Halsey and Endometriosis

What is Endometriosis? 

Endometriosis is a condition that occurs when a tissue that is similar to the tissue that lines a woman’s uterus grows outside the uterus. Endometriosis most commonly involves the ovaries, fallopian tubes and the tissue lining the pelvis. In rare cases, endometrial-like tissues have been found beyond the area where pelvic organs are located. 

The endometrial-like tissue acts as endometrial tissues do - it thickens, breaks down and bleeds with each menstrual cycle. However, since this tissue has no way to exit the body, it becomes trapped and when this involves the ovaries, cysts called endometriomas may form. The surrounding tissue becomes irritated and eventually develops scar tissue and adhesions.

Endometriosis can cause severe pain, especially during menstrual periods. 

What are the symptoms of Endometriosis?

The primary symptom of Endometriosis is pelvic pain which is often associated with menstrual periods. Pain with menstrual periods is common, however, women with Endometriosis describe menstrual pain as far worse than usual. 

Here are the common signs and symptoms of endometriosis: 

Painful periods (dysmenorrhea): Pelvic pain and cramps begin before and extend for several days into a menstrual period. In addition, the patient might suffer lower back and abdominal pain. 

Pain during sexual intercourse: Pain during or after sexual intercourse is commonly associated with this disease. 

Pain during bowel movements or urination: These symptoms most likely occur during the menstrual period.  

Excessive bleeding: Patients may experience occasional heavy menstrual periods or bleeding between periods (intermenstrual bleeding). 

Infertility: In some cases, this disease is diagnosed in patients seeking treatment for infertility. 

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Other signs and symptoms

Other common symptoms and signs are fatigue, diarrhoea, constipation, bloating or nausea, especially during menstrual periods. 

It is important to note here that the severity of pain does not determine the severity of the disease itself. A patient might have mild endometriosis with intense pain or severe endometriosis with mild pain. 

Next, let’s look at the causes of this disease. 

What are the causes of Endometriosis?

The exact cause of Endometriosis is not confirmed. However, there are a few possible explanations for why the disease manifests. They are: 

Retrograde menstruation

The menstrual blood containing endometrial cells flows back through the fallopian tubes and into the pelvic cavity instead of leaving the body. When this happens, the endometrial cells stick to the pelvic walls and the surfaces of pelvic organs. Over time they continue to grow, thicken and bleed over the course of each menstrual cycle.  

Transformation of peritoneal cells

Experts have proposed that hormones or immune factors promote the transformation of peritoneal cells- cells that line the inside of the abdomen- into endometrial-like cells.

Embryonic cell transformation

Another possible explanation is that hormones such as estrogen may transform embryonic cells into endometrial-like cells during puberty. 

Surgical scar implantation

After surgical procedures like a hysterectomy or a C-section, endometrial cells may attach to a surgical incision.  

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Endometrial cell transport

The lymphatic system may transport endometrial cells to other parts of the body. 

Immune system disorder

There might be a problem with the immune system that makes the body unable to recognize and destroy the endometrial-like tissue growing outside the uterus.   

How is Endometriosis diagnosed?

Here are a few ways of diagnosing Endometriosis:

• Pelvic Exam: To check for cysts or scars behind the uterus.
• Imaging Test: For detailed pictures of the patient’s organs.
• Laparoscopy: Inserts a thin tube with a camera on the end (called a laparoscope) to see where and how big the lesions are.
• Biopsy: During a laparoscopy, specialists look at it under a microscope to confirm the diagnosis.
  

What is the treatment for Endometriosis?

The treatment for Endometriosis is usually decided based on a few preceding factors such as:

• The severity of the symptoms. 
• The patient’s plans for future pregnancies.
• The patient’s age.
• The severity of endometriosis.

Medications, including pain medications and hormone therapies, can be used to control the symptoms. 

Hormonal options for suppressing endometriosis include the following:

Birth control methods: Hormonal suppression options can be used, including combination options using estrogen and progesterone or progesterone-only options. They come in multiple forms, including oral birth control pills, patches, vaginal rings, birth control shots, Nexplanon implants or IUDs. 

Gonadotropin-releasing hormone (GnRH) medications: This medication is actually used to stop the patient’s menstrual cycle by putting the reproductive system on hold and thereby relieving the patient of pain. 

Danazol (Danocrine): This is another type of medicine that stops the production of hormones that lead to periods. Patients who take this medication might go through the occasional menstrual period or not at all. 

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Other medications can also include over-the-counter pain relief drugs and non-steroidal anti-inflammatory drugs. 

Surgery is another solution sometimes prescribed to relieve the patient of symptoms and improve fertility in some cases. Surgical options to treat this disease include:

Laparoscopy: in this surgical procedure, the surgeon makes a smaller than 1-centimetre cut on the patient's abdomen and inserts a thin tube-like structure called a laparoscope into the patient’s body. Through this tool, the doctor is able to see inside the patient’s body and identify endometriosis. 

Hysterectomy: This procedure is applied when the cases are severe. The surgeon here removes the uterus based on the amount of endometriosis and scar tissue present, the presence of other uterine conditions like adenomyosis, and based on the patient’s desire for future fertility. 

And that is everything about Endometriosis, the disease that three-time Grammy award nominee Halsey was diagnosed with, in 2016.

Before we conclude, have you heard about superstar athlete Venus Williams’ struggle with an almost ‘invisible’ disease? If not, click on the link and read all about Venus Williams and Sjogren’s Syndome.

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