Endometriosis

Risk Factors For Endometriosis

Endometriosis may occur at any point during the reproductive age and affect any woman, but it is more likely to develop at some point after the first menstrual cycle (menarche).

Symptoms may develop over time and not become noticeable for several years. Often, in asymptomatic patients, a diagnosis of endometriosis is only achieved when investigating unexplained infertility.

While the idiopathic nature of endometriosis makes it hard to diagnose and treat, some risk factors may make you more prone to developing this disease during your lifetime. Let’s look at the risk factors in detail below.

Pregnancy History

If you have never given birth, you may be at greater risk of developing endometriosis.

This is because pregnancy temporarily stops the menstrual cycle and lowers the levels of estrogen in the body. In turn, this reduces the growth of endometrial cells inside and outside of the uterus.

If you already have endometriosis, pregnancy may temporarily reduce the intensity of your symptoms.

However, you can still develop endometriosis after carrying a baby to term. This is often due to the transfer of endometrial cells to organs outside of the uterus during a C-section.

Postpartum endometriosis may also occur in women who had long labor because the longer period of time between the rupture of the fetal membrane and delivery makes contamination and infections more likely.

Menstrual History

Some aspects of your menstrual history may make endometriosis more likely. These include:

• Starting your period at an early age, usually before 11
• Experiencing menopause at an older age
• Having menstrual cycles that are shorter than 27 days on average
• Having heavy periods that last longer than seven days

Having an early menarche and late menopause will increase your exposure to retrograde menstruation, while heavy or long periods may indicate an abundance of endometrial tissue. Both these factors may make endometriosis more likely.

Age

While the onset of endometriosis usually occurs during puberty, women in their 20s, 30s, and 40s are more likely to be diagnosed with this condition. This may also be because women in this age range may attempt to become pregnant and discover infertility problems.

Genetics

The prevalence of endometriosis in certain demographics may have a genetic factor, but no direct correlation has been established yet.

Generally, you may be at greater risk of developing this condition if one or more of your first-degree relatives (i.e.: mother, aunts, or sisters) have endometriosis. Having a family history of infertility may also be a genetic risk factor for endometriosis.

Higher Levels Of Estrogen

If your body produces excessively high levels of estrogen or you are exposed to this hormone throughout your lifetime, you may be at risk of endometriosis. This is because estrogen is responsible for supporting the growth and thickening of the endometrium during the menstrual cycle, which can make the build-up of endometrial tissue in and outside of the uterus more likely.

Low Body Mass Index

Endometriosis is more likely to occur in women with a slight, smaller frame, or low Body Mass Index (BMI). However, the connection between low BMI and endometriosis is unclear.

What’s more, in a new study, nearly 40% of the participants with endometriosis were overweight or obese, making a high BMI also a risk factor for endometriosis.

Medical Conditions That Block Menstrual Blood

Some medical conditions prevent the menstrual blood as expected, or flowing back into the fallopian tubes and ovaries, thus making endometriosis more likely.

Some of these medical conditions include abnormalities or obstructions in the uterus, vagina, or cervix.

Reproductive Tract Disorders

Some disorders of the reproductive tract can increase the risk of endometriosis.

• Uterine growths like polyps: Uterine growths may cause uterine bleeding, which can cause endometrial growths to be transported outside of the uterus. Uterine growths and polyps are both estrogen-dependent overgrowths, which means that the two conditions often coexist.
• Asynchronous uterine contractions: Uterine contractions are normal in a healthy uterus. When the pattern of these contractions becomes irregular, you may experience asynchronous uterine contractions. These can aggravate retrograde menstruation, thus making endometriosis more likely to develop.

How Endometriosis Is Diagnosed

Although endometriosis affects up to 11% of all women of reproductive age, most people experience a delay of nearly seven years in obtaining an accurate diagnosis.

However, over the past years, diagnostic protocols have improved to shorten this delay and ensure that women with endometriosis access adequate treatment as soon as possible.

Some of the tools used to determine a diagnosis of endometriosis include the following:

• Medical History: A healthcare provider – usually an Ob-Gyn – will assess your symptoms, review your medical history, and inquire about any previous pregnancies to determine whether you are at risk of endometriosis.
• Physical Exam: During a physical exam, a healthcare provider will palpate or manually feel your pelvis area to identify abnormalities such as cysts and scars, which may indicate the presence of endometrial tissue outside of the uterus.
• Ultrasound: Ultrasound tests use high-frequency sound waves to create images of the inner pelvic area. These tests can be used to determine the presence of endometrial implants outside of the uterus if these have not yet caused abnormalities that can be felt through physical examinations.
• Imaging Tests: Tests such as Magnetic Resonance Imaging (MRI) exams work similarly to ultrasound tests, but they use magnetic fields and radio waves to create detailed images of the organs in the pelvic area. These tests offer accurate insignia into the severity and location of endometrial implants.
• Laparoscopy: Laparoscopy is a minimally-invasive surgical procedure in which a surgeon will use a thin viewing instrument (laparoscope) to view the area inside the abdomen. This procedure can be used to determine the areas affected by endometriosis, collect tissue samples for testing, and remove parts of abnormal endometrial growth.

Consequences Of Leaving Endometriosis Untreated

Although there is no permanent cure for endometriosis, it is important not to let this condition go unaddressed. Without adequate treatment, endometrial implants outside of the uterus will continue to grow with every menstrual cycle. This may lead to severe complications, such as the following:

• Infertility: Scar tissue and blockages in the fallopian tubes may prevent egg cells from leaving the ovaries and implanting in the uterus, which can lead to temporary or permanent infertility.
• Chronic Pain: When the fallopian tubes are clogged by endometrial growth, blood may become trapped in the ovaries. This leads to cysts, scar tissue, and adhesions, which can cause severe chronic pain. In turn, long-term pain can affect your mental health, cause you to miss days at work, and lead to depression, anxiety, and social withdrawal.
• Cancer: Abnormal endometrial growth can develop into a tumor, thus slightly increasing your risk of developing epithelial ovarian cancer. More research is needed to determine the correlation between these two conditions.

The Prevalence Of Endometriosis

The World Health Organization estimates that around 10% of women of reproductive age worldwide have endometriosis – a percentage that accounts for 190 million people globally. The condition is present in nearly 40% of infertile women and reaches peak prevalence in women aged 15 to 44.

While, at a glance, these statistics show how common endometriosis is, it is believed that the number of women with endometriosis is much higher. This is because this condition is often underdiagnosed or misdiagnosed.

What’s more, the prevalence of endometriosis may depend on race and ethnicity.

A 2019 study shows that, compared to White women, Black women are less likely to obtain an accurate diagnosis for endometriosis, while Asian women are more likely to receive a diagnosis. Research on the prevalence of this disease among other ethnic groups – including American Indian patients – is still limited. What’s more, on average, women wait between 8 and 12 years from the start of symptoms to be diagnosed with endometriosis.

Is There A More Effective Treatment?

As seen above, hormone suppressants are the first line of treatment for endometriosis. Although these may be efficient temporary solutions, they are not suitable for women looking to conceive. Additionally, birth control pills and other hormonal therapies come with severe side effects, such as mood swings, weight gain and loss, nausea, headaches, skin problems, and decreased sex drive.

On the other hand, surgical interventions may be even more problematic. According to a 2014 study, 62% of people who undergo a hysterectomy for endometriosis still have pain after the procedure and require further treatment. 31% of these required a second surgery. Among those who had both their uterus and ovaries removed, 10% still had pain and 4% required a second surgery.

So, is there a more efficient treatment option that does not come with such severe side effects? If you are battling endometriosis, the Neurofunctional Pain Management program may be the solution you’ve been looking for. Learn more about these lines of treatment below.

Find A Solution For Endometriosis Pain

Endometriosis is certainly a chronic, life-limiting condition that can impact all aspects of your life, from your ability to be productive at work to your plans to conceive. However, dangerous surgical interventions and hormonal therapies are no longer the only options available to fight the pain you are experiencing.

With Neurofunctional Pain Management, you can regain control over your body and magnify your quality of life without medications or invasive procedures.