Endometriosis Awareness Month

Samah Ahmed

Did you know that March is Endometriosis Awareness Month? So, what exactly is endometriosis? Why is an entire month dedicated to it? And how prevalent is it? Before we answer these questions, let's go over some basic anatomy and physiology to create the groundwork, starting with the uterus! 

 

The Uterus

The uterus is a hollow organ found in the female pelvis whose main function is to nourish and carry a foetus through its development until birth. The uterus is made up of three layers, which are known as the endometrium (the innermost lining), myometrium, and perimetrium. The endometrium will be the focus of this article. This layer is commonly referred to when studying the menstrual cycle. These cycles are governed by two hormones known as oestrogen and progesterone. Oestrogen causes the lining of the uterus to grow thicker, while progesterone plays a role in regulation. If pregnancy does not ensue, the lining is shed and this is what is known as a period! 

 What is endometriosis?

Endometriosis is a condition in which the tissue of the endometrium is found in other parts of the body. In most cases, the tissue rarely extends past the pelvic region. The cause of it is not known. Since the ectopic tissue is similar to the tissue of the endometriosis, and because it responds to the levels of hormone within the body; it can expand, bleed and produce symptoms. Interestingly, if ectopic endometrial tissue is present within the lungs, it can present symptomatically as a bloody cough during menstruation! However this is a rare occurrence.    

What are the symptoms?

So what are the symptoms of endometriosis? They can vary from person to person. Some may not have any at all, but others will present with symptoms depending on where the ectopic tissue lies. The most common ones include: pain with bowel movements (often during monthly periods), pain during or after sexual intercourse, painful menstruation and sub/infertility. Since these symptoms overlap with other medical conditions, (and since no test can detect it), your doctor will need to have a high clinical suspicion for it, otherwise, it may be confirmed with surgery. Your doctor can only confirm the diagnosis through a laparoscopic procedure to attest that ectopic endometrial tissue is indeed present.  

Are there risk factors?

Like many other medical conditions, endometriosis does have some associated risk factors both modifiable as well as non-modifiable! Below are risk factors as well as some factors associated with a decreased risk.

 

Endometriosis Risk Factors:

  1. Early age for first period (aka early menarche)
  2. Shorter menstrual cycle length
  3. Taller Height
  4. Alcohol Use
  5. Caffeine Intake 

 

Factors associated with a decreased risk:

  1. Parity (Pregnancy)
  2. Use of oral contraceptives
  3. Regular exercise
  4. Fish and omega 3 fatty acids

  

How is endometriosis treated?

With modern medicine, there are many options available for the treatment of endometriosis and the preference is up to the patient! Both medicinal as well as surgical treatments are available.

Doctors can recommend what are known as non-steroidal anti-inflammatory drugs or NSAIDs. Examples of NSAIDs include ibuprofen or diclofenac. They do not cure the endometriosis, but merely treat it. 

Birth control medicines can also be used as a treatment and they come in many different forms including oral pills, skin patches, intrauterine devices or vaginal rings. It’s important to note that they are not an appropriate treatment option if one is looking into becoming pregnant. 

Two surgical options are available: The first is a laparoscopy whereby the surgeon removes the ectopic tissue, and the other is known as a hysterectomy. The latter is a good option for individuals who are certain that their families are complete. 

In the case that one wishes to become pregnant, its important that they speak with their doctor and review all the available options to make the best decision. 

 

How prevalent is endometriosis, and why is there a month dedicated to it? 

Now that the basics of endometriosis is covered, how common is this medical condition? According to the World Health Organization, “endometriosis affects roughly 10% of reproductive age individuals globally”. Since it is very prevalent, a group known as Endometriosis association established endometriosis awareness month in 1993 in order to help educate the masses, raise money through fundraisers for research and to help promote policies for these women as an endometriosis advocate! Today, many events are held in honour of this cause through summits as well as conferences!

 

To conclude

From basic anatomy to the endometriosis association, there was a lot that was touched on for endometriosis today! Although there is a lot that has been discovered about this medical condition, science is striving to learn more! Awareness-raising, education, prevention, research and clinical research are all on the agenda. We must remember that there is a lot more to be done in terms of raising awareness of this condition in our communities, in the health care professionals that care for people with endometriosis, and in our communities at large.   

 

 

  

References:

  1. https://medlineplus.gov/ency/imagepages/19263.htm#:~:text=The%20uterus%20is%20a%20hollow,the%20lining%20of%20the%20uterus. 
  2. https://www-uptodate-com.proxy.library.rcsi.ie/contents/endometriosis-the-basics?search=Endometriosis&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1#H463000859 
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5737931/ 
  4. https://www.mayoclinic.org/diseases-conditions/endometriosis/symptoms-causes/syc-20354656#:~:text=Endometriosis%20most%20commonly%20involves%20your,where%20pelvic%20organs%20are%20located.
  5. https://www.who.int/news-room/fact-sheets/detail/endometriosis#:~:text=Endometriosis%20affects%20roughly%2010%25%20(190,and%20girls%20globally%20(2). 
  6. https://www.everydayhealth.com/endometriosis/awareness-month/ 

 



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