What is endometriosis?

March is Endometriosis Awareness Month . This is a key period for all associations seeking to inform the population about this gynecological disease that has been ignored and unexplored for a long time. This is particularly the case of ENDOmind , the French association for actions against endometriosis, which is organizing in France, this Saturday March 26, 2022, EndoMarch 1 ^, the global march for endometriosis . Are these numerous efforts bearing fruit? In the EndoVie ² survey published in June 2020 by EndoFrance , the French association fighting endometriosis , 83% of the general public sample said they had already heard of this period-related condition . Half said they knew what it was about. But serious gaps were felt on several points, such as risk factors or treatment possibilities . And you, could you answer the question: what is endometriosis? Together, let's review 5 key characteristics that help understand and explain what endometriosis is.

1. A gynecological disease linked to the endometrium

Endometriosis is an inflammatory gynecological disease associated with the endometrium. This medical term refers to the lining lining the inside of the uterus in women. We speak of endometriosis when cells of this endometrium migrate and develop in an abnormal and unhealthy way outside the uterine cavity.

In a healthy woman of childbearing age, the endometrium changes under the influence of variations in ovarian hormones with each menstrual cycle. It gradually thickens in the event of welcoming an embryo for a future pregnancy. Then, if fertilization of the egg does not take place after sexual intercourse, it bleeds, disintegrates and is eliminated in the form of vaginal discharge called periods. It is then replenished during the new cycle and so on.
In women with endometriosis, endometrial cells that have moved outside the uterus remain sensitive to the effect of these hormones and continue to follow these same cyclical changes. Thus, each month, they thicken and then bleed inside the body at the time of menstruation; the released blood cannot drain properly. This causes tissue changes called “endometriosis lesions” in the affected areas. This results in local inflammations and a possible change in the functioning of the affected organs, causing pain and complications.

Endometrial cells preferably colonize areas located close to the uterine source (see diagram ³ opposite). The majority of lesions are therefore found in the pelvis region, at the level:

• peritoneum (membrane covering the abdominal cavity and the organs located there);
• ovaries;
• uterosacral ligaments;
• of the vagina;
• of the rectum;
• or bladder.

But they can also reach more distant organs, such as the small intestine or, exceptionally, the lungs. Several areas can be affected simultaneously in the same person.

2. A common ailment

It is now estimated that at least 10% of menstruating people – cisgender women, transgender men and non-binary people – have endometriosis worldwide. This represents around 200 million individuals worldwide and around 2 million people in France ⁴ . Endometriosis is therefore a common disease. These figures relating to endometriosis correspond to a low estimate, certainly lower than reality, since many people affected are not detected, due to lack of conclusive symptoms or a good diagnosis.

Endometriosis mainly occurs in women of childbearing age, including young pubescent girls, who can be affected by this disorder from their adolescence. More rarely, some postmenopausal women continue to suffer from this condition, despite the cessation of their menstrual cycles.

The factors favoring the appearance of endometriosis are numerous, such as having parents affected by this condition, experiencing short menstrual cycles with heavy periods, not having had a child or having had one after the age of 30. .

3. A benign but disabling and chronic condition

Endometriosis is a benign disease in the sense that it does not endanger the patient's vital prognosis. However, it is very often synonymous with severe debilitating pain and serious complications, such as infertility. It therefore has significant repercussions on daily life, whether on a personal level – disrupted sexual activity, difficulty conceiving a child, etc. – or on a professional level – inability to go to work, lack of understanding from colleagues and superiors. Additionally, it is a disorder that lasts a long time and progresses slowly. All of these characteristics make it a chronic disease. This is why the recognition of endometriosis as a long-term condition (ALD) is being studied in France ⁵ .

4. A disease with multiple symptoms

There are different forms of endometriosis. They are distinguished from each other by the location and depth of the lesions, which vary depending on the patient. For example, we speak of adenomyosis when lesions are present in the myometrium, the muscle of the uterus on which the endometrium rests.

This multifaceted nature of endometriosis gives rise to diverse and varied manifestations. In some, the disease is completely asymptomatic: they do not feel any harmful effects on the body. But for many women, it results in one or more intense and severe, even disabling, symptoms.

• pain during periods;
• pain during sexual intercourse;
• pain and urinary infections;
• intestinal and digestive disorders;
• regular pelvic and lower back pain;
• infertility.

This list is non-exhaustive and in no case exempts from a medical consultation by a specialist in the disease.

5. A disorder that is still poorly understood and poorly diagnosed

Discovered in 1860, endometriosis remains a poorly understood disease. It could be explained in particular by menstrual reflux. This is the rise in the abdomen, through the fallopian tubes, of small quantities of menstrual blood during periods. This phenomenon is present naturally in 90% of menstruating people. However, only 10% of them have endometriosis. Therefore, it is commonly accepted that other triggers come into play in the occurrence of the disease. In addition to menstrual reflux, there are genetic, environmental, hormonal, anatomical and immune factors, which are now being studied by researchers. We therefore say that endometriosis is multifactorial.

Due to this complexity, the diagnosis of endometriosis is an obstacle course for the majority of patients. The average time between the first symptom and the definitive diagnosis is estimated at 7 years. Likewise, there is no treatment for endometriosis, that is to say therapeutic measures which act on the causes of the disease and which allow it to be cured. Health professionals strive to provide relief to patients by prescribing medications that act on the symptoms or performing surgical procedures to remove the lesions.

So, the question “what is endometriosis?” » now has no secrets for you! For even more information on the subject, do not hesitate to browse the EndoFrance and ENDOmind sites . And if you yourself suffer from this disease, go to the Perdième store . Effective, comfortable and enveloping, our menstrual underwear will bring you a little well-being and softness during your possible episodes of heavy periods and painful periods.

Written by cd

Sources:

1. Worldwide EndoMarch .
2. Results of a large survey on the lives of women suffering from endometriosis . (2020, June 17). EndoFrance Association.
3. Endometriosis . (2020, September 28). GynécoMarseille.
4. Understanding endometriosis . ameli.fr
5. Afp, FA (2022, January 13). Endometriosis: a unanimous vote in the Assembly to recognize the disease as a long-term condition . Franceinfo.