Poorly understood, misdiagnosed, and inadequately treated... Endometriosis has long left many women alone with their pain. Today, it is estimated that at least 10% of women of childbearing age are affected by endometriosis. Here are some clarifications on this condition.
What is endometriosis?
Painful menstruation is a common reason for gynaecological consultations. The most frequent culprit: endometriosis. Endometriosis refers to a condition in which the uterine lining, known as the endometrium, grows outside of the uterus. The endometrial tissue then invades other structures of the body and induces inflammation, which is the source of the pain. In cases of endometriosis, tissues similar to the uterine lining are found in the Fallopian tubes, the ovaries, the pelvic cavity, the intestines, the bladder and even exceptionally in the lungs or the brain.
It is a complex and under-diagnosed condition. It is estimated that endometriosis affects 10% of women of childbearing age. Most often, the pain begins around 15 - 20 years of age, even though several years pass before the diagnosis is made. Pain is not the only consequence of endometriosis. Indeed, it is a common cause of infertility, with almost half of the women experiencing fertility problems being affected by it. Endometriosis lesions react in the same way as the uterine lining, thickening throughout the menstrual cycle and shedding during menstruation.
Typically, during menstruation, blood is expelled through the vagina. In the case of endometriosis, some of the menstrual blood flows back up through the fallopian tubes and can even spill into the pelvic cavity. This phenomenon is known as "retrograde menstruation". Menstrual blood corresponds to the shedding of the uterine lining. Therefore, this blood contains uterine lining cells, which can adhere to extra-uterine structures and proliferate, thus creating endometriosis lesions. Following cyclical bleeding, these clusters of endometrial cells spread, continually creating new endometriosis lesions. This explains why the pain intensifies over the years. These lower abdominal pains mainly occur during menstruation and sometimes during sexual intercourse or when using the toilet. As the affected organs can vary greatly, the experience differs significantly from one woman to another. In some cases, endometriosis can even be completely asymptomatic.
If you believe you are suffering from endometriosis, do not hesitate to consult a doctor. Indeed, an early diagnosis can help prevent complications. The goal is to prevent the formation of new endometriosis sites and to destroy existing ones. For each woman, depending on her expectations, a personalised solution will be implemented. Thus, not only the pain, but also fertility issues can be treated. If you do not suffer from endometriosis but your periods are nevertheless painful, here are some tips to alleviate them.
MISSMER S. A. & al. Endometriosis. The New England Journal of Medicine (2020).