The month of March is Endometriosis Awareness Month.
According to the American Academy of Obstetricians and Gynecologists, 1 in 10 women suffer from endometriosis.
“What’s disturbing is that, on average, it takes ten years for the condition to be diagnosed in the U.S.
The Endometriosis Foundation of America reports that “many endometriosis patients are misdiagnosed, often multiple times, leading to unnecessary and inappropriate treatment.”
The condition has historically been diagnosed in women in their thirties and forties. As diagnostic tools have improved—and doctors have taken younger women’s complaints of intense pain during their periods more seriously—recent research now shows that “endometriosis often starts in the teen years, and one study found that up to 70 percent of teens reporting chronic pelvic pain will eventually go on to be diagnosed with endometriosis.”
Over the next 2 weeks, I am going to discuss endometriosis and what NaProTechnology has to offer women who suffer from this disease.
But first, we need to understand the disease of endometriosis, the causes and how it is best diagnosed by doctors.
What is Endometriosis?
It is a disease marked by the implantation of endometrial tissue (the tissue that lines the uterus) to other locations outside of the uterus. But, the tissue still behaves the same as if it was still a part of the uterus.
As the hormones begin to change in the cycle, the endometrial tissue builds up preparing for implantation. But, the problem with the endometrial tissue that has migrated outside of the uterus is that it cannot breakdown via menstruation as it would if it was located inside of the uterus.
Instead, women suffer with multiple debilitating symptoms:
Dysmenorrhea (menstrual cramps)
Dyspareunia (painful intercourse)
Heavy or irregular bleeding
Nausea at time of menses
Diarrhea and/or painful bowel movements
Dizziness or headaches with menses
Low-grade fever and low resistance to infection
What causes Endometriosis?
Unfortunately, research has not been able to find one cause for endometriosis. There are multiple theories, but none have been able to definitively be proven as the cause for the disease.
We do know there is a genetic component to endometriosis. Endometriosis Foundation of America states that women who have a close relative with endometriosis have a 5-7 times greater risk of developing it themselves. More research is needed, however, to fully understand the genetic component in endometriosis.
There is a common theory of retrograde menstruation as a cause of endometriosis and was first described in 1927 by Dr. J.A. Sampson. This is the theory that women, during the course of their menstrual flow, will have endometrial cells that flow backward through the fallopian tubes, land at various sites in the pelvic cavity and implant themselves.
The problem with this theory is that nearly all women have retrograde menstruation to some extent, but not all women have endometriosis. More research is needed to find out how retrograde menstruation affects women differently.
According to the Endometriosis Foundation of America, the immune system and body’s inflammatory response also contribute to endometriosis, but the mechanisms are poorly understood.
How is Endometriosis diagnosed?
Bloodwork, urine, MRI, and ultrasounds have proven unreliable for successfully identifying endometriosis. Pelvic exams can indicate high suspicion of endometriosis, but they do not confirm it.
Dr. Thomas Hilgers states in his book, The NaProTechnology Revolution, that the “gold standard” for diagnosis is a diagnostic laparoscopy with histological (microscopic examination of the tissue) confirmation. Laparoscopy should be performed in the first half of the menstrual cycle.
This is because the laparoscopy is often combined with laparoscopic treatment and treatment prior to menstruation is associated with a higher recurrence rate with a shorter recurrence-free interval.
Dr. Hilgers goes onto say that the most common symptom he has seen of endometriosis is that of infertility. These women may have some of the other common symptoms as stated above, but it is also common to have none of the symptoms and even a normal pelvic exam.
Diagnostic laparoscopy then becomes the only way the disease can be positively identified.
Can Endometriosis affect a woman’s fertility chart & hormone levels?
Yes! Dr. Hilgers has found through his NaProTechnology research that a large population of women with endometriosis have shown a high incidence of both limited mucus cycles and dry cyles when charting the Creighton Model FertilityCare System.
Dr. Hilgers went on to conduct hormone evaluations on a population of women with endometriosis. He found that there was a strong frequency of progesterone deficiency in the postovulatory phase of the cycle.
He also studied patients from the point of view of the ultrasound characteristics of their ovulation patterns. He found that 60% of the 331 women he studied who underwent serial ultrasound examination had an abnormal ovulation pattern.
He also found that patients with endometriosis and infertility had a high incidence of premenstrual symptoms, making the underlying hormonal abnormality similar to that observed in premenstrual syndrome.
Now, endometriosis does not mean that a woman will definitely be infertile. According to the Endometriosis Foundation of America, 30-40% of women with endometriosis experience issues with their fertility. Some women do not even realize they have endometriosis until they try and become pregnant.
If you suffer from any of the above symptoms associated with endometriosis, talk with your doctor. NaProTechnology doctors are a great resource for women who are seeking a doctor who will listen and seek to find the underlying cause of their fertility health issues, such as endometriosis.
Next week we will discuss the treatments available for endometriosis, the myths surrounding some treatments and how NaProTechnology can help.
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