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Endometriosis affects nearly 10% of women in France, according to figures from the French social security services. This chronic, gynaecological disease can be extremely debilitating. There are currently different therapeutic solutions depending on the stage of the disease, hence the importance of early diagnosis.
In endometriosis, you can hear the term ‘endometrium’. The endometrium is the tissue that covers the inner lining of the uterus and thickens at the beginning of each menstrual cycle. The endometrium is expelled each month through the vagina when no embryo is implanted: these are your periods. (See the article entitles ‘Your first period’)
In almost all women, there is what is called retrograde menstruation: instead of flowing through the vagina, periods flow up through the fallopian tubes and into the abdominal cavity. For 90% of women, it's eliminated every month without a problem. In the remaining 10%, the endometrium stays there, for no known reason. That is endometriosis.
This uterine tissue may attach itself to the ovaries, but also to the fallopian tubes, ligaments that support the uterus, the rectum, vagina, etc. or, more rarely, the intestine, colon or bladder.
Every month, at the time of menstruation, it acts exactly like the uterine endometrium: it bleeds, causing an inflammatory reaction on the affected organs and leaving scars with each menstrual cycle.
A number of hypotheses (genetics, heredity, environment, etc.) have been put forward to explain the causes of endometriosis, but we still do not know exactly why some women suffer from it and not others.
Endometriosis can occur without particular symptoms, but in most cases, endometriosis is detected following dysmenorrhoea, very severe pain in the pelvis accompanying menstruation, the intensity of which can even become disabling for women who suffer from it.
Since endometriosis can affect various organs, the symptoms can also be very different.
The main ones, apart from dysmenorrhoea, are:
- pain during sexual intercourse
- urinary problems
- chronic fatigue
- problems with bowel movements (constipation or diarrhoea)
It should be noted that these symptoms may appear independently of each other.
Finally, one last symptom, which is painful in another way: infertility. For women whose ovaries and fallopian tubes are affected, there is, indeed, a risk for their fertility. Some women discover that they have endometriosis when they go for a consultation because they are having trouble getting pregnant.
You should know that, even now, it still takes an average of seven years to diagnose the disease*, which is a lot...
You should not hesitate to consult a general practitioner or gynaecologist if you have any of the symptoms listed above, especially severe pain during menstruation or sexual intercourse.
Your doctor will then prescribe several examinations (ultrasound, MRI, hysterography, etc.) in order to make a diagnosis. Laparoscopy remains the reference examination (it is a surgical procedure) which allows lesions to be identified and tissue to be removed for analysis.
It is not possible to ‘cure’ endometriosis, but, with proper treatment, it is now possible to fight the pain and slow down the progression of the disease.
Hormonal or surgical treatment may be considered, upon the advice of a health care professional.
Endometriosis is a disease that can be very difficult to live with, both physically and psychologically. Many associations exist, offering advice, assistance and support. Do not hesitate to contact them.
* Source: EndoFrance