National Endometriosis Month

National Endometriosis Month

Endometriosis is a common condition, that affects millions of women worldwide. Estimates are that 6-10% of reproductive-age women are affected by endometriosis. In women who have pelvic pain, it is found in up to 70%.  Typically endometriosis causes extremely painful periods, as well as pelvic pain, and can cause pain during intercourse, pain involving the bladder and other pelvic organs.  The pain can be debilitating for some, but not everyone.  In addition to pain, it can also be a cause of infertility.  The condition is unpredictable, in that when it is present it doesn’t always cause pain and it doesn’t always cause infertility; and interestingly, the severity of disease found at surgery does not directly correlate with the degree of symptoms that women experience.

The disorder occurs when the cells that line the inside of the uterus begin to grow outside of the uterus, and the growth of endometriosis is stimulated by estrogen, one of the hormones naturally produced during menstrual cycles.  When estrogen production triggers the proliferation of those cells, and other hormonal fluctuations result in bleeding, pain results.  The growth of that tissue can cause scarring internally that can affect the reproductive organs, as well as the other pelvic organs, including the bladder and rectum, and intestines.  The areas that are involved contribute to the sites and types of pain that are experienced.

The condition can be suspected based on a patient’s symptoms, but can only be definitively diagnosed by surgery.  It is also important to note that sometimes the endometriosis lesions can be microscopic and only found by pathologic inspection from biopsies taken at surgery.

For women living with endometriosis, especially when their symptoms aren’t adequately treated, other conditions including anxiety and depression can also develop.  Quality of life can be adversely affected, and missed school and work are common in women suffering from the disease.

There are a number of treatments that are traditionally used that often give a lot of relief.  The synthetic hormones in the progestin family have the effect of suppressing or shrinking endometriosis lesions and are often effective at helping to control the pain.  These hormones can be used via birth control pills, hormone-containing IUDs, injectable and implantable birth control methods, and are effective for many women suffering from the disorder.  There are other medications that can be implemented, strong ones that can induce a temporary state of menopause, but make sure to ask about the possible side effects of these medications before trying them.  Newer ones as well, that work through unique mechanisms.

Cannabis medicines including Cannabidiol and THC have been studied in animal models and in benchwork and show efficacy in helping relieve symptoms.

Living with endometriosis can present many challenges for women, but there are many treatment options, including holistic ones that offer relief for many women.  If you experience severe pain with menstrual cycles or during intercourse, speak to your doctor about the possibility of endometriosis and about what your options are.

In good health,

Dr. Wendy

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