What is Endometriosis?
To begin, it is important to understand that minor cramping during menses is normal, particularly in younger women. Inflammatory hormones are linked to menstrual discomfort in many women and girls; such discomfort is not typically cause for alarm and may be remedied through a variety of measures. This is called “dysmenorrhea”.
Dysmenorrhea is NOT the same as endometriosis.
During a normal period, the body naturally sheds the endometrium (the clinical term for lining of the uterus). In some women and girls, tissue resembling the endometrium implants in outside the uterus. Unlike normal endometrium, these implants do not exit the body. The aberrant process gives rise to microscopic bleeding, development of cysts known as endometriomas or "chocolate cysts", painful inflammation, fibrosis and formation of adhesions (fibrous bands of dense tissue). The result is significant pain, which may become chronic over time.
This is endometriosis.
A growing societal crisis carrying a staggering price tag in excess of $100 billion annually in associated costs, approximately 176 million women and girls worldwide between the ages of 15-49 are affected by the disease, during what should be the most promising, productive years of their lives1. Endometriosis also accounts for a significant loss of productivity - 11 hours per woman per week; 38% more than for women with similar symptoms without endometriosis2.
The disease typically develops on pelvic structures including bladder, bowels, intestines, ovaries and fallopian tubes, but can also be diagnosed outside the reproductive region in areas like the diaphragm, lungs (where it induces a dangerous condition called Catamenial Pneumothorax) and less commonly, areas even far removed from the abdominopelvic area (i.e. brain). Symptoms often start early in life, but are ignored by caregivers, healthcare consumers and practitioners alike. Indeed, 70% or more of teens with pelvic pain go on to be later diagnosed with endometriosis4.
1 Adamson, Hummelshoj et al. Creating solutions in endometriosis: global collaboration through the World Endometriosis Research Foundation. J of Endometriosis 2010;2(1):3-6
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2, 6 Nnoaham KE, Hummelshoj L et al. Impact of endometriosis on quality of life and work productivity: a multicenter study across ten countries. Fertil Steril. 2011 Aug;96(2):366-373.e8
3 Kokcu, A. Gynecologic Oncology: Relationship between endometriosis and cancer from current perspective. Archives of Gynecology & Obstetrics Volume 284, Number 6, 1473-1479, DOI:10.1007/s00404-011-2047-y
4 Yeung P Jr, Sinervo K, Winer W, Albee RB Jr. Complete laparoscopic excision of endometriosis in teenagers: is postoperative hormonal suppression necessary? Fertil Steril. 2011 May;95(6):1909-12, 1912.e1. Epub 2011 Mar 21
5 Naseer-ud-Din; Ataullah Khan; Nudrat Illahi. Prevalence & Presentation of endometriosis in Patients Admitted in Nishtar Hospital, Multan. Jamc Vol. 12 No. 3, 2000