Endometriosis: a reproductive disease

November 3, 2015

Endometriosis is an often-misunderstood disease that affects at least 1 million women in Canada alone. There is too often a delayed diagnosis, as many women are only diagnosed after they have tried to conceive without success.  Learn more about the symptoms and treatments below.

Endometriosis: a reproductive disease

1. What is it?

Endometriosis occurs when tissue much like the uterine lining is found outside of the uterus. Locations can include the ovaries, Fallopian tubes, uterine ligaments, bowel, outside of the uterus, bladder, bowel, vagina and cervix as well as scar tissue. The tissues become growths and lesions and respond to the hormones of the menstrual cycle. This causes microscopic bleeding, which leads to scar tissue, tube blockage, inflammation, pain and sometimes adhesions on the bowel.

Women also experience "chocolate cysts," which are blood-filled cysts on the ovaries. The immune system sees this internal bleeding as an open wound and responds by making scar tissue.

2. Symptoms

Endometriosis is a chronic disease without a known cure. Quality of life concerns include lack of energy, severe pain during menses and infertility. The primary symptom of endometriosis is marked pain during and before periods. Many women with advanced stages of the disease are debilitated by pain on a daily basis.

Some women find they are unable to work, attend school, or care for their children while menstruating because the pain is so severe. Discomfort and infertility can be great sources of stress and even depression. Other key symptoms are pain with intercourse, infertility, lack of energy, painful bowel movements and urinating during periods as well as various gastrointestinal issues.

Endometriosis is classified in four stages, according to the severity and location of the disease, and currently Western medicine uses laparoscopy as the main diagnostic tool for endometriosis.

3. Treatments

As the disease is presently considered to be incurable, the treatments either aim to preserve fertility, or restore it and to help alleviate pain or even delay or prevent the growth of the disease.

  1. Pain medication is very often required, usually at prescription strength. Ibuprofen is effective for anti-inflammation and moderate pain. However, most women often find that narcotics are the most effective type, while others have found success with fibromyalgia drugs that are applied topically.
  2. Hormones, including the birth control pill (continuously) and GnRH agonists, may be prescribed. While many women find relief from both of these options, others cannot tolerate the side effects.
  3. An IUD is a birth control device which stops the woman from menstruating; some women have great success with this device and the cessation of a cycle, while others find the insertion difficult to tolerate, and still others have uterine cramping that is intolerable. However, it is one of the most popular medical treatments.
  4. Surgery, either laparoscopy or laparotomy, and on occasion hysterectomy (although many patients continue to have severe pain post hysterectomy) might be required. Types of surgery include excision surgery, which removes endometrial deposits and lesions; this type of surgery takes a great deal of skill, and other methods include laser ablation and electrical fulguration. It is important to see a doctor who specializes in the disease and has experience operating on women with endometriosis. You can find doctors online.
  5. Alternative treatments are recommended by Western doctors in some cases, including acupuncture and nutritional steps, including anti-inflammation diets. It should be said that because endometriosis has so many symptoms and negative effects on a woman's quality of life (including pain, infertility, inflammation, and on occasion, anxiety and stress and difficulty with one's gastrointestinal system), a holistic approach is very important.
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