Endometriosis – A Common Disorder for Women
Happy endometriosis awareness month! — said no one.
Millions of women have been diagnosed and are being treated for endometriosis. This month is a reminder to many people that this disease will or can effect you or someone you know.
Endometriosis is an estrogen-dependent disease that affects at least 10% of women (Ninoaham, 2011). In short, endometriosis is endometrial-like tissue (tissue normally inside the uterus) that is located outside the uterus. The negative effects of this disease can be significant and includes physical issues such as:
- dysmenorrhea (painful periods)
- non-menstrual pelvic pain
- dyspareunia (painful sexual intercourse)
Endometriosis Can be Difficult to Diagnose
The economic costs for individuals and healthcare institutions, associated with endometriosis has reached into the billions (Simoens, 2007). One might think that the significant impacts this disease has on the individual would prompt women to seek help from their physicians at breakneck speed, yet it often takes 6-10 years for someone to be diagnosed with endometriosis; this may be due to both physician- and patient-predisposed issues (Ninoaham, 2011). In fact, 22% of women eventually diagnosed with endometriosis had seen 5 or more physicians prior to their diagnosis and 55% had to see 3 or more physicians before receiving the diagnosis (Greene 2009).
Women with endometriosis have a variety of co-occurrences and are often managing one or more additional diseases. This should be looked at as a chronic condition that requires a lifelong management plan. Women with endometriosis may be at higher risk of:
- gynecologic cancers such as ovarian cancer
- autoimmune diseases such as rheumatoid arthritis and Graves (thyroid) disease
- cardiovascular disease
- preterm labor
Endometriosis can be diagnosed clinically, but the fact that surgical diagnosis and treatment are looked at as definitive, puts pressure on both the patient and the physician to consider surgery as almost a necessary evil.
How Does Estrogen Affect Endometriosis?
One double-edged sword in the pathway for treatment for endometriosis is the necessary but not sufficient place estrogen holds. Since estrogen will stimulate the growth of endometrial tissue inside or outside the uterus, if we can lower the amount of estrogen within a woman’s body, we can alleviate some of the pain associated with this disease. While decreasing estrogen levels may improve pain, the negative effects on a woman’s body may trade one problem for another.
Progesterone or how some women with endometriosis are affected by progesterone may also be a player. Women with endometriosis have different gene expression. Specifically, several genes that progesterone normally turns off after they ovulate remain turned on, and those that are turned on remain off.
CHI Health is currently looking at better ways to diagnose endometriosis in a non-invasive manner. We are evaluating the genetic causes of endometriosis and are taking part in multi-center clinical trials looking for newer drugs to treat endometriosis pain. We are creating new animal models to discover alternate pathways to address the root cause and find new treatments for endometriosis.
If you have questions or feel you may be suffering from endometriosis, schedule an appointment with one of our women’s health providers.