Painful periods are common but are they normal, or your body trying to tell you somethings up?
Endometriosis is a condition where tissue similar to the endometrium – tissue lining the uterus that we shed during menstruation – grows outside of the uterus, causing pain, inflammation and in some cases, infertility.
With the condition affecting one in ten women, it is a big issue that needs more awareness.
Being Endometriosis awareness month (#endomarch) we delved into the topic with Women’s Health and Fertility Expert Jacqui Lamplugh.
Jacqui explains the common symptoms, how to get diagnosed and how to treat it as well as why the pill may be masking or even making your symptoms worse.
So, is it a hormone disorder?
Is it an auto-immune disease?
One thing’s for sure, it is not just a ‘bad period’
Jacqui says sex education at school failed to teach young women about their bodies, and they weren’t taken seriously about period issues until they were having trouble falling pregnant later in life.
“Sex ed really failed me when it came to my body and my periods and knowing how everything works,” she said.
When she was 18 she read a book about fertility which she ‘couldn’t put down’, and from that moment on, she knew I had to share this with other women.
She went on to study naturopathy, and gained her Masters and Reproductive Medicine just to help other women understand their bodies and get pregnant.
Jacqui explained that endometriosis was not just a hormonal condition, and that it could be more of an auto-immune disease with how similarly it reacts in the body.
“Endometriosis only affects women of menstruating age because it is influenced by our hormones, but there’s so much more to endometriosis than just hormones and I think that’s what can make it so complex”.
When the endometrial like tissue grows outside of the uterus, its molecules react to hormones and inflammatory substances.
Because its outside of the uterus, it causes a lot of pain and it grows like a vine, infiltrating and attaching itself to internal organs.
It can start affecting the ovaries and fallopian tubes, the bowel and bladder, and it’s quite common to get adhesions on the organs and cyst on the ovaries.
Endometriosis is still often misdiagnosed as just a ‘’bad period’’, and women are often prescribed the contraceptive pill to ease symptoms, but Jacqui warns that this could be making it worse.
“We’ve learned more recently that your period actually shouldn’t be very painful. It’s not normal and there’s something going on.
Jacqui says endometriosis can also affect mental health
“Just living with pain and the knowing that you’ve got a diagnosed condition can have a huge impact on mental health and then there is the inflammatory component, and we know that inflammation really affects the brain and how it functions.
“Something that was once fobbed off as just hormonal, needs to be looked at holistically to give these woken the results they deserve.”
“We need to look at the systemic chronic inflammation you, need to look at their energy levels, their mental health, the immune disruption that’s going on and trying to work on all of that to help them to have a much more enjoyable life.”
Symptoms of endometriosis
With it taking, on average, seven to ten years to get diagnosed, Jacqui urges anyone who experiences the symptoms to get checked out and seek treatment, even if they are not looking to get pregnant. Symptoms include:
- Painful period
- Heavy periods
- Lots of clots with period
- Painful sex
- Painful bowel movements
- Lethargy / fatigue
“Don’t let anyone say – Oh, well, that’s just part of being a woman. Period pain is not it’s common, but it’s not normal like it’s your body telling you that something is not right.
“It’s not until they’re actually struggling to get pregnant and going through all that
heartbreak that someone sits down and take them seriously. That’s the most disheartening thing.
“So if you feel that you may have endometriosis I would be pushing the point with your health care practitioner now and just going in there quite informed.
How is Endometriosis diagnosed?
Unfortunately, endometriosis cannot be diagnosed by a blood test or ultrasound, it can only be diagnosed with a laparoscopy, a keyhole surgery to have a look internally.
“That’s when doctors will get a clear look at what’s going on in and around the uterus and ovaries and surrounding organs,” Jacqui said.
“That’s another reason why it can take so long to get a diagnosis as well, when treating people we are always trying to be as un-invasive as possible, but if you feel like you have endometriosis, be confident and ask, keep seeking second or third opinions, if you feel like you’re being off,”
“Keep seeking answers and don’t give up until you know what’s wrong.”
Treatment of Endometriosis
When treating endometriosis, Jacqui says it’s important to have a holistic approach, to get the best results.
While there is no cure, there are methods of slowing down and reducing the symptoms. Including:
- Laparoscopy to remove endometrial-like tissue.
- Anti-inflammatory diet
- Anti-inflammatory fats like salmon, walnuts, chia seeds
- Gluten free
- Reduced dairy or dairy free (some women don’t need to eliminate)
- Reduce sugar intake.
- Oestrogen detox
- 30g of fibre per day
- Lots of green leafy vegetables like broccoli, cabbage and Brussel sprouts
- Reduce contact with endocrine disrupting chemicals (EDC)
- Phthalates, BPA and dioxins – found in beauty and cleaning products
- Stabilise immune system
- Reduce stress
While it’s often prescribed for endometriosis, the contraceptive pill does not cure it, it only masks the symptoms for some, and makes them worse for others.
“The most widely used contraceptive pill contains oestrogen, and we know that endometriosis is aggravated oestrogen, so for some women it can actually be aggravated and once you stop that pill, you are going to have to still deal with the endometriosis” Jacqui said.
Some women who do have endometriosis choose to go on hormonal contraception, and in that case, I recommend non oestrogen strategies like the Marina or the ones that contain only progesterone and no oestrogen.”
“Laparoscopy surgery is the gold standard for treating endometriosis, that helps reduce the inflammation and a lot of the symptoms, but that needs to go hand-in-hand with other methods to slow its rate of growth back and keep those symptoms manageable.”
Another treatment option is to look reduce the amount of exposure you are having to endocrine disruption chemicals (EDCs) which are in everyday product and mimic oestrogen in the body.
“Studies have shown women with endometriosis had higher levels of EDCs in their blood.”
Things like phthalates, BPA and dioxins are in products like plastic, fabric softener, perfume and makeup, as well as feminine products like tampons and pads, so it’s advisable to use organic wherever possible, and only spray perfume on your clothes not the skin.” Jacqui added.
While there is no cure, and still so much to learn about endometriosis, the case is clear that there is so much more to the condition than hormones and using a holistic approach to treatment including diet, stress, immunity and reducing inflammation, is going to be a win win for sufferers.