Endometriosis

What is endometriosis?

Endometriosis is a chronic and often painful condition where tissue similar to the lining of the uterus starts growing outside the uterus. This tissue can attach to the ovaries, fallopian tubes, and other parts of the pelvic cavity, and in rare cases, even beyond.

Each month, this misplaced tissue responds to hormonal changes just like the uterine lining: it thickens, breaks down, and bleeds. But unlike menstrual blood, this blood has no way to exit the body, leading to inflammation, cysts (called endometriomas), and scar tissue. Over time, this can cause organs in the pelvis to stick together—a painful condition known as adhesions.

The most common symptom of endometriosis is pelvic pain, particularly during or around the time of menstruation. But the condition can also lead to pain during sex, heavy bleeding, and fertility challenges. For some, the pain is manageable, but for others, it can be life-altering.

While there's currently no cure for endometriosis, a combination of medical treatments, lifestyle changes, and sometimes surgery can provide relief and help manage complications. If you're experiencing persistent pelvic pain or struggling with fertility, don’t ignore it—early diagnosis and the right care can make a meaningful difference in your quality of life.

What are the causes of endometriosis?

Despite its widespread impact, the exact cause of endometriosis remains unclear. However, several well-supported theories offer insight into how this complex condition might develop. It’s important to understand that no single explanation fits all cases; different factors may contribute in different individuals.

1. Retrograde Menstruation

One of the most common theories is retrograde menstruation, where menstrual blood flows backward through the fallopian tubes into the pelvic cavity instead of exiting the body. This blood carries endometrial cells, which may stick to surrounding tissues and begin to grow, causing inflammation and pain during each menstrual cycle.

2. Immune System Dysfunction

Some researchers believe that the immune system may fail to recognize and destroy the endometrial-like tissue growing outside the uterus. This allows it to implant, grow, and persist in places it shouldn’t.

3. Cellular Transformation

Hormones or immune factors might trigger certain cells, such as peritoneal cells (which line the abdominal cavity) or embryonic cells (from early development), to transform into endometrial-like tissue. This theory could explain why some girls show signs of endometriosis even before their first period.

4. Surgical Complications

In some cases, endometrial cells may attach to surgical scars, such as those from a C-section or hysterectomy. These transplanted cells can grow and cause endometriosis in the area of the scar.

5. Blood and Lymphatic Transport

It’s also possible that endometrial tissue spreads to other areas through the bloodstream or lymphatic system, much like how cancer cells can travel in the body. This could explain why endometriosis sometimes appears in distant organs.

6. Genetic and Environmental Factors

Endometriosis tends to run in families, suggesting a genetic link. Environmental toxins or hormonal imbalances might also play a role by influencing how cells grow and respond to inflammation.

What are the symptoms of endometriosis?

Endometriosis can feel different for every person. Some may have intense pain, while others may have no symptoms at all. However, the most common signs often relate to the menstrual cycle and reproductive system. Recognizing the symptoms early can help you seek timely care and improve your quality of life.

1. Pelvic pain

Often the most noticeable symptom, this pain is usually linked to the menstrual cycle and can range from mild to severe. Some women describe it as a deep, sharp, or cramping pain that worsens over time.

2. Painful periods (Dysmenorrhea)

Intense menstrual cramps that may start before your period and last several days into it. The pain may also radiate to the lower back and legs.

3. Pain during or after sex

Discomfort during intimacy is a common and distressing symptom of endometriosis, often due to deep tissue involvement.

4. Pain with bowel movements or urination

These symptoms usually occur during menstruation and may indicate that endometriosis is affecting the bladder or bowel.

5. Heavy menstrual bleeding

You may experience unusually heavy periods (menorrhagia) or spotting between periods.

6. Infertility

Endometriosis can make it harder to get pregnant. It is sometimes first diagnosed during fertility evaluations.

7. Chronic fatigue

Ongoing pain and inflammation may contribute to a persistent sense of tiredness and low energy.

8. Digestive issues

Symptoms such as bloating, constipation, diarrhoea, and nausea, especially during periods, can overlap with other conditions like IBS (irritable bowel syndrome).

When to See a doctor

If you experience ongoing pelvic pain, especially if it's interfering with daily activities or accompanied by other symptoms listed above, it’s important to consult a healthcare provider. Endometriosis can be managed effectively with early diagnosis and the right treatment plan.