does not correlate with a women’s pain. For example, one patient might have severe pain with stage 1 and another minimal pain with stage 3. However, women with late stage (stages 3-5) are more likely to have endometrioma’s or “chocolate ovarian cysts”.
Pain from endometriosis can present itself in many ways, but can be severe and mind-numbing in each form. Adhesion’s may feel sharp, searing and pulling accompanied by labor-like cramping and aching from inflammation. Patients often report feeling unable to get comfortable in any position, and that physical movement increases pain.
How is endometriosis diagnosed?
The average diagnosis for endometriosis takes 10+ years. Aside from a lack of awareness and broad set of symptoms, the main reason for delayed diagnosis is that imaging tests (CT, MRI, Ultrasound) cannot confirm, or in most cases even detect endometriosis. The only way to receive a definitive diagnosis is via biopsy taken from laparoscopic surgery.
How is endometriosis treated?
Hormones + GnRH
After an initial diagnosis of endometriosis, the majority of patients are put on hormones or estrogen depleting medications named GnRH antagonist (Lupron). Unfortunately, neither are a very effective treatment for the disease and only mask symptoms for a limited time. In addition, they bring with them a slew of awful side effects.
Most gynecologists perform ablation surgery. This technique may open up a short-term window of fertility, but is unsuccessful in treating pain and the disease long term. It only removes the surface layer of the disease, leaving cells behind and often fuels endo to grow back even stronger. The ablation technique leaves women with an 85% chance of the disease returning.
The gold standard treatment for endometriosis is excision surgery. This technique removes deep infiltrating endometriosis at the root of the disease. Excision is performed by an endometriosis excision specialist. This treatment is the closest thing to a cure, leaving women with less than a 5% chance of the disease returning.
Pregnancy & hysterectomy are NOT cures or proper treatment options for endometriosis.
Why early diagnosis + treatment is important
The earlier a woman is diagnosed and given proper treatment, the better chance she has of regaining a pain-free life. If someone is in late stage of the disease with a lot of internal trauma (like myself), successful excision surgery can greatly improve their quality of life but in some cases may not take away their pain entirely. So many years of harm to the tissues from repeated ablation surgeries and tensing of pelvic floor muscles can result in nerve issues and heightened pain signals.
Pelvic Floor Therapy is a widely successful treatment option for continued pain after excision surgery and is recommended by most specialists. Some women who have not tried surgical intervention also find relief of