This condition involves tissue similar to the lining of the uterus growing outside the uterus. It is not uterine lining tissue. This is a, at first glance small, but nevertheless so important difference. Because endometriosis can also grow without a uterus. Many affected individuals often hear sentences like: "Just have your uterus removed. Then you'll be at peace!". However, it's not that simple. Removing the uterus does not cure endometriosis. In the case of pure adenomyosis, however, removing the uterus is often a common form of therapy. Adenomyosis was long thought to be a subtype of endometriosis. Nowadays, however, adenomyosis is considered an independent condition1. It strongly resembles endometriosis. In adenomyosis, the tissue that resembles the uterine lining (some sources say it is actually uterine lining), grows within the uterus or in the muscle layer of the uterus.
But today we focus on endometriosis: Endometriosis has long been no longer a purely female disease. Not only women* can suffer from it. The condition also does not spare non-binary and intersex individuals. For this reason, it is so important, especially in relation to endometriosis, to pay attention to one's choice of words, to include all individuals. Because who would have thought: Cis-men can also be affected by endometriosis. Treatment for prostate cancer with high doses of estrogen can lead to endometriosis in cis-men2.
The symptoms are very individual and vary. There are those affected who feel no symptoms or pain at all. Once again, this shows: Endometriosis has many faces.
Frequently described symptoms:
- Severe pelvic pain (cycle-dependent and cycle-independent)
- Pain during or after sexual intercourse
- Pain during gynecological examinations
- Bladder and bowel complaints
- Unfulfilled desire for children
- Incontinence
- Bleeding from the intestine and/or bladder
- Numerous intolerances, allergies
- Leg and/or shoulder pain
- Extreme bloating or the so-called "Endobelly"
Of course, there are many more symptoms. The list is really endlessly long. In any case, a doctor should always be consulted if the symptoms already severely restrict daily life and one suffers from severe pain. No one has to go through this alone.
Endometriosis & Menopause
The myth that endometriosis disappears after menopause is a widespread myth. Menopause does not cure endometriosis either. Because endometriosis does not just disappear because one is going through menopause. However, there are those affected who notice an improvement in symptoms during or after menopause. Then the affected individuals are merely symptom-free, but not yet cured of endometriosis.
The lowered estrogen level can slow down the growth of endometriosis, as the sex hormone naturally regulates the buildup of tissue. Many affected individuals therefore have less trouble with the classic complaints of endometriosis after menopause. However, this does not automatically mean that there is no more endometriosis in older age. A study showed that out of about 42,000 women*, approximately 2.55% suffered from endometriosis after their last menstruation4. Another study describes that endometriosis is an estrogen-dependent condition that tends to regress following the last menstruation, but still restricts up to 2.2% of this group of individuals5. Thus, it is proven that there are individuals who still struggle with their endometriosis after their menopause.
Guest post by: Vivian Vanessa Wagner @endoloewin
Sources:
1 Benagiano G, Brosens I, Habiba M: Structural and molecular features of the endomyometrium in endometriosis and adenomyosis. Hum Reprod Update. 2014; 20(3): 386-402
2 Giannaruni et al., 2006; Fukanaga, 2012; Rei et al., 2018; Zamecnik und Hostakova, 2013
3 Matalliotakis M, Matalliotaki C, Trivli A, Zervou MI, Kalogiannidis I, Tzardi M, Matalliotakis I, Arici A, Goulielmos GN. Keeping an Eye on Perimenopausal and Postmenopausal Endometriosis. Diseases. 2019 Mar 12;7(1):29. doi: 10.3390/diseases7010029. PMID: 30870972; PMCID: PMC6473414.
4 Haas D, Chvatal R, Reichert B, Renner S, Shebl O, Binder H, Wurm P, Oppelt P. Endometriosis: a premenopausal disease? Age pattern in 42,079 patients with endometriosis. Arch Gynecol Obstet. 2012 Sep;286(3):667-70. doi: 10.1007/s00404-012-2361-z. Epub 2012 May 5. PMID: 22562384.
5 Zanello M, Borghese G, Manzara F, Degli Esposti E, Moro E, Raimondo D, Abdullahi LO, Arena A, Terzano P, Meriggiola MC, Seracchioli R. Hormonal Replacement Therapy in Menopausal Women with History of Endometriosis: A Review of Literature. Medicina (Kaunas). 2019 Aug 14;55(8):477. doi: 10.3390/medicina55080477. PMID: 31416164; PMCID: PMC6723930.