WHAT IS ENDOMETRIOSIS

Endometriosis is a chronic, highly inflammatory, whole-body disease where tissue similar, but not identical, to the lining of the uterus that is found elsewhere in the body.

This chronic, highly inflammation creates lesions that become inflamed and irritated, resulting in pain, scar tissue formation, and organ dysfunction. Even though it is most commonly found in the pelvis, other possible locations include but are not limited to: the bladder, bowels, appendix, diaphragm, lungs, and kidneys. To date, endometriosis has been found in virtually every organ in the body.

Signs & Symptoms

Everyone with endometriosis experiences symptoms differently. Symptoms range along a spectrum including (but not limited to): “killer cramps” to heavy or irregular periods, nausea, vomiting, diarrhea and or constipation, pain with urinating, pain during sex, fatigue, brain fog, and infertility. Some may experience symptoms on a cyclical basis while others may have symptoms every day. This colorful symptom profile is one of the factors that makes endometriosis difficult to diagnose.

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Diagnosis

A diagnosis of endometriosis cannot be 100% confirmed by CT scans, MRIs, or ultrasounds. The abnormal cells need to be collected via biopsy, during a surgical procedure called a laparoscopy. While symptoms can give doctors a suspicion of endometriosis, relying on symptoms alone may lead to misdiagnosis and improper treatment. If you suffer from any of the symptoms previously mentioned, book an appointment to speak to your doctor or a specialist. Preparing for that appointment is vital.

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Treatment

Though hormonal treatments (OCPs, Lupron, Orlissa, Etc.) are highly regarded as an acceptable treatment of the disease itself, in actuality, it only manages the symptoms. Removing Endometriosis lesions by excision surgery with an endometriosis specialist is used for effectively treating Endometriosis lesions. Many surgeons perform a less successful surgical technique, ablation, that simply burns away the top of the disease, leaving the root behind. Excision surgery requires a very high level of surgical skill, since endometriosis can be found anywhere in the body. Though endometriosis does not have a cure, many who have undergone expert excision surgery have seen long-term relief in symptoms, decrease in pain, and improved quality of life. Surgery to remove the disease is only the first step of a multidisciplinary approach to more effectively treating endometriosis.

Excision of Endometriosis

Unfortunately, no one truly knows the exact cause. There are a few proposed theories that include stem cells, genetics, immunologicdysfunction, and environmental toxins. More research is needed to confirm the true cause(s) of endometriosis.
There is currently no cure for endometriosis. Though treatments such as hysterectomy, birth control, Lupron, Orlissa, and pregnancy may be presented as curative, none of these options can cure the disease itself.
Endometriosis largely affects those of reproductive age, but the disease can also be found in those who have not yet started menstruation, teens, and after menopause.
There is no gold standard staging system for endometriosis, but the most widely adopted is the revised American Society for Reproductive Medicine (rASRM) classification system. The weighted value system is scored and summed according to the size of the endometriotic lesions in the ovaries, peritoneum, and fallopian tubes, and the severity of adhesion at each of the aforementioned sites. The system assigns a stage of 1 through 4, with 1 being minimal and 4 being severe. This staging system is globally adopted, but its disadvantages are that it does not factor in extra-pelvic lesions and it does not consider the patient’s symptoms. Therefore, the stage of disease does not directly correlate to the degree of symptoms that a patient experiences.
Endometriosis is a top cause of infertility. Infertile women are 6 to 8 times more likely to have endometriosis than fertile women.
To date, endometriosis has been found on every organ in the body. Some common locations where endometriosis is found within the pelvis include the rectovaginal cul de sac, peritoneum, ovaries, and fallopian tubes. However, endometriosis is also often commonly found in areas outside of the pelvis such as the bowels, bladder, diaphragm, and lungs.
A recent research study from The University of California San Francisco over 600 correlations between Endometriosis and other conditions. The findings help support the understanding that chronic inflammation and immune system dysfunction in endometriosis affect the entire body, not just the pelvic region.
Additionally, recent‍ research from The University of Oxford uncovered a genetic correlation between endometriosis and several autoimmune diseases, suggesting that a shared genetic basis may underlie the increased risk. Women with endometriosis were found to have a 30-80% increased risk of developing autoimmune diseases like rheumatoid arthritis, multiple sclerosis, and coeliac disease, as well as autoinflammatory conditions like osteoarthritis and psoriasis.
Because endometriosis is a systemic, full-body disease, your care time should consist of a multidisciplinary team. This includes but is not limited to an excision specialist/OBGYN who is an expert in endometriosis treatment and care, primary care physician, physical therapy, nutritionist, mental health therapist, pain management, and in some cases a gastroenterologist, urologist, or pulmonologist.