One in ten women are impacted by endometriosis (Zondervan et al., 2018 & Coxon et al., 2018), or maybe I should be more clear; more often this condition initiates in one's teen years or in their early twenties, but on average it takes about ten years to diagnose. Wonder why? Their complaints are written off as normal and they are dismissed. They go on to miss school, work, and even miss out on career aspirations or face issues with fertility, even having early hysterectomies before having a child. Worse still, many women are offered narcotics to manage pain instead of solutions that address the underlying problem, and they ultimately find themselves addicted or later under going multiple surgeries.
Endometriosis is intriguing from a clinical perspective as the condition occurs when the tissue that normally lies inside the uterus grows outside the uterus, such as on the ovaries, bowel, or the tissue lining the pelvis. The female reproductive system is not in fact, a closed system so there is potential for this tissue to escape and reestablish itself elsewhere, a sort of retrograde (Guo et al., 2021).
Just like the lining within your uterus, your hormones trigger this tissue and it breaks down as if it were part of your flow, yet there is no escape. Instead, this blood irritates the surrounding tissues and eventually causes adhesions or scar tissue between the abdominal cavities. Chronic abdominal pain and pelvic discomfort results, as does #constipation, and urinary and fertility problems.
These women often seek emergency care in absolute agony. Again, thank goodness, not a condition I can relate, but I've met with many women who are absolutely distraught. Not just because of their pain and discomfort, but because they can't find practitioners who will listen. Their lives are in chaos, with disruptions in their relationships, their employment, school, and life!
Many undergo surgery after surgery, once they are finally diagnosed, and if not done properly, these lesions just grow back and more surgery, more adhesions, and more scarring occurs. Women with #endometriosis are more than three times as likely to fill an opioid prescription and to use higher doses. Xanax is also often part of this combination of treatment and most are not told that these two in combination increase their risk for fatal overdose by tenfold!
Functional & Integrative Approach
Endometriosis is not just a hormonal or endocrine problem; it's a chronic inflammatory condition that includes immune dysfunction and tissue damage. At the same time, cells that usually mediate the damage are actually working against their host. These good cells have gone rogue, but what do they say about people with autoimmune diseases such as endometriosis - no one better to kick my own ass than myself!
The involvement of the immune system and chronic inflammation means these women are also at risk for eczema, allergies, asthma, other autoimmune conditions, and chronic fatigue syndrome. Cancers, most especially ovarian and breast, are more common as well. Infertility is common due to scarring and adhesions. Major stuff, right? This is why it is so infuriating that this condition goes missed in so many women, pushed aside as normal discomforts of just being a woman. My goal is to empower you through education.
As estrogen increases, endometrial tissue grows in excess, inside and outside the uterus (Guo et al., 2021). That tissue is fed by estrogen and then sheds with your flow, but when inside your abdominal cavity, this flow has no where to escape. It can find itself anywhere, even on the lungs and I haven't a clue how, but even in the sinuses. This blood is a major irritant. It is damaging and creates great suffering.
The thing is though, endometriosis goes even deeper. It's about genetics. It's about altered immunity and imbalanced growth, even abnormal endocrine signaling. This may result from toxic exposures our mother's were exposed to while we were growing in her womb. We look at the microbiome, hidden toxin exposures, and dietary factors when evaluating for an underlying trigger. We would also evaluate mast cells as part of the altered immunity as these accumulate in endometriotic lesions (Guo et al., 2021). We talk a bit more about this in our Epigenetic program.
Stress & Endometriosis
Chronic over-activation of the stress response causes a domino effect on immune dysregulation and inflammation, which can aggravate - or may even be one of the contributing causes of endometriosis. Chronic stress also causes increased pain perception, and researchers now believe that this phenomenon plays a role in nerve fiber changes that are associated with endometriosis pain.
References
Coxon, L., Horne, A. W., & Vincent, K. (2018). Pathophysiology of endometriosis-associated pain: a review of pelvic and central nervous system mechanisms. Best Practice Res Clin Obstet Gynaecol, 51, 53-67.
Guo, X., Xu, X., Li, T., Yu, Q., Wang, J., Chen, Y., Ding, S., Zhu, L., Zou, G. & Zhang, X. (2021). NLRP3 inflammasome activation of mast cells by estrogen via the nuclear-initiated signaling pathway contributes to the development of endometriosis. Frontiers of Immunology, 12.
Zondervan, K. T., Becker, C. M., Koga, K., Missmer, S. A., Taylor, R. N., & Vigano, P. (2018). Endometriosis. Nat Rev Dis Primers, 4(9).
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