Understanding Endometriosis: Symptoms And Causes

Endometriosis is a common reproductive disorder that affects 1 in 10 women in the UK. It typically occurs in people aged 18 to 35, but it’s not uncommon for it to affect girls as early as 12 or 13 years old, with symptoms arising during their first period.

We’ve heard a lot about endometriosis in the last decade, but what is it and how can it be treated? In this guide, we’ll tell you everything you need to know.

In a rush? Read this quick summary:

  • Endometriosis is common and affects 1 in 10 women in the UK, typically between ages 18 to 35. 
  • Endometriosis is when tissue grows outside of the uterus and can spread to other parts of the body like the bowel and bladder.
  • Symptoms include pain when having sex, during periods, or when opening bowels, back pain, heavy bleeding, and difficulty getting pregnant.
  • It is not yet clear what causes endometriosis but some theories include retrograde menstruation, genetics and a weak immune system.
  • There is no cure but treatment options include pain relief, hormonal treatment, and surgery.

What is endometriosis?

Endometriosis is when tissue that resembles the lining of the womb grows outside of the uterus and can spread to other parts of the body like the bowel and bladder. The tissue will thicken and bleed during the menstrual cycle, but with no way of it being expelled from the body, it remains there. This is a problem because surrounding tissue will get irritated, leading to scarring and adhesions. It can also trigger cysts to form, also known as endometriomas. 

What causes it?

It’s not clear what causes endometriosis, but there are some theories. These theories are lacking evidence, but include:

Retrograde menstruation

Anyone who has periods can experience retrograde menstruation. This is when some of the endometrium (lining of the womb) flows back into the pelvis during your period. The idea is that this tissue can then grow and spread, leading to endometriosis. So, why wouldn’t it affect everyone who has periods? Well, that’s where this theory is a bit unclear. The belief is that some people can expel the tissue before it grows, while others can’t. However, there are some women who have developed endometriosis after a hysterectomy, so in some ways, that disputes that theory.

Genetics

There’s evidence to suggest that endometriosis can be passed down in families. If your mother or sister has endometriosis, then you are at a higher risk of developing the condition, too. 

Weak immune system

People with endometriosis generally have a weaker immune system, but it’s unclear whether the condition itself weakens the immune system or whether people who have immune system problems earlier on in life are at higher risk. 

Environmental factors like mold and other toxins

There have been animal studies to suggest that being exposed to certain toxins can put you at risk of endometriosis. It’s still not clear how this can affect humans, though.

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What are the symptoms?

There are four stages of endometriosis: minimal, mild, moderate and severe. You would think that the severity of the condition would reflect the symptoms, but this couldn’t be further from the truth. There are many people who have mild endometriosis but experience severe symptoms and there are people with moderate to severe endometriosis who have milder symptoms. 

Symptoms include:

  • Pain during sex
  • Pain during periods
  • Pain when opening bowels
  • Back pain
  • Heavy bleeding and bleeding between periods
  • Bleeding after sex
  • Difficulty getting pregnant 

Some people also experience IBS-related symptoms, which is common if there is endometriosis on the bowel. If you have any of the above symptoms, seek advice from your GP immediately. Don’t put it off as endometriosis can cause infertility and other health complications. 

What treatment options are there?

Even though there is no cure for endometriosis, there are options to manage your pain, decrease symptoms and allow you to get pregnant. 

Pain relief

The first thing that many people seek is pain relief. Your GP could recommend that you take ibuprofen or paracetamol to help you manage on days when the pain is severe or interfering with your day-to-day life.

Hormonal treatment

Oestrogen is believed to encourage the growth of endometriosis, so by reducing oestrogen you could see an improvement in your symptoms. Progestogens, in the form of the mini pill, the implant or the injection, can help to control period pain, heavy periods, and other uncomfortable symptoms. However, this won’t help in all cases, and it’s not an option for anyone who is trying to get pregnant or is trying to avoid hormones. 

Surgery

Surgery is the best option for anyone who is struggling to get pregnant or have more severe symptoms. Usually, a laparoscopy will be carried out, which is keyhole surgery. During the procedure, the surgeon will remove the endometriosis tissue by using heat or a laser. If there are cysts or endometriomas present, these will be removed as well. Many people see great relief after having surgery and it can greatly improve your chances of conceiving naturally, too. 

Can it go away on its own?

There are some myths that endometriosis can go away on its own or that pregnancy can cure it. This isn’t true. While it’s possible that pregnancy can see a reduction in symptoms, it’s likely that your symptoms will return soon after childbirth. 

Does the menopause cure it?

For many people, the menopause can significantly reduce their symptoms, or they might not experience any symptoms at all. This is because the body starts producing less oestrogen, which in turn, stops the body producing endometrium. However, it’s believed that 2 to 5 percent of women will still struggle with endometriosis even after menopause. 

Can you get pregnant with endometriosis? 

There are some concerns that endometriosis can cause infertility due to the scarring and adhesions. But the good news is in many cases, it’s still possible to get pregnant. According to Endometriosis UK, 60 – 70% of women with endometriosis will get prevent naturally and without intervention. For those who struggle to get pregnant, surgery and IVF can greatly increase the chances, and many women will go to have healthy pregnancies. Something to keep in mind is there is a slightly higher risk of miscarriage in people with endometriosis, which will affect around 1 in 4 pregnancies. If you have any concerns, you should raise them with your GP. 

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