Are you experiencing menstrual cramps during your period?
This slight discomfort is usually common in most women.
But when you feel that the menstrual pain hurts more than the usual and becomes intolerable, it may be a signal to take your situation seriously.
Extreme menstrual and pelvic pain are indicative symptoms of endometriosis which affects a lot of women worldwide.
Endometriosis is a gynecological condition where the tissues lining the uterus, the endometrium (hence the name), begin to grow outside and reach the other reproductive organs and even up to the parts of your abdomen and most of the time cause severe pain during menstrual period.
Since the outgrowths are endometrial in nature, they also respond to hormonal changes during menstrual cycle and continue to thicken and shed every time you have your period.
Doesn’t sound too alarming right?
But remember, these endometrial tissues grow outside your uterus, thus, the bleeding cannot exit your body!
Over time this result to irritations, swelling and scarring on the normal tissues of affected neighboring organs. In some cases, it may even result to some organs and pelvic tissue to attach to each other.
The common parts where endometriosis can develop are
Rarely, endometrial tissues can reach and form in the areas outside the pelvic cavity such as:
Typically, when the condition reaches the ovaries, fluid-filled cysts called ovarian endometriomas are formed within the ovarian tissues.
These are also commonly chocolate cysts. This name is derived from the characteristic brown and tar-like appearance of the cysts that is very similar to chocolate.
This chocolate-like appearance is caused by old menstrual blood and tissues that are trapped inside the cavity of the cysts in the ovary.
These cysts can grow from 2-20 cm in size and can develop in one or both ovaries. This condition can be found in 20-40% of women with endometriosis although mostly linked with more severe stages.
In addition to extreme menstrual and pelvic pain, some of the most common symptoms also include:
Chocolate cysts also exhibit similar symptoms with endometriosis since it is a subgroup of this condition—usually in the more severe stages.
When a cyst ruptures, severe pain is usually experienced on the location of the cyst in the body.
If you are still in menstruating age, there is always a chance of developing this condition.
Without treatment, patients have reported that symptoms temporarily end with pregnancy and permanently cease after menopause.
However, since endometrial tissues respond to hormones like estrogen, increased level of these hormones will trigger endometriosis symptoms even after menopause.
If you have been trying to conceive for a long time now and have been failing, you may consider seeing to your gynecologist because based on reports on infertility on women, 20-50% have endometriosis.
The out-of-place endometrial tissue growths can impose a threat to the other healthy reproductive organs and affect the ability to conceive a child.
In fact, based on studies, women with ovarian endometriomas (chocolate cysts) has been found to have fewer and weaker egg cells and have increased levels of follicle stimulating hormones (FSH)—an indication of an unhealthy ovary.
With treatment (as discussed below), the removal of cysts and endometrial tissue outgrowths can improve the chance of getting pregnant but absolute fertility is not guaranteed.
In some cases, after treatment, other women still have difficulty getting pregnant or cannot conceive at all while some women report normal conception despite having ovarian endometriomas.
For fertility problems, your doctor may recommend you to a fertility specialist to help you.
Although there are not yet proven causes, researches have speculated these following reasons on how and why endometriosis develops;
(1) peritoneal cells in the lining of your abdomen,
(2) embryonic cells into endometrial cells as influenced by hormones or immune factors
Any woman in their reproductive age can be affected by this condition but it has been reportedly most common in women aged 30-40.
If you are a woman in your 30s and have not yet given birth before, the risk may be is higher for you.
In addition, the following also increases your chances of having endometriosis:
If you recognize these symptoms in your body, the best thing you must do is to write them down and see your doctor as soon as you can.
Based on your list, your doctor may already have a suspicion and able to recommend any of the following diagnostic test that may include examining your abdomen and pelvic area:
Depending on the severity of the condition, your gynecologist may refer you for laparoscopy —a procedure where a surgeon looks at inside your abdomen.
Before the procedure, you will be given general anesthetic and a small incision near your navel will be made. Then, a small viewing device called laparoscope will be inserted to search for existing endometrial tissues outside the womb. Through this test, the location, size and severity of the endometrial tissues can be determined.
In addition, your surgeon may take sample tissues for biopsy to know the extent of the condition.
Based on the results of your diagnostic tests, your doctor will be able to asses the severity and the stage of your endometriosis.
These stages are determined depending on the number, thickness, location and the extent of complexity and threat to other nearby organs caused by the endometrial tissues.
The commonly accepted endometriosis stages are the following:
No, the extent of pain that you feel is not a measure of the severity of the condition and obviously cannot be used to determine what stage of endometriosis you have.
Based on the reports, some patients that have Stage 4 endometriosis exhibit lesser pain and symptoms while patients with Stage 1 or 2 endometriosis experience intolerable pain and evident symptoms and vice versa.
Therefore, the level of pain is not a reliable indication of the stages.
Proper diagnosis from your doctor is still the surest way to determine the severity of your endometriosis.
For endometriosis, the following treatments are available depending on the severity of the condition:
Your doctor may advise you to undergo surgery if he/she finds it necessary.
These surgical treatments may include:
Before committing to a surgical procedure, it is important to know that invasive procedures can sometimes cause additional problems like infections, bleeding or damage to affected organs. Also, surgeries require long recovery periods and should be taken into consideration.
That’s why proper dialogue with your doctor is very important. Typically, your doctor will primarily recommend trying conservative treatment methods and will only opt for surgery if initial medications do not work.
Even after surgery, there is still a chance that endometriosis and pain may return.
Also, about 30 percent of surgically removed chocolate cysts recur. This recurrence happens when the endometrial tissues and cysts are very large and may leave traces that were not completely removed.
The risk of recurrence may be lowered if you get pregnant after surgery but there is no absolute guarantee.
By nature, endometriosis is a non-cancerous condition. However, studies have shown that ovarian cancer occur at higher rates in women with endometriosis. Though the risk of developing ovarian cancer in a woman’s lifetime is very low, research suggests that endometriosis increases the risk.
In extremely rare cases, women with endometriosis can develop a type of cancer called endometriosis-associated adenocarcinoma.
Dealing with a disease can be very hard. In some women, the symptoms and complications brought about by endometriosis can bring a great weight on their emotional health and lead to depression.
It may be beneficial for you to look for support groups in your community and talk to other women experiencing the same condition to help you cope.