Endometriosis

Endometriosis is a long standing, inflammatory condition made worse by ebs and flows in oestrogen… Causing the growth of endometrial tissue outside of the uterine cavity. It effects the whole body and is caused by underlying imbalances and miscommunication between your bodies different systems. It’s not just bad period pain… Don’t let anyone ever tell you different dahrrling!

What the F%#k actually is it?

Basically it’s where the tissue that is naturally in your uterus and sheds every month is also be found in other parts of your body, most commonly in your abdominal cavity and around your rectum… Places it shouldn’t be. 

This tissue is naturally sensitive to changes in your oestrogen levels, so your symptoms change when you have your natural menstrual cycle (Hence why the pill is often recommended to flatten the natural hormone fluctuations). The tissue grows in the first half of your cycle when oestrogen peaks and then triggers a bleed around the time of your period when oestrogen drops. Bleeding into your abdominal cavity or anywhere else in your body for that matter is NOT FUN! It’s not just bad period pain y’all!

Signs and Symptoms

Symptoms can vary dramatically from person to person because they largely depend on where that nasty extra tissue is growing. 

Commonly associated with symptoms of: 

  • Chronic Pelvic Pain
  • Infertility
  • Heavy painful periods
  • Severe bloating
  • Vaginismus is often associated
  • Pain when poo’ing
  • Pain during sex
  • Poor gut function (Constipation, diarrhoea, IBS)
  • Anxiety/ Depression

Endo is prone to progression and recurrence. 

Starting your period at a young age and short menstrual cycles have been associated with increased risk for endometriosis.

What's Actually Happening in your body?

Basically in short. No one really knows why some women get endometriosis and some don’t. There is no ‘bug’ that attacks you and causes endometriosis, however it is thought that there is a mismatch and imbalance between your genes, hormones, environment (things you eat and drink) and your immune system. — This basically explains the underlying cause of may autoimmune conditions. There is no one cause, instead it’s your bodies way of showing you that the automatic processes in your body are off and something needs to be done. 

In women with no endometriosis, their level of endometrial oestrogen and chemicals that either contract or relax your uterus (prostaglandins) are low. Women with normal levels of progesterone (People with PCOS or women with regular cycles) also help to reduce the high levels of oestrogen and keep your hormones in check. In Women with Endometriosis they have 3 distinct differences: 

  • High local oestrogen production
  • High local prostaglandin (inflammation) production
  •  Resistance to actions of progesterone

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PhD Exercise Physiologist and Nutritionist

Dr. Stacey Sims 

Hormones tell our body what to do. How to eat, sleep and even when to grow. They give us our appetite and sex drive. They help us have babies, They make us happy, sad and giddy in love.

In men, these hormones are pretty stable day in and day out (though they certainly change over a lifetime). In women, however, it’s another story. And that story centres around the menstrual cycle.

What tests tell Me i have it?

The techniques used to diagnose endometriosis currently are quite invasive, however recently there has been revelations in ultrasound machines and quality of reading the results. 

You can have a hint that you may have endometriosis from the signs and symptoms above, also having an ultrasound will give you some idea also. These techniques however aren’t specific enough, hence why it takes on average 7 years for women to be diagnosed with endometriosis. 

Diagnosis is given with an exploratory laparoscopy or an ‘ex-lap’ for all of your Grey’s Anatomy fiends out there. This basically consists of surgeons going in for a key whole surgery (3 small wholes in your stomach), having a look around and burning or cutting off the extra endometrial tissue that shouldn’t be there. 

Based on where, how much and what they find, your diagnosis varies. You can be graded from 1-4. 

These grades are not based on the level of pain you experience. Someone with a grade 2 diagnosis may experience greater pain that the most severe tissue growth of a grade 4. 

Can other things be affected too?

  • Fertility
  • Hypothyroidism
  • Chronic Fatigue syndrome
  • Rheumatoid Arthritis
  •  Other autoimmune conditions

Things that make it worse?

Pregnancy has a protective effect that helps to decrease severity of endometriosis. This impact however tends to decrease overtime. Breast feeding and multiple pregnancies also help to decrease endometriosis, and the risk increases the longer time since last childbirth. 

Heavy alcohol consumption and caffeine also may increase the risk of developing or worsening endometriosis. This is thought to be because of their impact on hormonal imbalance and damage to the liver making it harder to breakdown and excrete hormones.

The incidence of endometriosis is increased in women that experience their first period at a young age, have short menstrual cycles and experience menstrual pain. 

What can I Do about it?

From the current research, it is thought that to the best of our knowledge that endometriosis is an inflammatory condition that is made worse by oestrogen. 

Conventional methods of treatment: 

  • Often put on contraceptive pill to flatten fluctuations in hormones
  • Can be recommended drugs that block the action of oestrogen
  • Exploratory surgery called a laparoscopy where they remove excess tissue from places it shouldn’t be
  • D+C that burns off excess tissue inside the uterus
  • Hysterectomy: As a last resort to remove the uterus and ovaries so that our natural production of hormones is halted. (Note this cannot be reversed and you will be put on hormone replacement therapy afterwards)

Reduce Inflammation and Co-ordinate immune response 

  • Focus on healing the gut and removing inflammatory foods (Often these include: wheat, dairy, eggs and corn–> You can get an IgG Food sensitivity blood test that tells you exactly what’s triggering your immune system and inflammation)
  • Omega 3 supplementation
  • Magnesium supplementation
  • Reduce stress in your life. This helps to balance your stress hormone which then helps to regulate your inflammation

Balance Hormones (Oestrogen)

  • Removing inflammation is a great way to help your gut regulate your hormones
  • Support your liver 
  • Eat based on what phase you’re in, in your menstrual cycle
  • Vitamin B complex to help regulate hormones
  • Decrease stress baby! If you’re stressed than all of your hormones go haywire. 

References

Fritz, M. and Speroff, L., 2010. Clinical Gynecologic Endocrinology And Infertility. 8th ed. Lipponcott Wilkins & Williams.