by Dr. Margaret ArandaMarch is International Endometriosis (ên dō mē tri ō sîs) month! What IS endometriosis? Affecting 176 million women worldwide and 5.5 million in the USA, the uterus lining sheds blood during mentruation, plus with "endo", there are bits and pieces of uterine tissue scattered outside of the uterus, & they all bleed with menstruation, too.
The most common patient complaints are:
(1) Pelvic Pain: can be mild, moderate, or severe.
(2) Infertility. So, take it seriously.
The Origin is thought to be from: hormones, 'retrograde menstruation,' Transplantion Theory, Coelomic Metaplasia, heredity, cell-mediated immunity, humoral immunity, and/or genetics (3). So did you register at GeneFo.com to get evaluated for the gene for endo? Yah....
Facts: Generally considered to be a benign condition, endo has turned cancerous in 1% of women, and doctors may always want to use that small number to take your ovaries out. Ask them if they can't just check your blood level of CA-125 every 6 months instead. The Pain can be very mild, or it can be incapacitating. And some women can still get pregnant and have a baby with 'endo.' So keep up the faith.
Image 2. The Pathophysiology of Endometriosis. The uterus lining is inflamed with free radicals and other metabolites, resistant to progesterone. Menstrual blood falls out of the Fallopian Tubes, instead of going up the Fallopian tubes, into the uterus, and out the vagina. Implants of Endometriotic Origin are then implanted outside the uterus, with new blood vessel growth, new nerve growth, new steroid production, and invasion of other pelvic structures like the ovary (depicted above). All the added sensory, sympathetic and parasympathetic nerves make each "implant" feel pain in each area of the implants. (Image courtesy of www.WomensHealthSection.com)
Mothers, try to get your daughters diagnosed with this before she marries off to a man that is also devastated to accept that she can not bear children. This diagnosis should not be made that late in life, girls and ladies. We can do better than that. We can get good at talking about it, discussing it with the right people, asking questions in online groups, and discovering the diagnosis as soon as possible. Only then can we 'put it in a box' and deal with it.
I bet that 95% of teen girls who menstruate have never heard this word. And I also bet that there are lots and lots of women who have had prolonged, painful periods for years and years stretched into decades...and now they are married and the husband is left to actually live with the grown woman now....and he sees her suffering. He sees her pain. A good man would not accept this for his loving wife. He would want to find out what is wrong, and take her to a doctor(s) until she has a diagnosis.
This "doctor shopping" is discussed in both my adult books, and I do encourage it if you know that there is "something" wrong with your body.
But if you are referred to a surgeon for an operation....WHOAA! Slow down and get a 2nd or even a 3rd opinion.
Because some women have had a hysterectomy for endometriosis, with ovaries removed and then suffer "surgical menopause" as a Crash Course. And these women cry every day. Others have had scraping (i.e., ablation) of the uterus' lining, and it worked just fine, without undue emotional trauma. So, proceed with care.
Keep your antennae up. Learn one step at a time. Talk to your doctors, friends, family, groups of women that have it, and be informed and educated. Women ARE helping women on this, and there are entire organizations dedicated to only Endometriosis, like the following list that is not meant to be all-inclusive. So let's proceed.
The Endometriosis Association
Endometriosis at the Mayo Clinic
Endometriosis Foundation of America
World Endometriosis Research Foundation & Resources
St. Hope Foundation
ROSE: Research OutSmarts Endometriosis
Women helping Women. National Endometriosis Month of March! Let us continue to educate our daughters. They need to at least "hear about it." We can get good at this!
Dr Aranda's Short Stories