Endometriosis - Killer Cramps, Pelvic Pain

There is a condition that is the No. 1 cause of pelvic pain in women. It is also a major factor in infertility. The cause is unknown and there is no cure. Many women who suffer from this condition have debilitating pain and often miss school and work. The average time from the onset of symptoms to a diagnosis is nine years (unless your main complaint is infertility, then it is three years). And, unless you have it or know someone with it, you have probably never heard of it. The condition is endometriosis.

There are many symptoms of endometriosis. Pelvic or lower back pain associated with periods is the most common. The pain caused by endometriosis should not be confused with ordinary period pain or cramps. Endometriosis pain is sometimes debilitating and can cause vomiting and loss of conciseness for some women. Other symptoms include, but are not limited to, pain during or after intercourse, fatigue, heavy or irregular periods, gastrointestinal upsets and infertility. However, different women present symptoms in different ways, making it difficult to know exactly what the cause is. One thing is for sure, if pain is severe enough to affect daily life, it is not normal and a doctor needs to be consulted.

There are many theories about what causes endometriosis. Retrograde menstruation (endometrial tissue flows back through the fallopian tubes during menstruation and implants in the pelvis or abdominal cavity), exposure to dioxins, heredity, and autoimmune disorders are the most common. However, the exact cause is still unknown. Whatever the cause, endometriosis is a serious issue for many women affecting quality of life and relationships.

Many women are told that pregnancy or hysterectomies are the cure for endometriosis. There is no cure. The are many other factors that should go into planning for a child, and treatment for a medical condition should never be one of them, especially since the pain is likely to return after birth. Hysterectomies are permanent and should only be considered as a last resort after exhausting all other options. Even after a hysterectomy, pain can still persist if all implants have not been removed. While there is no cure, there are many forms of treatment for endometriosis. The most common treatment is hormone therapy such as birth control pills. Most hormone therapies calm the symptoms of pelvis pain and heavy or irregular periods however, they do little to treat the source of the problem. Excision surgery has been shown to provide lasting results for some women, and can be performed during an initial diagnostic surgery. Unfortunately, most women will continue to have some level of discomfort or pain after every type of available treatment.

There are several factors contributing to the astounding length of time it takes for women to be properly diagnosed with endometriosis. Frequently, many young women are led to believe that a level of discomfort is expected during a cycle. Because endometriosis pain usually begins at the start of menstruation, many young women are not able to fully describe the severity of the pain. They are often told that cramps and pain are to be expected and will soon go away. Other women are told that cramps are "the curse of Eve" and must be suffered. In addition, discussing symptoms related to endometriosis remains taboo in our society. Most women are uncomfortable discussing their menstruation or some of the more embarrassing symptoms; because of this, many young women are afraid to tell doctors, mothers or caregivers about severe cramps, pain or other symptoms. Furthermore, because of the vast range of symptoms it is difficult to pinpoint exactly where the problem starts. For example, endometrial implants on the intestines frequently present with more gastrointestinal issues and are commonly diagnosed as Irritable Bowel Syndrome. In addition, since there is much research to support that endometriosis is an autoimmune disorder, it is more likely that women have other autoimmune conditions as well. Because of the amount of time not feeling well, but looking healthy, many women are treated as hypochondriacs (a person that believes they are sick all the time, but really are not). Since surgery is the only way to confirm the diagnosis of endometriosis, many doctors hesitate to perform a laparoscopy on young women and, treat with birth control before confirming endometriosis. Moreover, many doctors and medical professionals do not know of or truly understand the condition. According to the Endometriosis Association, "many myths and misconceptions about endometriosis still persist, even in medical literature". It is difficult to believe that, in our advanced society, there would still be wives tales and a lack of research on any topic; however, endometriosis has suffered from just that. Before nine years ago the most recent, substantial research found on the topic was over eighty years old. While there seems to be a perfect storm of causes preventing the early detection and therefore treatment of endometriosis, there is a very simple answer to solve this problem; Education.

According to the study "Time Elapsed from Onset of Symptoms to Diagnosis of Endometriosis in a Cohort Study of Brazilian Women" the average diagnosis time from the first symptom of pain to diagnosis is an astounding nine years. While most of the study was performed in Brazil, there was sufficient evidence to show that the same conclusions are also true in the US and the UK. The conclusion of the study stated that, "the delay in diagnosing endometriosis was considerably long, and especially so in young women with pelvic pain and in adolescents. Clearly, more information about endometriosis must be made available to general physicians and gynecologists in order to reduce the time taken to diagnose this condition." Since the symptoms of endometriosis usually present in young woman of school age, staff such as nurses and counselors need to be better informed of the effect of endometriosis both mentally and physically. This would help in recognizing a problem earlier. Most importantly, women need to take control of their own health. If something does not feel right, it usually isn't.
It is apparent that more research needs to be performed on this condition. And, that there needs to be more support for those suffering from endometriosis, who believe they are alone. To learn more about the effects of endometriosis visit endocenter.org, endometriosis.org or endometriosisassn.org.