While it affects nearly one in ten women in France, or 2.5 million French women, endometriosis is a disease still largely ignored by the public and the medical community. This common condition is difficult to diagnose and is a possible cause of female infertility. Here are 7 things to know about this disease.
Endometriosis is a gynecological disease that is little known to the general public. However, it is quite common, as it is estimated to affect nearly one in ten women of reproductive age.
It affects almost 40% of women who suffer from chronic pelvic pain, particularly during menstruation. Pain can also occur while using the toilet (during urination or bowel movements), at the time of ovulation, and during sexual intercourse.
Endometriosis is characterized by the presence of uterine tissue outside the uterine cavity. The disease is due to the implantation of endometrial fragments on other organs. This anomaly (also called "ectopic localization") can affect different organs: the vagina, ovaries, fallopian tubes, digestive tract, bladder, or rectum.
These cells, which have the same characteristics as those of the uterine lining or endometrium, proliferate under the influence of ovarian hormones. They behave like the uterine lining under the influence of hormones: they multiply, bleed, and leave fibrous scars with each menstrual cycle.
The disease generally manifests as chronic inflammatory reactions and can lead to the formation of scar tissue on the affected organs.
In general, endometriosis manifests as:
- severe pelvic pain.
- heavy periods.
- and, sometimes, infertility.
The presence of tissue similar to the uterine lining outside the uterus most often causes Painful periods sometimes associated with several other symptoms.
To alleviate this pain, patients are generally advised to take a Contraceptive pill continuously to suppress periods. However, this imperfect "solution" does not cause the disease to regress and also does not solve fertility problems.
In some cases, this gynecological condition is asymptomatic. This means it does not cause any symptoms, making it difficult to detect. In such cases, the disease is often discovered "by chance" in women who have difficulty conceiving.
Endometriosis is sometimes a silent disease. Moreover, even in the presence of heavy and very painful periods, doctors do not always consider this diagnosis.
It is estimated that most patients have to wait between 5 and 10 years before the correct diagnosis is made by the medical profession.
This delay is problematic for several reasons:
- the sometimes very painful symptoms remain unexplained for the women who suffer from them.
- this disease is progressive, hence the importance of detecting and treating it as early as possible.
- the lesions caused by this disease can damage many organs and lead to infertility.
- this medical "wandering" can last several years and be costly for Social Security.
To make a diagnosis, doctors generally perform:
- a clinical examination.
- a pelvic ultrasound.
- a pelvic MRI.
- an analysis of the endometrial tissue taken during a surgical procedure called laparoscopy.
A saliva test, called Endotest, would allow a reliable diagnosis to be made in a few days. But it is not yet marketed in France.
Endometriosis is a disease to be taken seriously as it can prevent you from having children. It is believed to be responsible for about 40% of female infertility cases in France.
It is estimated that 30 to 40% of patients affected by this disease experience fertility problems. This figure should also reassure you because it means that half of the women concerned have almost normal fertility.
A French study dating from 2016 and conducted on 750 women demonstrated that this pathology increases the risk of miscarriage. The disease is believed to cause 10% more miscarriages during the first trimester of pregnancy (i.e., 29.1% of miscarriages in women suffering from endometriosis, compared to only 19.4% in the control group).
Even though endometriosis lesions resemble "metastases" that invade multiple organs, this gynecological disease does not increase the risk of cancer.
In endometriotic patients, the risk of developing ovarian cancer is less than 1%.
It should also be noted that the intensity of symptoms and pain is not proportional to the extent of internal lesions.
The mechanisms behind endometriosis are still poorly understood. One of the most probable hypotheses is the following: during menstruation, blood would pass through the fallopian tubes and reach the abdominal cavity, carrying fragments of endometrium or cells capable of creating new endometrial lesions.
Certain genetic and environmental factors could also be involved in the onset of this disease.
Researchers are particularly questioning the possible role of endocrine disruptors... A study conducted on mice showed that prenatal exposure of mice to Bisphenol A promotes a pathology resembling endometriosis in females.
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