A Cup of Coffee – Endometriosis

Welcome back! Last week, we talked about the use of Turkey Tail mushrooms in conjunction with other cancer-fighting drugs. If you missed that blog and would like to catch up, click HERE.

This week, I researched a condition called Endometriosis. This blog was at the request of several readers. While I’ve never had endometriosis, I have a good friend who does, and it is no easy thing to live with. The pain is unbearable at times.

According to GoodRX Health, “Endometriosis is one of the most commonly misdiagnosed and misunderstood conditions—despite the fact that it affects an astounding one in 10 women between the ages of 15 and 44, according to the U.S. Office on Women’s Health.”

What is it?

Endometriosis gets its name from the word “endometrium”, which is the tissue that normally lines the uterus or womb. Sometimes, tissue similar to the tissue that lines the uterus grows outside of the uterus and on other areas of your body where it normally would not be found. This is when it becomes Endometriosis.

Like the endometrium (normal tissue inside the uterus), the endo tissue builds up and sheds with your menstrual cycle. But over time, the tissue that has been shed doesn’t have anywhere to go and becomes trapped. This can lead to inflammation, scarring, and cysts.

Does it have other names?

Yes. It can be referred to as endo, implants, lesions, or nodules.

Where are these implants usually found?

Most often, implants are found on the ovaries, fallopian tubes, the tissues that hold the uterus in place, and the outer surface of the uterus, the vagina, cervix, vulva, bowel, bladder, or rectum. Rarely, endometriosis appears in other parts of the body, such as the lungs, brain, and skin.

Is it painful?

Endometriosis can cause pain — sometimes severe — especially during menstrual periods and bowel movements. Fertility problems also may develop.

Listen to someone who not only lives with this disorder but treats it as well…

“As a practitioner, I describe endometriosis pain [as] sharp, stabbing, achy, twisting, or burning, and it may or may not correlate with your period … As a patient, I would [add that] endometriosis pain is like a gut-wrenching bomb that goes off in your insides. Its shrapnel tortures you physically, emotionally, and financially forever.”

—Dr. Sallie Sarrel, PT, ATC, DPT, pelvic physical therapist, and endometriosis advocate in New York and New Jersey

Why is it so painful?

Women’s Health.gov tells us, “Endometriosis growths may swell and bleed in the same way the lining inside of your uterus does every month — during your menstrual period. This can cause swelling and pain because the tissue grows and bleeds in an area where it cannot easily get out of your body.

The growths may also continue to expand and cause problems, such as:

• Blocking your fallopian tubes when growths cover or grow into your ovaries. Trapped blood in the ovaries can form cysts.
• Inflammation (swelling)
• Forming scar tissue and adhesions (type of tissue that can bind your organs together). This scar tissue may cause pelvic pain and make it hard for you to get pregnant.
• Problems in your intestines and bladder”

How is this diagnosed?

Cedars Sinai recommends an MRI for an accurate diagnosis of Endometriosis. “MRI is often used in addition to the pelvic ultrasound as MRI can help detect smaller sites of endometriosis, especially along the bowel and pelvic ligaments. An MRI exam is necessary because deeper structures are difficult to see by ultrasound.“

WebMd adds, “The only way to truly diagnose endometriosis is by laparoscopy. You’ll get general anesthesia for this surgery, so you’ll be asleep. A surgeon will make a small cut and insert a tiny, thin viewing tool through your stomach to look for signs of endometriosis. They may also take a small tissue sample, or biopsy, for testing. This will help rule out other causes.“

How is this disorder measured?

WebMD gives us staging information. “The most widely used scale is from the American Society of Reproductive Medicine. Doctors assign points according to the spread of the endometrial tissue, its depth, and the areas of your body that are affected.

“Based on the results, the condition is ranked in one of four stages:

• Stage 1 or minimal: There are a few small implants or small wounds or lesions. They may be found on your organs or the tissue lining your pelvis or abdomen. There’s little to no scar tissue.
• Stage 2 or mild: There are more implants than in stage 1. They’re also deeper in the tissue, and there may be some scar tissue.
• Stage 3 or moderate: There are many deep implants. You may also have small cysts on one or both ovaries, and thick bands of scar tissue called adhesions.
• Stage 4 or severe: This is the most widespread. You have many deep implants and thick adhesions. There are also large cysts on one or both ovaries.”

Here are the types

WebMD also goes on to discuss the different types of endo:

“Endometriosis is also grouped by what area of the pelvis or abdomen it affects. There are four main types:

• Superficial peritoneal endometriosis. The peritoneum is a thin membrane that lines your abdomen and pelvis. It also covers most of the organs in these cavities. In this type, the endometrial tissue attaches to the peritoneum. This is the least severe form.
• Endometriomas. These are dark, fluid-filled cysts. They’re also called chocolate cysts. They vary in size and can appear in different parts of your pelvis or abdomen, but they’re most common in the ovaries.
• Deeply infiltrating endometriosis (DIE). In this type, the endometrial tissue has invaded the organs either within or outside your pelvic cavity. This can include your ovaries, rectum, bladder, and bowels. It’s rare, but sometimes a lot of scar tissue can bond organs so they become stuck in place. This condition is called frozen pelvis. But this only happens to 1%-5% of people with endometriosis.
• Abdominal wall endometriosis. In some cases, endometrial tissue can grow on the abdominal wall. The cells may attach to a surgical incision, like one from a C-section.”

Symptoms:

We looked to the Mayo Clinic for this section of our blog.

“Common signs and symptoms of endometriosis include:

• Painful periods (dysmenorrhea). Pelvic pain and cramping may begin before and extend several days into a menstrual period. You may also have lower back and abdominal pain.
• Pain with intercourse. Pain during or after sex is common with endometriosis.
• Pain with bowel movements or urination. You’re most likely to experience these symptoms during a menstrual period.
• Excessive bleeding. You may experience occasional heavy menstrual periods or bleeding between periods (intermenstrual bleeding).
• Infertility. Sometimes, endometriosis is first diagnosed in those seeking treatment for infertility.
• Other signs and symptoms. You may experience fatigue, diarrhea, constipation, bloating or nausea, especially during menstrual periods.“

Does the pain get worse the longer this goes untreated?

Interestingly enough, no. The Mayo Clinic says, “Most of the time, the stage and type of your condition doesn’t affect your symptoms. For example, a person with stage 1 endometriosis may have worse pain than someone with stage 4. The exception is infertility. Women with stages 3 or 4 are more likely to have trouble getting pregnant than those with stages 1 or 2.”

What can this be mistaken for?

Endometriosis is sometimes mistaken for other conditions that can cause pelvic pain, such as pelvic inflammatory disease (PID) or ovarian cysts. It may be confused with irritable bowel syndrome (IBS), a condition that causes bouts of diarrhea, constipation, and abdominal cramping. IBS can accompany endometriosis, which can complicate the diagnosis.

Is there a cure?

Unfortunately, no. I know that’s not what you wanted to hear. You didn’t do anything to cause this, and yet it is your burden to bear. There are, however, many options in terms of surgeries and medications. Please consult with a doctor to see if one of these solutions might work for you.

Above all, don’t give up. Insist on getting the proper testing to see if you have this condition, and once diagnosed, advocate for proper treatments. You shouldn’t have to live in debilitating pain.

Please take a minute and watch this video featuring an Osteopathic Doctor that was posted on the website of The Mayo Clinic.

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As always, this blog is not a replacement for sound medical advice. I am not a doctor. Please make an appointment to see your healthcare provider and put a good plan in place that works for you and the needs of your body.

That’s all I have for you this week, dear reader. I’ll see you back here next Wednesday to share another cup of coffee. Until then, be good to yourself and each other.

Mind, Body, Spirit…Osteopathic Doctors treat the whole person, not just the ailment. Is your PCP a DO? Would you like to learn more about Osteopathic Physicians? Click HERE!