Endometriosis is a chronic condition where tissue resembling the lining of the uterus grows outside its usual location. This condition affects approximately 10% of reproductive-aged women globally, impacting around 190 million individuals. While often associated with significant pain, it can manifest with various symptoms that affect daily life.
Understanding Endometriosis
Endometriosis involves the growth of tissue similar to the endometrium, the inner lining of the uterus, in other areas of the body. These growths, sometimes called implants or lesions, most commonly appear on organs within the pelvis, such as the ovaries, fallopian tubes, and the outer surface of the uterus. They can also affect the bowel and bladder, and in rare instances, may be found in more distant locations.
This misplaced tissue behaves similarly to the uterine lining, responding to the body’s monthly hormonal fluctuations. It thickens and then attempts to break down and bleed with each menstrual cycle. Unlike menstrual blood from the uterus, this tissue has no way to exit the body, leading to irritation, inflammation, and the formation of scar tissue and adhesions. These processes contribute to the pain and other symptoms experienced by individuals with endometriosis.
Endometriosis and Menstrual Irregularities
Endometriosis is most frequently recognized for causing painful periods (dysmenorrhea) and heavy menstrual bleeding (menorrhagia). The condition can also contribute to other menstrual irregularities, including irregular cycles or missed periods. While missed periods are not typically considered a primary direct symptom of endometriosis, they can occur due to several indirect factors.
Significant hormonal imbalances, often characterized by higher estrogen levels associated with endometriosis, can disrupt the regularity of the menstrual cycle. Chronic pain and inflammation linked to endometriosis can also induce stress, which affects the hypothalamic-pituitary-ovarian axis, a system that regulates menstruation. Physical changes, such as the formation of cysts on the ovaries called endometriomas, can lead to diminished ovarian reserves and issues with ovulation.
Scarring and adhesions caused by endometriosis can physically interfere with the normal ovulatory process or obstruct the fallopian tubes, impacting period regularity. Some individuals may experience symptoms of a period without actual bleeding, related to ovarian endometriomas.
Beyond Menstrual Changes: Other Symptoms
Beyond its impact on menstruation, endometriosis can cause a range of other symptoms. Chronic pelvic pain is a prominent feature, persisting throughout the menstrual cycle and often intensifying during periods. This pain can be sharp, dull, or cramping, and may radiate to the lower back or abdomen.
Pain during or after sexual intercourse (dyspareunia) is another common symptom, frequently described as deep pain. This discomfort arises from inflammation and scar tissue in the pelvic area, making certain movements painful. Individuals may also experience pain with bowel movements or urination, particularly during their menstrual period, if endometrial-like tissue grows on the bladder or bowel.
Fatigue is a frequent symptom, linked to the body’s inflammatory response. Endometriosis is also a significant cause of infertility, affecting approximately 30-50% of women. This can occur due to scarring that interferes with egg release or blockages in the fallopian tubes.
When to Seek Medical Advice
Individuals experiencing persistent pelvic pain, unusually heavy or painful periods, irregular bleeding, or missed periods should seek medical advice. It is important to consult a healthcare professional if these symptoms significantly interfere with daily activities or quality of life. Early intervention can assist in managing symptoms and potentially slow the condition’s progression.
Diagnosing endometriosis can be challenging. The diagnostic process typically begins with a thorough review of symptoms and a physical pelvic examination. Imaging tests, such as ultrasound or MRI, may identify potential signs, though they cannot definitively confirm the condition. A definitive diagnosis requires a minimally invasive surgical procedure called a laparoscopy, during which a surgeon can visualize and sometimes remove endometrial-like tissue.