Endometriosis and How to Treat it
Endometriosis is a disease which affects roughly 1 million people in Canada and about 10% of women of reproductive age. It is defined by the presence of endometrial tissue (the lining of the uterus which sheds during the menstrual cycle) outside of the uterus. About 30% of individuals with endometriosis have difficulty conceiving, and 40-50% of individuals with persistent pelvic pain have been diagnosed with the disease. Endometriosis can cause chronic pelvic pain, dysmenorrhea (painful periods), dyspareunia (pain during intercourse), and bowel and bladder symptoms. Due to changes in pelvic and uterus anatomy, endometriosis can also cause difficulty conceiving.
The cause of endometriosis is not certain and currently has no curative treatment, though treatments to manage symptoms are available. What we do know about endometriosis is that endometrial cells develop outside of the uterus, which respond to estrogen just as the cells within the uterus do during the menstrual cycle. This response can cause inflammation and pain, which can lead to scarring and adhesions. Individuals who have congenital abnormalities, genetic predispositions, low birth weight, early menarche (the age when you experience your first period), and abnormal periods are more at risk to develop endometriosis. Strangely, the severity of symptoms is not directly related to the severity of the disease. Some individuals may have extensive endometriosis and experience no symptoms.
How is Endometriosis Diagnosed?
Historically, endometriosis was diagnosed through surgical procedures to visualize the abnormal cell growth. Today, endometriosis is often diagnosed without invasive surgical procedures and is based on symptoms, physical examination, and imaging such as MRIs and transvaginal ultrasounds. If you are experiencing endometriosis symptoms, speak to your healthcare provider or book an appointment with a medical doctor at Maud Medical Clinic in Calgary.
Medical Treatments
Though there is no cure for endometriosis, treatments can help individuals manage their symptoms. First line treatments include the use of NSAIDs (nonsteroidal anti-inflammatory drugs, like Advil or Aleve) or hormonal therapies. Hormone therapies are used with the goal of suppressing the menstrual cycle so that the endometrial cells do not become inflamed, causing pain. These therapies are contraceptive in nature (hormonal birth control), so they are not acceptable for patients who are trying to conceive. Hormone therapy must be prescribed by a medical doctor.
Surgical interventions may be considered when hormone therapy or pain management is not advisable for the patient (like for those trying to conceive), or has not adequately relieved symptoms. Surgical procedures can be used to remove scar tissues and endometrial growths. In some extreme cases, individuals who have no plans to conceive in the future may decide, with their doctor, to have a hysterectomy (removal of uterus), with or without one or both ovaries. Removal of ovaries will cause premature menopause due to the hormonal changes which will occur.
Holistic Management
Though it has not been thoroughly studied at this point, many individuals feel that diet and lifestyle changes have helped their endometriosis symptoms. Certain foods can promote less inflammation in the body. Though seeing your healthcare provider to discuss your symptoms should always be the first step, consider speaking to a nutrition counsellor about how changing your diet may help with endometriosis symptoms.
If you are experiencing persistent symptoms or have concerns about your health, speaking with a physician at a Calgary medical clinic can provide clarity, reassurance, and appropriate care.
This article is not medical advice, please speak to a Maud professional for a deeper understanding and medical advice.
References:
Catherine Allaire, Mohamed A. Bedaiwy and Paul J. Yong, “Diagnosis and management of endometriosis”, Canadian Medical Association Journal, March 14, 2023
