Endometriosis, a chronic health condition, occurs when tissue resembling the uterine lining grows outside the uterus, leading to various distressing symptoms. Some of the symptoms of endometriosis include pain during menstruation, sexual intercourse, and bowel movements, alongside symptoms like nausea, fatigue, and mental health concerns. Contrary to popular misconceptions, this condition extends beyond mere menstrual discomfort, impacting multiple facets of a person’s health and wellbeing.(1)
The condition’s impact on fertility varies based on the tissue’s location. Additionally, it can also affect organs beyond the reproductive system, including the lungs. Approximately ten percent of females of reproductive age globally experience endometriosis. Although rare, it can also affect males. The condition’s diverse symptoms often lead to delayed diagnoses. Risk factors include a family history of endometriosis, early onset of menstruation (before the age of 11), heavy or prolonged periods, and shorter monthly cycles.(2,3)
Diagnosis typically involves laparoscopic surgery under anesthesia. Treatments aim to manage symptoms through hormone therapy or pain relief medication. Surgical intervention may be necessary for severe pain or fertility issues. Presently, there is no known cure for endometriosis.
Often overshadowed by myths and misunderstandings, it is crucial to understand the factual aspects surrounding endometriosis. Let us dispel the myths and shed light on the reality of this complex condition.
Myth 1: Severe Menstrual Pain Always Means a Normal Period
Fact: While discomfort during menstruation is common among many individuals, intense or debilitating pain during periods might hint at an underlying condition like endometriosis. While most females experience some level of discomfort during their menstrual cycle, severe and persistent pain beyond the usual range of period-related discomfort could potentially signal the presence of endometriosis.(4) Endometriosis causes tissues similar to the uterine lining to grow outside the womb, leading to increased pain and discomfort during menstruation or even throughout the cycle. Therefore, it is crucial to recognize that extreme period pain warrants attention and medical evaluation to rule out conditions such as endometriosis and seek appropriate treatment if necessary.(5,6)
Myth 2: Pregnancy is a Cure for Endometriosis
Fact: It is actually a common misconception that pregnancy serves as a definitive cure for endometriosis. However, medical experts assert that pregnancy does not eliminate endometriosis, and there is no scientific evidence to support its curative effects on this chronic condition.
Some experts have stated that while some women may experience temporary relief from endometriosis symptoms during pregnancy, this is not a universal experience. Certain individuals might notice improvements in their symptoms, but others may observe no changes or even a worsening of symptoms throughout pregnancy. In fact, despite changes in hormone levels during pregnancy, there are no known instances of endometriosis being cured by childbirth.
Studies indicate that while hormonal fluctuations during pregnancy might lead to varying pain levels post-delivery, pregnancy itself does not offer lasting benefits for individuals with endometriosis. Research findings suggest that although some endometriosis lesions might regress during pregnancy, others remain stable or can even progress.(7,8)
It is important to recognize that while pregnancy might temporarily alleviate symptoms for some individuals, it is not a cure for endometriosis. Seeking professional medical guidance remains crucial for managing this chronic condition effectively. Consulting healthcare providers helps in understanding treatment options and developing appropriate strategies to address the symptoms and impact of endometriosis on overall health and well-being.
Myth 3: Only Female Reproductive Organs Get Affected by Endometriosis
Fact: While it is true that endometriosis lesions primarily develop in the pelvis and lower abdomen, but it is a misconception that this condition solely impacts the female reproductive organs.
Although endometriosis lesions are commonly found in the pelvic region, they also have the potential to develop anywhere in the body. Most endometriosis does not directly affect the reproductive organs, but it can implant on the peritoneum’s inner abdominal surface, causing pain. However, endometriosis can also extend beyond the pelvis and has been observed in various unexpected locations, including the lining of the lung and, sometimes rarely, even in the brain, triggering seizures during menstruation.
Although occurrences of endometriosis in distant sites are infrequent, healthcare professionals play a crucial role in monitoring and identifying potential signs or symptoms of endometrial implants in atypical locations.
Research, such as a 2017 study in mice, hints at the possibility of endometriosis cells migrating to organs distant from the pelvis, suggesting that instances of endometriosis in non-pelvic areas may be more prevalent than previously recognized.(9)
It is, therefore, important to understand that while endometriosis primarily affects the pelvic region, it definitely has the potential to show up in various other parts of the body.
Myth 4: Hysterectomy – A Potential Cure to Endometriosis
Fact: While a hysterectomy, which is a surgical procedure involving the removal of the uterus, may alleviate symptoms for many individuals with endometriosis, it does not guarantee a permanent cure for the condition.(10)
Doctors all over the world emphasize that although a hysterectomy can provide some relief from endometriosis symptoms for some individuals, the condition might reoccur even after the surgery. This recurrence may especially occur if endometrial lesions persist outside the uterus or in cases where the ovaries, the primary producers of estrogen, remain intact.
It is important to remember that endometriosis is responsive to estrogen, and a hysterectomy only removes the uterus. It does not remove the ovaries that are responsible for the very production of estrogen. As a result of this, a hysterectomy alone does not eliminate endometriosis.(11)
Additionally, the nature of endometriosis lesions varies, ranging from surface-level lesions to more invasive types like deep infiltrating endometriosis (DIE), which can extend into organs such as the bowel.(12,13) Even in cases where ovaries are removed or hormonal suppression is initiated, these deeply infiltrating lesions may persist and not improve.
While a hysterectomy may offer symptom relief and satisfaction for some individuals, it is crucial to understand that this is not a guaranteed cure for endometriosis.
Myth 5: Endometriosis Inevitably Leads to Infertility
Fact: While studies indicate that a significant percentage of individuals with endometriosis encounter challenges with conception – ranging from 30% to 50%, the presence of endometriosis does not inevitably lead to infertility.(14)
A diagnosis of endometriosis diagnosis does not automatically translate to an inability to conceive. It is important to remember that every individual’s fertility journey with endometriosis varies. There have been many cases where individuals with severe endometriosis successfully went on to conceive, while some with milder forms of the condition faced challenges. The unpredictability of this disease underscores the need for personalized evaluation and treatment.
It is, therefore, important to note that while endometriosis might influence fertility, it does not uniformly mean that you cannot become pregnant. Again, consulting healthcare professionals is critical, especially when managing endometriosis with medications that may affect conception. Collaborating with medical experts ensures appropriate guidance and potential adjustments to treatment plans for individuals wanting to conceive.
Myth 6: Endometriosis Is Caused By Abortion
Fact: There is an assertion that abortion leads to endometriosis. However, it is quite likely that this emerged from political debates related to abortion. Nevertheless, it is important to know that this claim lacks any kind of factual basis.(15)
Even today, the exact cause of endometriosis remains uncertain, though a genetic link appears to play a role. Importantly, there is also no scientific evidence supporting the idea that abortion causes endometriosis.
It is crucial to distinguish between myths and factual information regarding endometriosis. Scientific consensus confirms that abortion does not cause the development of this chronic condition. Understanding the lack of substantiated evidence is essential in dispelling misconceptions surrounding endometriosis and abortion. Furthermore, consulting healthcare professionals and relying on evidence-based information can help in better understanding and management of endometriosis-related concerns.
Myth 7: Menopause Means an End to Endometriosis
Fact: Contrary to popular belief, entering menopause does not automatically resolve endometriosis. Research indicates that an estimated two to five percent of females experience postmenopausal endometriosis, suggesting that the condition can persist beyond menopause.(16)
The onset of menopause does not guarantee the cessation of endometriosis. In reality, endometriosis might still develop even years after menstruation ceases.
This is the same misconception related to hysterectomy, where the removal of the uterus does not always mean the end of endometriosis. Similarly, menopause may not serve as a definitive cure for the condition.(17)
If individuals undergoing menopause continue to experience endometriosis-associated pain, consulting a doctor becomes absolutely necessary for exploring effective pain management strategies. The persistence of symptoms post-menopause emphasizes the need for ongoing medical guidance and care to address and manage endometriosis even beyond reproductive years.
Myth 8: High Estrogen Levels are linked to Endometriosis
Fact: It is necessary to debunk this misconception as there is a lack of conclusive evidence supporting the idea that high levels of estrogen directly cause endometriosis. However, at the same time, medications that block estrogen receptors have shown promise in alleviating symptoms associated with the condition.(18)
While high estrogen levels might not be the sole cause of endometriosis, ongoing research suggests a potential link between estrogen and its receptors in the processes associated with the condition. A recent 2022 study highlights the potential role of immune system activity in preventing or treating endometriosis. Researchers discovered that specific white blood cells’ activation might trigger chronic inflammation, potentially contributing to the condition’s development.(19)
This evolving understanding underscores the complexity of endometriosis, indicating that it involves several factors beyond just the estrogen levels.
Conclusion
In understanding a disease like endometriosis, separating facts from fiction is essential. Dispelling medical myths surrounding this condition is important for accurate understanding and effective management. From debunking misconceptions about its causes to exploring its persistence beyond menopause, acknowledging the complexity of this condition is necessary. By debunking myths and looking at emerging research, it is possible to pave the way for enhanced understanding, improved management, and more personalized care for those affected by endometriosis.
- who.int. (2021). Endometriosis. [online] Available at: https://www.who.int/news-room/fact-sheets/detail/endometriosis.
- Rei, C., Williams, T. and Feloney, M., 2018. Endometriosis in a man as a rare source of abdominal pain: a case report and review of the literature. Case reports in obstetrics and gynecology, 2018.
- https://www.nichd.nih.gov/. (2022). What are the risk factors for endometriosis? [online] Available at: https://www.nichd.nih.gov/health/topics/endometri/conditioninfo/at-risk.
- gov. (2017). Period problems? [online] Available at: https://www.womenshealth.gov/menstrual-cycle/period-problems.
- Evans, S., Moalem-Taylor, G. and Tracey, D.J., 2007. Pain and endometriosis. Pain, 132, pp.S22-S25.
- Huntington, A. and Gilmour, J.A., 2005. A life shaped by pain: women and endometriosis. Journal of clinical nursing, 14(9), pp.1124-1132.
- Leeners, B., Damaso, F., Ochsenbein-Kölble, N. and Farquhar, C., 2018. The effect of pregnancy on endometriosis—facts or fiction?. Human reproduction update, 24(3), pp.290-299.
- Prescott, J., Farland, L.V., Tobias, D.K., Gaskins, A.J., Spiegelman, D., Chavarro, J.E., Rich-Edwards, J.W., Barbieri, R.L. and Missmer, S.A., 2016. A prospective cohort study of endometriosis and subsequent risk of infertility. Human Reproduction, 31(7), pp.1475-1482.
- Samani, E.N., Mamillapalli, R., Li, F., Mutlu, L., Hufnagel, D., Krikun, G. and Taylor, H.S., 2019. Micrometastasis of endometriosis to distant organs in a murine model. Oncotarget, 10(23), p.2282.
- Sandström, A., Bixo, M., Johansson, M., Bäckström, T. and Turkmen, S., 2020. Effect of hysterectomy on pain in women with endometriosis: a population‐based registry study. BJOG: An International Journal of Obstetrics & Gynaecology, 127(13), pp.1628-1635.
- Namnoum, A.B., Hickman, T.N., Goodman, S.B., Gehlbach, D.L. and Rock, J.A., 1995. Incidence of symptom recurrence after hysterectomy for endometriosis. Fertility and sterility, 64(5), pp.898-902.
- Tosti, C., Pinzauti, S., Santulli, P., Chapron, C. and Petraglia, F., 2015. Pathogenetic mechanisms of deep infiltrating endometriosis. Reproductive Sciences, 22(9), pp.1053-1059.
- Halis, G., Mechsner, S. and Ebert, A.D., 2010. The diagnosis and treatment of deep infiltrating endometriosis. Deutsches Ärzteblatt International, 107(25), p.446.
- Lee, D., Kim, S.K., Lee, J.R. and Jee, B.C., 2020. Management of endometriosis-related infertility: Considerations and treatment options. Clinical and experimental reproductive medicine, 47(1), p.1.
- Wheeler, J.M., Johnston, B.M. and Malinak, L.R., 1985. The relationship of endometriosis to spontaneous abortion. Fertility and Sterility, 44(2), pp.89-93.
- Secosan, C., Balulescu, L., Brasoveanu, S., Balint, O., Pirtea, P., Dorin, G. and Pirtea, L., 2020. Endometriosis in menopause—renewed attention on a controversial disease. Diagnostics, 10(3), p.134.
- Inceboz, U., 2015. Endometriosis after menopause. Women’s Health, 11(5), pp.711-715.
- Chantalat, E., Valera, M.C., Vaysse, C., Noirrit, E., Rusidze, M., Weyl, A., Vergriete, K., Buscail, E., Lluel, P., Fontaine, C. and Arnal, J.F., 2020. Estrogen receptors and endometriosis. International journal of molecular sciences, 21(8), p.2815.
- Donnez, J. and Cacciottola, L., 2022. Endometriosis: an inflammatory disease that requires new therapeutic options. International Journal of Molecular Sciences, 23(3), p.1518.
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