Endometriosis is one of the most common female diseases, affecting up to 10% of women of reproductive age worldwide. Find out how it is diagnosed, what can influence the risk of developing it, and three common myths surrounding endometriosis.
What is Endometriosis?
Endometriosis is a chronic inflammatory disease in which tissue similar to the uterine lining (called the endometrium) grows outside the uterine cavity. This misplaced tissue, just like the lining in our uterus, reacts to regular hormonal fluctuations. It grows and thickens throughout the menstrual cycle, triggering an inflammatory reaction and leading to uncomfortable symptoms.
Worldwide, 1 in 10 women suffer from endometriosis, which corresponds to up to 10% of women of reproductive age. (1,2) In most cases, it affects the ovaries, intestines, and tissues in the pelvic area. A special type of endometriosis is adenomyosis, which manifests as tissue growth into the muscular wall of the uterus. (3) Approximately 12% of women experience endometriosis in other parts of the body, which makes its diagnosis even more complicated. (4,5)
Symptoms
Symptoms indicating the possible presence of endometriosis are very varied. Some women have a confirmed diagnosis but experience no significant pain or problems. For others, the disease prevents normal functioning throughout the entire cycle, or during certain phases when hormone levels change significantly.
Common symptoms of endometriosis include:
- Very painful and heavy periods
- Painful sexual intercourse
- Pelvic and lower abdominal pain
- Digestive and intestinal problems
- Infertility or difficulty conceiving
How is it diagnosed?
Diagnosing endometriosis is a rather complex matter. Several methods are used to detect it, but almost none of them are 100% effective or without negative side effects.
A relatively suitable method is anamnesis. To some extent, endometriosis can be discussed – or directly confirmed – based on the symptoms a woman experiences. However, the absence or minimal occurrence of symptoms that we commonly associate with endometriosis does not rule out its presence. Anamnesis can, however, be the first successful step in deciding on further examinations.
The only way to get a definitive diagnosis is through an operation called laparoscopy. This is a procedure where necessary instruments are inserted into the body, allowing the doctor to see into areas between organs and take tissue samples for further observation. This confirms whether the lesions are of endometrial origin. During this operation, any found lesions are usually removed immediately. However, laparoscopy also carries several risks, including poor healing or infection.
Other examples of methods include ultrasound or magnetic resonance imaging. Ultrasound for detecting endometriosis is often more powerful than the standard ones you encounter at the gynecologist. It can detect endometriosis in the ovaries, bladder, or help find adenomyosis. For visualizing lesions that ultrasound cannot reach, magnetic resonance imaging (MRI) is used, which works on the principle of a magnetic field. However, this is a more expensive and time-consuming method. (6)
Endometriosis myths and facts
Although many women suffer from endometriosis, there are still many questions surrounding it. Let's clarify three common myths.
Myth #1: Endometriosis is caused by retrograde menstruation
Endometriosis is a very complex disease, and many scientists and doctors around the world are trying to explain how it develops and how it could be prevented.
One of the oldest and best-known theories about the origin of endometriosis is retrograde menstruation. Menstrual blood, which accompanies the shedding of the uterine lining, leaves the body through the vagina. According to some studies, however, part of the blood flow travels back into the fallopian tubes and pelvic cavity instead of exiting the body. This backflow, called retrograde menstruation, can carry endometrial cells, which can then attach and grow on the surface of other pelvic organs.
However, this theory is not fully understood or confirmed, as up to 70-90% of women have some degree of retrograde menstruation, but not all of them develop endometriosis. (7)
Myth #2: Hormonal contraception cures endometriosis
Hormonal contraception is a very common form of pregnancy prevention, but it is often recommended by specialists and doctors to alleviate the symptoms of certain hormone-related diseases and conditions.
Hormones and their health are often the driving force behind endometriosis, which can significantly worsen its symptoms. Imbalances in estrogen and progesterone contribute particularly to heavy and painful periods or significant premenstrual symptoms such as mood swings, breast tenderness, nervousness and anxiety, or increased cravings. Hormonal contraception shuts down your endogenous hormones and replaces them with synthetic ones. For this reason, it can indeed temporarily alleviate hormonal problems or symptoms of endometriosis and thus generally improve its course. This is because your reproductive hormones, which may currently be out of balance, are almost completely inactive. (8)
However, endometriosis is not just about hormones; we must not forget other factors that influence endometriosis: the immune system, chronic inflammation, or our genetic makeup.
Confused immune cells cannot recognize misplaced endometrial tissue, and regular tissue bleeding due to hormonal changes triggers a wave of inflammation. Add to that an unhealthy lifestyle in the form of inappropriate eating habits or poor sleep quality, and we have an endless cycle of chronic inflammatory reactions that fuel endometriosis.(8,9)
Hormonal contraception can act as a temporary solution or alleviate intractable symptoms of endometriosis. However, it is still a metaphorical band-aid for problems that cannot solve all issues.
Myth #3: Endometriosis is caused by high estrogen levels
Estrogen is one of the hormones regulating the menstrual cycle. For many years, endometriosis was associated only with hormonal imbalance, especially with estrogen levels, which thus acquired a rather unpleasant label. It is true that hormonal fluctuations and imbalances play a significant role in the development of endometriosis and largely determine how a woman will experience it.
However, excess estrogen may not be the only problem. It has been found that in many cases, women had optimal levels of both hormones, estrogen and progesterone. Nevertheless, the body behaved as in the case of estrogen dominance. This is due to so-called progesterone resistance.
Although you produce sufficient amounts of progesterone, the uterine lining cannot utilize it. Progesterone is an anti-inflammatory hormone and in a normal cycle helps to break down endometrial tissue. However, in women with progesterone resistance, this breakdown may not occur, and instead, estrogen will continue to dominate. This accelerates the growth of the lining and promotes the conversion of cells to endometrial ones.
Furthermore, progesterone resistance can be an important factor in infertility in cases of endometriosis, as progesterone is essential for preparing the uterus and maintaining pregnancy.(10,11)
So, estrogen may be responsible for some unpleasant symptoms, but endometriosis is far from over with it. Besides estrogen and the influence of hormones, we must not forget other factors of endometriosis.
Endometriosis is a complex female disease for which there is currently no effective cure. In many cases, however, its manifestations can be alleviated through diet and a healthy lifestyle, thus making the disease almost unnoticeable and allowing one to live in harmony with it. Women with endometriosis often have a significant deficiency of essential nutrients. The absolute basics for a better cycle (not only) with endometriosis are magnesium, which helps alleviate cramps and has anti-inflammatory effects, zinc, which supports proper immune response and hormonal balance, and vitamin E as a significant antioxidant. All three of these substances and much more can be found together in the Endo Complex.
Do you suspect endometriosis or has your doctor confirmed it? Are you interested in how you can influence its course?
Contact our Femvie specialists who will create an individualized plan for you based on your medical history, laboratory results, symptom monitoring, cycle analysis, and a 90-minute initial consultation. Our specialists will provide a complete evaluation of your health condition and continuously support you to achieve results. Information on how consultations work can be found here.
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If you have any questions about women's health, do not hesitate to contact our experts at the Femvie advisory center. They will be happy to answer all your questions for free.*
*The advisory center does not replace gynecological support and assistance. If you are experiencing any health problems, we recommend contacting your doctor as soon as possible.
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Frequently asked questions about endometriosis
How do I know if I have endometriosis?
Endometriosis manifests as severe painful menstruation, pain during sexual intercourse, fatigue, and digestive problems. The only way to definitively confirm it is laparoscopy. If your symptoms interfere with your daily life, consult a gynecologist.
How long does it take to get a diagnosis?
The average time from the first symptoms to a diagnosis of endometriosis in the Czech Republic is 7–10 years. Many women are long dismissed with the notion that painful menstruation is "normal".
Can endometriosis be treated naturally?
Endometriosis cannot be completely cured, but symptoms can be naturally alleviated with an anti-inflammatory diet, dietary supplements, exercise, and stress reduction. Natural support does not replace medical care but can significantly improve quality of life.
