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 affect the risk of developing it, and what three common myths about endometriosis are circulating.
What is endometriosis?
Endometriosis is a chronic inflammatory disease in which tissue similar to the lining of the uterus (called the endometrium ) grows outside the uterine cavity . The misplaced tissue, like the lining in our uterus, responds to regular hormonal fluctuations. It grows and thickens during the menstrual cycle, which triggers an inflammatory response and leads to unpleasant symptoms.
Endometriosis affects 1 in 10 women worldwide , or up to 10% of women of reproductive age. ( 1 , 2 ) It most commonly affects the ovaries, intestines, and pelvic tissues. Adenomyosis is a specific type of endometriosis that occurs when tissue grows into the muscle wall of the uterus. ( 3 ) Approximately 12% of women have endometriosis in other parts of the body, making diagnosis even more difficult. ( 4 , 5 )
Symptoms
Symptoms that indicate the possible presence of endometriosis vary widely. Some women have a confirmed diagnosis but do not experience any significant pain or discomfort. For others, the disease prevents them from functioning normally throughout their cycle or during certain phases when hormone levels change significantly.
Common symptoms of endometriosis include:
- Very painful and heavy menstruation
- Painful sexual intercourse
- Pelvic and lower abdominal pain
- Digestive and intestinal problems
- Infertility or difficulty conceiving
How is the diagnosis made?
The diagnosis of endometriosis is quite complex. There are several methods used to detect it, but almost none of them are 100% effective or come with side effects.
A relatively suitable method is the anamnesis . To some extent, endometriosis can be discussed - or directly confirmed - based on the symptoms that accompany a woman. However, the absence or minimal presence of symptoms that we commonly assume are associated with endometriosis does not exclude the presence of endometriosis. However, the anamnesis can be a successful first step in deciding on further examinations.
The only way to get a definitive diagnosis is through a surgery called laparoscopy . This is a procedure that involves inserting instruments into the body, allowing the doctor to see into the spaces between the organs and take tissue samples for further examination. This can confirm whether the growths are endometrial in origin. During this surgery, any growths found are usually removed. However, laparoscopy carries several risks, including poor healing or infection.
Other examples of methods are ultrasound or magnetic resonance imaging . Ultrasound for detecting endometriosis tends to be a bit more powerful than the usual ones you encounter in gynecology. It can detect endometriosis in the ovaries, bladder or help find adenomyosis. Magnetic resonance imaging, which works on the principle of a magnetic field, is used to display deposits where ultrasound cannot reach. However, it 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 clear up 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 actually develops and how endometriosis could be prevented.
One of the oldest and most well-known theories of endometriosis is retrograde menstruation . Menstrual blood, which accompanies the shedding of the uterine lining, leaves the body through the vagina. However, some studies suggest that some of the blood flows back into the fallopian tubes and pelvic cavity instead of leaving 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 treats endometriosis
Hormonal contraception is a very commonly used form of pregnancy prevention, but it is often recommended by experts and doctors to alleviate the symptoms of certain diseases and conditions related to hormones.
Hormones and their health are often the driving force behind endometriosis, which can significantly worsen its symptoms. An imbalance of estrogen and progesterone contributes to heavy and painful periods or significant premenstrual symptoms, such as mood swings, breast tenderness, nervousness and anxiety, or increased appetite. Hormonal contraception turns off your endogenous hormones and replaces them with synthetic ones . For this reason, it can actually temporarily alleviate hormonal problems or endometriosis symptoms and improve its overall course. Because your reproductive hormones, which may be currently out of balance, are almost not active at all. ( 8 )
However, endometriosis is not just about hormones; we cannot forget about other factors that influence endometriosis: the immune system, chronic inflammation, or our genetic makeup.
Confused immune cells fail to recognize misplaced endometrial tissue , and the regular bleeding of the tissue due to hormonal changes triggers a wave of inflammation. Add to that an unhealthy lifestyle in the form of poor eating habits or poor sleep, and you have an endless cycle of chronic inflammatory response that feeds endometriosis. ( 8 , 9 )
Hormonal contraception can work as a temporary solution or to alleviate the intractable symptoms of endometriosis, but it is still a band-aid that cannot solve all the problems.
Myth # 3 : Endometriosis is caused by high estrogen levels
Estrogen is one of the hormones that regulates the menstrual cycle. For many years, endometriosis was associated only with hormonal imbalances, especially with estrogen levels, which has 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 endometriosis.
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. However, the body still behaved as if it were estrogen dominant. This is called progesterone resistance .
Even though you produce enough progesterone, the uterine lining can't use it. Progesterone is an anti-inflammatory hormone and helps break down endometrial tissue during a normal cycle. However, in women with progesterone resistance, this breakdown may not occur, and estrogen will continue to dominate instead . This will accelerate the growth of the lining and encourage the cells to convert to endometrial.
Additionally, progesterone resistance may be an important factor in infertility in 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. In addition to estrogen and the influence of hormones, we cannot forget other factors of endometriosis.
Endometriosis is one of the most complicated female diseases for which there is no effective cure yet. In many cases, however, the symptoms can be alleviated with diet and a healthy lifestyle, and thus the disease can be almost unknown and lived in harmony with it. Women with endometriosis tend to have a major deficiency of essential nutrients. The complete basis for a better cycle (and not only) in endometriosis is magnesium , which helps relieve cramps and has an anti-inflammatory effect, zinc, which supports a proper immune response and hormonal balance, and vitamin E, as an important antioxidant. All these three substances and much more can be found together in Endo Complex .
Do you suspect endometriosis or has your doctor directly confirmed it ? Are you wondering how you can influence its course?
Contact our Femvie experts who will create an individual plan based on your medical history, lab results, symptom monitoring, cycle analysis and a 90 min. initial consultation. Our experts will give you a complete assessment of your health condition and will support you on an ongoing basis to achieve results. Information on how consultations work can be found here .
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*The consultation does not serve as a substitute for gynecological support and assistance. If you are experiencing any health problems, we recommend that you contact your doctor as soon as possible.
