What is Endometriosis?
Endometriosis, pronounced en-doe-me-tree-O-sis, is a painful condition in which tissue similar to the lining of the uterus, called the endometrium, grows outside the uterus.
This abnormal growth typically affects the ovaries, fallopian tubes, and the tissue lining the pelvis. In some cases, the endometrial-like tissue can extend beyond the pelvic region. Despite being located outside the uterus, this tissue behaves similarly to the endometrial lining, thickening, breaking down, and bleeding with each menstrual cycle.
However, because it is trapped inside the body, this can lead to complications. When the ovaries are involved, cysts known as endometriomas may develop, which can irritate surrounding tissue, causing the formation of scar tissue and adhesions—fibrous bands that can cause pelvic tissues and organs to stick together.
Endometriosis can begin with the onset of menstruation and persist until menopause. It causes chronic inflammation and scar tissue formation in the pelvic region and, less commonly, in other parts of the body. Despite ongoing research, the exact cause of endometriosis remains unknown, and there is currently no cure or definitive prevention method. However, symptoms can be effectively managed with medication or, in some cases, surgical intervention.
Symptoms of Endometriosis
Endometriosis is often associated with severe pelvic pain, particularly during menstruation. Some individuals also experience pain during sexual intercourse or when urinating or having a bowel movement. Additionally, fertility problems can be a concern for some.
Not everyone with endometriosis will experience symptoms, but common signs include:
Pain in the lower abdomen or pelvis, which may worsen:
- During menstrual periods
- During or after sexual activity
- When urinating or having a bowel movement
- Chronic pelvic pain
- Heavy menstrual bleeding or irregular bleeding between periods
- Difficulty conceiving
- Bloating, nausea, and fatigue
- Emotional issues such as depression or anxiety
TENS Machines for Endometriosis
TENS (Transcutaneous Electrical Nerve Stimulation) devices are designed to relieve pain by sending mild electrical currents through the body via electrodes placed on the skin.
These currents stimulate sensory nerve endings, prompting the brain to release endorphins, the body’s natural painkillers, providing relief without the side effects often associated with medication.
TENS machines have become popular for managing various conditions, including nerve pain, muscle inflammation, sciatica, arthritis, and increasingly, endometriosis. Wireless TENS units, in particular, are favoured for their convenience. Many users place the electrodes just below the belly button, starting with a low setting and gradually increasing it to find their optimal level of relief.
Causes of Endometriosis
Endometriosis is a complex condition affecting women from their first period through to menopause, across all ethnicities and social backgrounds. The exact cause remains unknown, but several theories exist:
- Retrograde Menstruation: Menstrual blood containing endometrial cells flows backwards through the fallopian tubes into the pelvic cavity, where the cells implant and grow outside the uterus.
- Cellular Metaplasia: Cells outside the uterus change to resemble endometrial cells and begin to grow.
- Stem Cells: Stem cells may spread through the bloodstream or lymphatic system and cause endometriosis.
- Genetics: The condition appears to run in families, suggesting a genetic link.
Other factors, such as the role of oestrogen, are also thought to influence the development and persistence of endometriosis. The relationship between oestrogen and endometriosis is complex, as the absence of oestrogen does not necessarily prevent the condition.
Diagnosis of Endometriosis
Diagnosing endometriosis can be challenging due to its varied symptoms, which often resemble those of other conditions. A thorough examination of menstrual symptoms and chronic pelvic pain is crucial, but no single screening tool or test can definitively diagnose endometriosis.
Imaging techniques such as ultrasound or MRI may detect ovarian endometriomas, adhesions, and deep nodular disease. However, a definitive diagnosis often requires histologic confirmation through laparoscopy, where a camera is inserted into the pelvis to visually inspect for endometriosis and take tissue samples if necessary.
Unfortunately, diagnostic delays are common, with research indicating an average delay of 7.5 years from the first doctor visit to a confirmed diagnosis.
Alternative Treatments for Endometriosis
While there is no cure for endometriosis, various treatments can help manage symptoms. Treatment options are personalised based on the severity of symptoms and whether the individual wishes to become pregnant. They include:
Treatment plans are tailored to the individual, considering factors like effectiveness, side effects, long-term safety, and cost. It's important to note that while hormonal treatments can be effective in managing symptoms, they may not be suitable for those who wish to conceive.
Surgery can improve pain and fertility outcomes, depending on the extent of the disease. Additionally, addressing pelvic floor muscle abnormalities through physiotherapy and complementary treatments may provide further relief.
