Endometriosis is a chronic condition that occurs when a woman's uterine tissue grows outside her uterus. The tissues grow in clumps called implants and may spread to the ovaries, fallopian tubes, intestines, and other abdominal organs. Endometriosis affects about ten percent of women of reproductive age. Early diagnosis improves the prognosis, so it is important that women seek medical evaluation if they experience any of the condition's symptoms.
Depending on the severity of the condition, women often experience mild to severe pelvic pain when they develop endometriosis. The pain can occur just before or during menstruation, when ovulating, or in rare cases, at any time throughout the month. Endometrial tissue that grows outside the uterus will act as it normally would — it will thicken and bleed during menses, but in this unnatural location, this leads to inflammation, which further contributes to pelvic pain. Many women assume the pain is caused by their menstrual cycle, which can lead to a delay in diagnosis and treatment.
Endometriosis can also cause pain in the lower back, rectum, legs, and thighs. Usually, the pain can be attributed to organ (endometrial tissue) dislocation, a common side effect of endometriosis. Many medical conditions less dangerous than endometriosis can result in aches and pains throughout the body, but if this symptom develops along with other symptoms of endometriosis, it is best to seek a medical diagnosis. Doctors may employ pelvic exams, ultrasounds, and MRIs for diagnosis.
Some studies show more than 50% of women with endometriosis feel pain during intercourse. This is usually the result of abnormal growth of the endometrial tissue in the ovaries, fallopian tubes and the lining of the pelvis. The thrusting motion of intercourse presses on these growths, causing pain and discomfort that can last beyond sex. This can impact libido if women come to dread sex due to the pain it causes. Some women report that other thrusting motions, such as inserting tampons, cause the same pain.
Endometriosis poses a threat to fertility, as it can cause adhesions, scar the fallopian tubes, inflame the reproductive organs, cause hormonal imbalances, and negatively impact the egg quality. This symptom affects 35 to 50 percent of women with endometriosis. Doctors assess the severity of the condition by stages, with stage 1 being the mildest and stage 4 the most severe. Depending on the severity of the condition, fertility treatments may be able to help women with endometriosis conceive. Most cases of endometriosis are mild and therefore associated with minimal scarring. Infertility is usually associated with stage 4 endometriosis.
Women with endometriosis may also experience excessive bleeding during menstruation and abnormal bleeding at other times of the month. In extreme cases, rectal bleeding and bloody stools present, as well as vaginal bleeding during intercourse. Any abnormal bleeding should be investigated by a doctor.
Many people with endometriosis experience urinary problems, including pain when passing urine, most notably during menstruation. Some women also notice bloody urine, though this is less common. Endometriosis also makes women more vulnerable to urinary tract infections (UTIs). Those with a tendency to develop the infections should be tested for endometriosis.
Endometriosis can also produce symptoms similar to irritable bowel syndrome or IBS. Diarrhea and constipation are common, and their prevalence in other conditions makes a correct initial diagnosis more difficult until other symptoms develop. Women with endometriosis may experience bloating, diarrhea, and constipation during their periods, and may feel pain with bowel movements.
Although doctors do not yet have a clear understanding of why endometriosis causes fatigue, it is common in nearly all women with the condition. One explanation is that chronic pain in the pelvis and other areas of the body disrupts sleep, causing malaise throughout the day. In addition, constant pain can lead to stress, which causes fatigue for various reasons. Inflammation also activates the immune system, which makes the body work harder to prevent illness and subsequently reduces energy levels.
Depression is a common symptom of endometriosis. Reaching a diagnosis can take years, and the constant barrage of symptoms without answers or treatment can adversely affect mental health. Additionally, endometriosis' ability to decrease fertility can impact emotional well being in women who are trying to conceive, thus increasing the risk of depression and anxiety.
Endometriosis may also produce symptoms that are not typically associated with uterine conditions. It can cause nausea, vomiting, hypoglycemia (low blood sugar levels), headaches, low-grade fevers, and more. These symptoms are less common, and none of them alone will alert a medical practitioner to endometriosis. This is why it is important to inform a doctor of all symptoms, no matter how disconnected they may seem, when seeking a diagnosis.
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