Key facts
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Endometriosis affects an estimated 10% (190 million) of reproductive age women worldwide.
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Endometriosis can impact sexual intercourse, bowel movements and/or urination; and mental health (including depression and anxiety).
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There is currently no cure for endometriosis; access to early diagnosis and effective treatment of endometriosis is limited in many settings and treatment aims to control symptoms and limit long-term impacts.
Endometriosis occurs when uterus-like tissue develops outside the uterus. This tissue can grow on the fallopian tubes, ovaries or intestines. Typically the tissue lining of the uterus sheds and leaves the body during menstruation. With Endometriosis, the tissue outside of the uterus still sheds in response to changing estrogen levels but is unable to leave the body. As a result it can cause painful symptoms, inflammation, infertility, scar tissue and bowel problems.
When endometriosis involves the ovaries, cysts called endometriomas may form. Surrounding tissue can become irritated and form scar tissue. Bands of fibrous tissue called adhesions also may form. These can cause pelvic tissues and organs to stick to each other.
What are the symptoms of Endometriosis?
Endometriosis is a chronic disease and symptoms include:
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Severe pain during menstruation; heavy menstrual bleeding
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Chronic pelvic pain (pain that does not go away when the menstrual cycle ends)
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infertility
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Abdominal bloating and nausea
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Painful during or after sex
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Pain with bowel movements or urination
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Excessive bleeding
The World Health Organisation (WHO) has identified that in many countries, the general public, family members and most health and care workers are not aware that the chronic pelvic pain people affected by endometriosis face is not normal. In low and middle-income countries, there is a lack of multi-disciplinary teams with the wide range of skills and equipment needed for the early diagnosis and effective treatment of endometriosis. In addition, many knowledge gaps exist, and there is need for non-invasive diagnostic methods as well as medical treatments that do not prevent pregnancy.
The Family Planning Association of Sri Lanka, emphasises that the pain for some individuals can be so severe that it interferes with daily activities, leading to missed work or school.
It can take an average of 7-10 years to get diagnosed with endometriosis. Many people find that their concerns are sometimes brushed off as just "bad period pains" instead of being taken seriously as potential endometriosis.
It's important that your symptoms are recognized and treated properly, so you receive the medical care and support you need.
Endometriosis lesions are classified into 3 major groups:
Superficial, peritoneal lesions are probably the most common, and are located in the peritoneum. These cysts do not exceed 5mm.
Cystic lesions of the ovaries (ovarian endometriomas) are hemorrhagic lesions that encyst under the ovarian parenchyma (the primary tissue of the ovary, primarily consisting of the ovarian and follicles) progressively displace it.
Deep, sub-peritoneal lesions (infiltration greater than 5mm) are hard, fibrous lesions in which hormone-dependent endometrial tissue is relatively poorly represented (15-20% of the volume of the endometriosis nodule).
A study done by the WHO, spotlights the significant impact that endometriosis has on health, social and economic implications. Severe pain, heavy bleeding, fatigue, depression, anxiety, infertility, poor sexual health and social isolation can dramatically reduce quality of life.
They further discuss how endometriosis is associated with infertility globally. Amongst women with infertility, as many as 25-50% have endometriosis. Heavy menstrual bleeding from endometriosis can contribute to iron deficiency and fatigue. Painful sex due to endometriosis can lead to interruption or avoidance of intercourse and impact the sexual health of affected individuals and their partners.
Although there is no cure for endometriosis, several treatment options can help manage symptoms including:
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Physical therapy for the pelvic floor
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Hormonal contraceptives such as the pill or IUD
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Surgery to remove endometrial tissue, which may also improve fertility if you’re experiencing infertility.
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Anti - inflammatory diet: avoiding processed foods and eating more more vegetables and Omega-3s
For those with symptoms, endometriosis sometimes may seem like other conditions that can cause pelvic pain. These include pelvic inflammatory disease or ovarian cysts. Or it may be confused with irritable bowel syndrome (IBS), which causes bouts of diarrhea, constipation and stomach cramps. IBS also can happen along with endometriosis. This makes it harder for your health care team to find the exact cause of your symptoms.
Endometriosis can be a challenge to manage. You may be better able to take charge of the symptoms if:
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Your care team finds the disease sooner rather than later.
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You learn as much as you can about endometriosis.
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You get treatment from a team of health care professionals from different medical fields, if needed.
