In the first of our four part series, we pinpoint what Endometriosis is and how it affects your fertility…
One patient can be diagnosed at stage IV endometriosis when she first becomes pregnant; another, who is at stage I, the mildest form, is infertile. For 10% of endometriosis sufferers around the world—the disease defies reasoning. It may affect your fertility or it may not. In the meantime, endometriosis can and should be diagnosed early and treated effectively.
Until a cure is found, women can remain hopeful through knowledge and support of each other. The more you educate yourself about it, the better are your chances of understanding it and managing it in ways that promote your fertility goals.
What is Endometriosis?
Endometriosis is a common female disorder in which tissues from inside the womb implants on the surface of the ovaries, the uterus and fallopian tubes. It causes pelvic pain, internal scarring, painful intercourse and difficulties getting pregnant.
How It Attaches To Reproductive Organs- When ‘rogue’ cells migrate from the uterus unto reproductive organs they form implants–microscopic attachments–that function normally, as if they were in their right environment.
During the menstrual cycle, a woman’s ovaries produce hormones that tell cells lining the uterus to swell and thicken. When a woman gets her period, the body removes this “endometrium.” For reasons not quite understood, the endometrial cells take root “outside” the uterus. Every time the woman menstruates these root systems also menstruates.
Your body cannot get rid of these bleeding cells and with nowhere to go, they remain functionally attached. The problem worsens as your immune system tries to heal the “open wound.” Every monthly “healing” creates scar tissues. Internal scars are fibrous, web-like structures called adhesions that stick to organs. Once they are close to nerve fibers, adhesions cause pain.
If attachment occurs in the tubes or onto ovaries, it can negatively impact a woman’s chances of conception. Some women develop large, dark brown cysts known as endometriomas or “chocolate” cysts on the ovaries.
Scar tissues and adhesions are not something good inside the pelvis; they tie organs together. Imagine the fallopian tubes, which need to free-float to catch eggs, being tied by scars.
How endometriosis can attach to other organs in the body- Endometriosis may form on other parts of the body. It may develop on the bladder, bowel, diaphragm, uterine surface and rectum.
Early endometrial implants are very small and look like clear pimples. If they continue to grow they may form flat, injured areas called lesions (scars), small nodules (knots) or cysts, which can grow from a pea size to a large grapefruit. Lesions can develop to the point where they cause obstruction and displacement of nearby pelvic organs, excruciating pain, inflammation and infertility. How many women suffer from this disease? An estimated 5.5 million American women and teenage girls suffer daily from endometriosis. Statistics reveal that endometriosis may be more common than AIDS and cancer. Studies indicate that 30% to 40% of women with endometriosis are infertile and many suffer painful periods as teens. Worldwide an estimated 176 million women have endometriosis.
The Endometrium Layer
Two layers can be distinguished in the endometrium: the stratum functionalis (made up of two joint layers) and the deepest basal layer– called the stratum basalis.
During normal menstrual flow, your hormones estrogen and progesterone influence the complete removal of the stratum functionalis. This upper layer atrophies and is sloughed off and removed through the vagina as period.
The deepest basal layer is fed by a blood supply (vascular) system and remains intact during the menstrual cycle. The arrangement of the blood supply system has important connections on the menstrual cycle. When progesterone is slowly withdrawn, it causes parts of the vascular (spiral arteries) system to constrict and this precipitates the ischemic phase, eventually resulting in blood flow.
How endometriosis affects their function. For many women, the stratum functionalis (the upper layer of the endometrium) flows “backward” (refluxes) into the fallopian tubes at menstruation. This is a common phenomenon among women of reproductive age and is believed to be one explanation why shed endometrial cells are found outside of the uterus. For more information, read Part Two of our Three Part Series “Causes and Symptoms of Endometriosis”…