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Endometriosis is one of the most common women’s health conditions. Endometriosis occurs when endometrial-resembling cells implant themselves and grow on areas outside of the uterine cavity, usually on the ovaries.  These cells are influenced by hormonal changes and bring on symptoms that are usually worse around the menstrual period. 

Those affected even include girls before their first menstrual period, women who had a hysterectomy and women in menopause who had a recurrence. “We estimate there are over six million girls and women in the United States alone, some as young as eight, diagnosed with endometriosis,” says Carol Drury of the Endometriosis Association.  

The cardinal symptom of endometriosis is pelvic pain.  “Women can also have lower back pain, painful intercourse, painful urination, problems with their bowels around their period and are fatigued,” says Drury.  There are some women who are asymptomatic.  “It is a puzzling disease,” says Drury.

Some women may have been told that menstrual-related pain is psychological or in their head.  Scientific evidence now proves symptoms and pain are reality. “Now, researchers know there are physiological reasons because there are substances called prostaglandins that cause regular menstrual cramps and are in involved in endometriosis pain,” says Drury. 

It is encouraged to make sure that your doctor fairly evaluates you rather than dismisses pain that could be indicative of endometriosis.  Most all women experience menstrual cramps, pain and bloating, but the normal and healthy level of these symptoms are manageable and not debilitating. “If you have cramps and take something over-the-counter and use a heating pad and it does not completely disappear, it is not normal,” says Drury.  

At present, the only way to definitively diagnose endometriosis is through an outpatient procedure called laparoscopy, which is done under anesthesia.  “It is a little incision in the navel and then a laparoscope, or a tube with a light on the end of it, is inserted so the doctor can visually look at all of the pelvic organs and at the same time do surgery which can be cutting, laser, burning or freezing,” says Drury. Researchers want to come up with a simpler way to diagnose endometriosis.  “Research is trying to find a non-invasive diagnostic technique so women do not have to go through surgery,” says Drury.  

Occasionally, diagnosis comes when a woman has trouble getting pregnant.  A main concern of women with endometriosis is infertility problems.  “About one third of women with infertility will get a diagnosis of endometriosis, and about one third of women with endometriosis will end up having a problem with fertility,” says Drury.  This makes early diagnosis and intervention imperative to women trying to get pregnant.

Much about the disease remains a mystery.  “Nobody knows the cause,” says Dr. Ken Muse, obstetrician/gynecologist at the University of Kentucky Chandler Hospital.  There has been a strong increase in cases of endometriosis recently.  In the last two generations, research has discovered a link between toxic chemicals in the environment and endometriosis.  One of the most toxic is dioxin, a byproduct of pesticides, fertilizers and from the incineration of medical waste and paper processing.  “Dioxin is a class of chemicals called an endocrine disruptor,’ says Drury.  “Endocrine disruptors act like hormones in our body which is the connection because endometriosis is hormonal.”

Much of the current endometriosis research is focusing on hormones.  “Scientists are looking at frogs in the Great Lakes and their sexual organs,” says Drury.  “The male sexual organs are being distorted because the endocrine disruptors are messing up their hormones.  It is shocking and most people are not aware.” 
 
Some research suggests that the immune system is involved.  There may be immune system abnormalities that contribute to the increase in endometriosis.  Studies show that the autoimmune diseases like rheumatoid arthritis and multiple sclerosis are seen more often in women with endometriosis.  Chronic fatigue syndrome has also been found to be more than one hundred times as prevalent in endometriosis sufferers compared to the general female population.  

Diet and maintaining a healthy immune system are the most practical things in women’s control to slow the growth of endometriosis.  You can watch what you eat, be careful to avoid pollutants or chemicals and consider taking probiotics which can help your immune system.  “You should take care of your immune system and try to avoid all of the chemical disruptors, not only dioxin in food and drinks but do not use chemicals in your household or in your yard,” says Drury.  Do not heat or store food in plastic. “A lot of women with endometriosis have multiple chemical sensitivities,” says Drury.  There is a campaign for safer cosmetics, especially with perfume. 

Women should not be afraid to take the initiative and talk to their doctor about endometriosis as well as whether hormone replacement therapy is an appropriate choice for their individual circumstances.  “If women go on hormone replacement therapy during menopause, it brings back the hormones that feed endometriosis,” says Drury.  “Some of it is about understanding enough not to go on hormone replacement therapy right away.”

Treatment usually culminates in surgery to remove the endometrial implants, adhesions and scar tissue with the most serious being a hysterectomy.  There are also hormonal medications with the lowest level being birth control pills.  Taking care of nutrition, general wellbeing and your immune system can be helpful for women with endometriosis.  Steer clear of misconceptions, such as pregnancy cures endometriosis.  The truth is that during pregnancy and breastfeeding you do not produce hormones that feed endometriosis so it may lessen your symptoms and seemingly go away, but neither cure endometriosis and it will come back.  “There is no cure at this point so women have to take charge of their health and search for the right doctor and treatment,” says Drury.