Are you or a friend suffering from debilitating period pain? It could be endometriosis.
Endometriosis (Endo) is a chronic inflammatory condition affecting 1 in 10 women. It involves the presence of endometrial tissue in areas outside of the uterus. Endometrial tissue usually grows inside the uterus and responds to fluctuations in hormones that prepare the uterine lining for conception and is shed during the menstrual period. Having this functioning tissue outside of the usual location causes inflammation, adhesions (like scar tissue) and often pain. The most common places that endo is found includes the ovaries, fallopian tubes and tissues lining your pelvis. However it can spread to the bladder and colon. Living with Endo can cause great physical and emotional stress, with sufferers often missing days off work or school and declining social outings due to symptoms. The long term emotional effects of chronic pain can also be debilitating to moods and motivation.
Symptoms
- Chronic pelvic pain at any time during your cycle
- Intense period pain
- Heavy periods
- Bloating
- Changes to bowel movements
- Pain during sexual intercourse
- Increased urination
- Fatigue
- Anxiety
- Nausea
- Headaches
- Fertility issues
Diagnosis
Although the symptom presentation can outline the likelihood of endometriosis it can only be formally diagnosed through a laparoscopy (a surgical procedure). On average it can take 8-10 years to be correctly diagnosed due to the absence of reliable non-invasive diagnostic tests and GP’s commonly being unwilling to do further investigations for patients. Many women suffer for years without answers, leaving them feeling helpless. It is commonly misdiagnosed as Irritable bowel syndrome (IBS) due to a significant overlap in symptoms or assumed to be ‘just period pain’. Often it is not until women are outlining their willingness to conceive or undergoing investigations for infertility that endometriosis is diagnosed. If you do not feel like you are getting the support you deserve from your GP, get a second opinion from another GP, find someone who will listen to you and help you.
Treatment
There is no cure for endometriosis. The current medical treatments are suppressive in nature only providing temporary relief during treatment. The oral contraceptive pill (OCP) and nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly prescribed as first line treatment however there is weak scientific evidence for effectiveness. Current successful treatments induce amenorrhea and due to significant side effects are only approved for short term use, additionally they have significant limitations for patients desiring conception Laparoscopic surgery to remove lesions is common, however the outcomes are unsatisfactory with recurrence high and evidence suggesting potentially negative effects on ovarian reserve
Holistic Management
Managing endometriosis requires a multi-faceted approach. Diet and lifestyle should be at the foundation of holistic care to reduce inflammation and support hormone balance. There is no ‘quick-fix’ and learning what affects the condition is important.
- Endo is an inflammatory condition. Supporting the body with anti-inflammatory and antioxidant foods and herbs is vital. Removing inflammatory foods and toxic lifestyle habits is essential, particularly if pain and or bloating is the primary symptom.
- Endometrial tissue responds to the hormones of the menstrual cycle, therefore ensuing an optimal balance of oestrogen and progesterone is important, particularly if your periods are heavy.
- Gut health, liver function and nutrient status are essential aspects of long term endo management. These require individual assessment by a qualified health practitioner.
- Enhancing pelvic blood flow with warmth, movement, massage, near-far infrared lights and acupuncture are very beneficial to support a reduction in inflammation.
- Stress management is key to managing endometriosis. Stress hormones affect our immune system, hormone balance and digestive system.
References
Ahn, S., Singh, V., & Tayade, C. (2017). Biomarkers in endometriosis: Challenges and opportunities. Fertility and Sterility, 107(3), 523- 532.
Brown, J., Crawford, TJ., Allen, C., Hopewell, S., & Prentice, A. (2017). Nonsteroidal anti- inflammatory drugs for pain in women with endometriosis (review). Cochrane Database of Systematic Reviews, 2017(1). doi: 10.1002/14651858.CD004753.pub4
Brown, J., Crawford, TJ., Datta, S., & Prentice, A. (2018). Oral contraceptives for pain associated with endometriosis (Review). Cochrane Database of Systemic Reviews, 2018(5). doi: 10.1002/14651858.CD001019.pub3
Becker, C., Gattrell, W., Gude, K., & Singh, S. (2017). Reevaluating response and failure of medical treatment of endometriosis: a systematic review. Fertility and Sterility, 108(1), 125- 136.
Bedaiwy, M., Alfaraj, S., Yong, P., & Casper, R. (2017). New developments in the medical treatment of endometriosis. Fertility and Sterility, 107(3), 555-565.
Liu, J. (2017). Endometriosis, Retrieved August 24, 2018, from https://www.merckmanuals.com/professional/gynecology-and-obstetrics/endometriosis/endometriosis
