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Suffering bad cramps? You may have endometriosis

by Saida Oliver, Opinion Editor

“I feel like my uterus is going to fall out,” said 23-year-old HPU student. Monica Pleuler was describing her menstrual anguish, which has continued intermittently for the last 10 years.


Sure, women experience discomfort while menstruating, but chronic pain during menstruation, before and after sex, and when urinating has become a common problem for millions of women. This isn’t just an excuse used by women to get out of work, school, and responsibilities. It is symptoms of the disease called endometriosis, a condition where tissue normally found in the lining of the uterus actually grow elsewhere in the body. The disease is present in the form of lesions. They are typically found in the pelvic cavity: on the ovaries, the fallopian tubes, and inner surface of the pelvis. However, they can also be found on caesarian section scars, on the bladder, bowel, intestines, colon, appendix, and rectum. In atypical cases, the disease has been found inside of the vagina, inside the bladder, on the skin, or even worse in the lungs, spine, and brain.

Endometriosis affects a recorded 5.5 million women in the U.S. alone. Granted that’s only about 4 percent, it is still significant. Wages lost due to the disease cost an estimated $35 billion annually. There are no numbers available for diagnosed treatment, but they go up if the diagnosis and treatment are delayed. Another risk of a delayed diagnosis is that 30-40 percent of women that have endometriosis are infertile. The later a woman begins treatment, the higher the risk of infertility.

The most common symptom of endometriosis is pelvic pain, which often is associated with the menstrual cycle because estrogen, released during menstruation, aggravates the tissues. Pain can also occur in the lower back region, during or after sex, and in the bowel.

Sarah Tjosvold, a 23-year-old graduate student at HPU, discovered that she had the disease in 2002. “It’s the most intense pain you will ever feel,” she said. “You want to pass out.” Tjosvold began having pelvic pain before, during, and after her monthly period. The pain became so unbearable that she was rushed to the emergency room. A laparoscopy revealed that she had endometriosis. The test required that an incision be made in her naval and in her side at her waist. Through the incisions, the lining of her uterus was scraped. In a “normal” case of endometriosis, there are a few lesions covering the effected area. In Tjosvold’s case, the procedure revealed that her entire ovary was encapsulated with tissue. This was the cause for her intense pain and it had to be removed immediately.

After the procedure, Tjosvold explained that she could hardly use the lower region of her body. “I couldn’t put my own shoes on for two weeks. I could hardly walk…You’d be surprised how much you use that part of your body. I was in a lot of pain.”

To control the disease, she went through chemical menopause. This process “tempered” estrogen production in her body so that she would not release any eggs and therefore would not menstruate. To maintain this status she receives regular shots of Depro Vera. Tjosvold complains of sporadic pain, but said, “The pain is not nearly as bad or consistent.”

There are several theories on how certain women develop endometriosis. One theory is genetic predisposition. The theory states that there is a hereditary link between first-degree women relatives. A worldwide study called the oxegene study is attempting to isolate the endometriosis gene in the blood samples of sisters.

Another theory, by Dr. John Sampson in the 1920s, is called retrograde menstruation. He proposed that menstrual tissues flow backwards through the fallopian tube and are deposited on the pelvic organs where they seed and grow. Researchers have discovered that 90 percent of women have a retrograde flow, but since not all of these women develop endometriosis, doctors have concluded that an immune system or a hormonal dysfunction may be the problem.

Since the cause of endometriosis is still unknown, there is no cure. Treatments only suppress the disease. Pain killers, hormonal treatments and surgery are the most common. The type of treatment chosen will be affected by the woman’s age and impact her fertility, so consulting out a gynecologist is very important.

If you have been concerned about pelvic pain or other unusual symptoms surrounding your menstrual cycle, take the warning signs seriously. You may have endometriosis and need to make an appointment with a gynecologist as soon as possible. Being honest about all symptoms during the visit is important to make sure that the doctor has all the information that she or he needs to develop an appropriate treatment plan for you.


2005, Kalamalama, the HPU Student Newspaper. All rights reserved.
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