For many women, the monthly cycle is a minor inconvenience to an otherwise amazing life. For others, their period – and the run up to it – can feel like a living hell. They put up with long, very heavy and incredibly painful periods. If this speaks to you, your symptoms could be linked to a number of conditions (which is why you need to talk to your GP about any concerns about your cycle), and one of them is endometriosis.
Endometriosis is estimated to effect 3-10% of women at reproductive age, and in 9-50% of infertile women. It is defined as the presence of endometrial glands and stroma outside of its normal location. These cells should normally only be present inside the uterus, but can appear in the pelvis, fallopian tubes, vagina and ovaries, and in more unusual locations such as in lung, brain or scar tissue.
Here’s where the problem is: those cells are hormonally active, just like those that line your uterus, and when womb cells shed every month (your period), the other cells do, too. The blood can’t flow out of the body, and this leads to the build-up of scar tissue and cysts. Because these endometrial cells can grow almost anywhere, women experience different symptoms, ranging (in addition to heavy painful periods) to painful bowel movements, pain during sex, back pain, fatigue and depression.
Endometriosis affects 2 million women in the UK alone. Most are diagnosed between 25 and 40, and it’s more common in women over 30 who haven’t had children.
The symptoms of endometriosis can vary a lot between individuals, some women have endometriosis without experiencing any symptoms at all until they have trouble getting pregnant. Most common symptoms include pelvic pain before and during sex, pain during sex, irregular bleeding or heavy periods, painful/bloody bowel movement during menstruation, painful/bloody urination during menstruation, swelling in lower abdomen, extreme tiredness, fertility problems.
Doctors don’t yet know what causes it. It may be one of a number of causes or a combination of several. We do know that it can be hereditary, and that retrograde menstruation might play a role (this is when the womb lining stays inside the body rather than leaving it as your period). Doctors do know that oestrogen dominance (where there is an excess of oestrogen compared with progesterone) plays a part.
An impaired immune response might also play a role, resulting in ineffective clearing of refluxed endometrial cells at the time of menstruation. This prompts inflammation contributing to an oestrogen/progesterone imbalance further feeding the cycle. It is unknown if these immune abnormalities are a cause, or result, of the endometriosis.
The only way to officially diagnose endometriosis is by laparoscopy, an operation during which a tiny camera is inserted into the pelvis. On average, it can take 7.5 years for a woman to be diagnosed with the condition, so if you have any concerns, you should see your GP right away.
There is currently no cure for endometriosis, but nutritional therapy can be an effective way to help you manage symptoms.
If this is something you have been diagnosed with, I warmly invite you to book a free female hormone health check with me. During our call, you can tell me about your experience, your diagnosis and we can work out the best next steps for you.