Endometriosis Awareness: Part One - Endo 101
Hi friends! Today I’m going to be talking about a topic that is really significant to me and something that I’ve spent a lot of time over the past 5-6 years learning about - Endometriosis. March is National Endometriosis Awareness Month and as someone who has been diagnosed with Endo, I want to really take some time to provide some education and awareness around the topic. Unfortunately, there seem to be a lot more questions about endometriosis than there are answers, currently, but the more we can educate women about what we do know about it, the more people can hopefully find some relief and improvement in the symptoms of this condition.
1 in 10 women are estimated to have been diagnosed with Endometriosis in the US, and really it’s expected that the number is actually much higher than that due to the fact that a lot of women go years with symptoms of endometriosis without having an actual diagnosis.
So what is Endometriosis?
An inflammatory hormonal condition that causes tissue similar to the tissue that lines the uterus (endometrium) to grow in other places of the body where it is not supposed to be. This tissue then bleeds on a monthly cycle just like the tissue inside the uterus but the blood has no exit from the body. This is severely irritating to the nerves, especially the abdomen and leads to severe pain and increased inflammation in the body. Over time, this irritation and inflammation lead to scar tissue that can cause the pelvic and abdominal organs to develop adhesions—meaning the organs can all stick together. This can cause bladder and bowel pain, constipation, pain with ovulation, severe menstrual cramping and pain, infertility, chronic pelvic pain, and pain with sex.
What causes Endometriosis?
Unfortunately, there is not an agreed-upon root cause yet - there are a few different theories that are being studied. However, what we do know is that once developed, it is an inflammatory condition with an abnormal immune response. Find more information about possible causes of endo here
What are the most common symptoms and how can it be diagnosed?
Endometriosis is complicated for a lot of reasons but the variability in symptoms and difficulties in diagnosing are some of the most frustrating ones. Symptoms can vary so much from woman to woman. Some women can have extremely painful, heavy periods with a lot of cramping, sometimes even being debilitating to the point that they have to stay home from work or school. Some women have G.I. symptoms specifically around the time of their period - IBS symptoms or constipation, or pain with bowel movements. For some women, they have no pain at all, or at least very little pain. Infertility is also a very common symptom of endometriosis, and sometimes is the first indication that there is some kind of dysfunction in the reproductive system. A few other symptoms are upper leg pain, joint pain, extreme bloating in the lower abdomen (known as Endo-belly) and ovarian cysts known as Endometriomas.
As far as diagnosing Endometriosis, there isn’t an easy answer here either. The only way to be absolutely sure that a woman has Endometriosis is through an exploratory laparoscopy (a surgical procedure where they make a tiny incision and use a scope to explore the abdomen for endometrial tissue). Obviously, this is a pretty invasive diagnostic measure and definitely comes with the risk of anesthesia, plus risk of creating even more scar tissue from the incision.
Doctors can sometimes make an educated guess based on symptoms and there are a few studies that show that the use of certain lab markers may indicate endometriosis in the body, but that isn’t a widely accepted method for diagnosis.
The other major issue with diagnosing Endometriosis is how often it’s missed. Because the most common symptom is painful periods, often the patient is just dismissed as having a low pain threshold or being overly dramatic about what they consider “normal PMS symptoms”. Also, it has become an easy-fix to just prescribe pain meds or an oral contraceptive to help with the pain rather than actually exploring the cause or assuming that it may be abnormal. Unfortunately, neither of these options actually fix the problem or provide long-term solutions to the pain.
What are the treatment or management options?
Again, there isn’t a super simple answer for this either. There hasn’t been one single treatment that has been found to be effective for everyone.
One common treatment option is surgical excision, as I mentioned before. Once the operation is done to look for Endometriosis, if found, they go ahead and remove any endometrial tissue they find, as well as adhesions. Even though this option often does provide temporary relief from the symptoms, the endometrial tissue often regrows and the surgery has to be repeated.
Some women who are not trying to become pregnant may choose a hormonal therapy option, such as oral contraceptives or other medications that suppress ovulation completely, but often still find that they deal with recurring symptoms. Some may even choose a hysterectomy, often out of desperation to find some relief.
It honestly can be such a debilitating and horribly frustrating condition because for many women it just comes back over and over, despite using one of these treatment options.
The good news, however, is that there are some alternative treatments that have shown to be very helpful in the management of symptoms as well as in reducing the overall inflammation in the body, which helps to address the root cause.
Based on what has been learned about how the role of a healthy microbiome, or good gut health, plays in hormonal balance and inflammation in the body, we know that taking steps to improve gut health is a great place to start.
Living an anti-inflammatory lifestyle has also been shown to have positive effects on symptoms and addressing the root inflammation. Eating an anti-inflammatory diet filled with a lot of vegetables (8 cups a day of leafy greens and other fiber-rich veggies), healthy fats like avocado and nuts, and clean protein from fish and plant-sources like legumes is very effective. Also avoiding known inflammatory foods like dairy, gluten, corn, beef, and sometimes even caffeine can help calm inflammation and allow the gut to heal more quickly. Taking a quality, whole-food multivitamin and omega-3 supplement also help to reduce inflammation.
Also, working to reduce and manage stress levels, getting at least 8 hours of quality sleep each night, and moving the body for 20-30 minutes a day have also been shown to reduce inflammation and improve symptoms.
In addition, there are other alternative methods like using herbal supplementation and acupuncture that are hugely beneficial to supporting the body’s ability to heal and dealing with painful symptoms.
The other factor that has shown to be very important in dealing with Endometriosis is reducing exposure to environmental toxins. Whether from non-organic foods - especially meat, plastics, toxic beauty or personal care items, household cleaners, etc. - all of these toxic exposure increase inflammation in the body, are known endocrine disruptors, and greatly increase the toxic load on our liver and other detox pathways in the body. These exposures can lead to increased levels of estrogen in the body which can further create hormonal imbalance and again lead to more inflammation.
There is no question about it - however, you choose to treat Endometriosis, it will take work. It’s estimated that someone with endometriosis will end up spending the same amount in healthcare expenses as someone with diabetes. It is a very real, very difficult condition and for those who are dealing with it on a daily basis, it can become all-consuming.
There is hope though! There is a lot of research being done and a lot of the alternative treatments that I mentioned are helping so many women regain control of their health and providing relief for them! If you know someone who has Endo, reach out to them this week and let them know you care for them and that you love them. I guarantee you they can use your encouragement!
In the next episode, released later this week, I’m going to be sharing my story with Endo and the things that have helped me.
Here are a few of my favorite resources for learning about Endometriosis and how some of these alternative therapies may help you:
Integrative Women's Health Institute: https://integrativewomenshealthinstitute.com/?s=Endometriosis+
Nancy’s Nook Education Page: https://www.facebook.com/groups/NancysNookEndoEd/
Dr. Jolene Brighten: https://drbrighten.com/causes-endometriosis-5-natural-treatment-strategies/
Natural Fertility Info: https://natural-fertility-info.com/?s=Endometriosis+
Acupuncture for Endometriosis Relief: https://www.healthcmi.com/Acupuncture-Continuing-Education-News/1770-acupuncture-beats-drug-for-endometriosis-relief
Tennessee Center for Reproductive Acupuncture: https://www.tennesseereproductiveacupuncture.com/phone/index.html