Unmasking endometriosis: Early diagnosis paves the way for better treatment

Endometriosis has long puzzled medical professionals, but recent leaps forward in understanding the condition have revealed how it affects women across the world. It’s treatable and the earlier the diagnosis, the quicker the path to effective management of the condition opens up.

Dr Jonathan Redelinghuys of Medicare24 called endometriosis a “great pretender” because the condition can present symptoms in various parts of the body, making diagnosis particularly challenging. “While it most commonly grows in the pelvic area, such as the pouch of Douglas or around the bowel, endometrial tissue has been found in distant areas like the thyroid, diaphragm, and even the lungs,” he said.

The great pretender

The biggest mystery surrounding endometriosis is how the tissue travels to different parts of the body. There are several theories about how this occurs. “The lymphatic system, which drains fluid from tissues, may act as a highway for endometrial tissue to spread throughout the body,” he explained.

This means that women with endometriosis can experience symptoms that may not immediately suggest a gynaecological issue. “It’s a condition that can migrate parts of its sum to anywhere in the body, which is why it can be so difficult to diagnose,” he added.

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Retrograde menstruation suggests that during menstruation, some of the menstrual tissue flows backward through the fallopian tubes into the pelvic cavity, where it then implants and grows. “It’s believed that this retrograde movement can also allow endometrial tissue to escape the uterus and settle in places where it doesn’t belong,” Dr Redelinghuys said.

There’s also a theory that suggests certain cells in the abdomen may undergo a transformation, changing into endometrial tissue due to abnormal mutations. “This idea likens the transformation to something like a benign tumour,” he added.

Endometrial tissue can grow where it should not

 “At its genesis, endometriosis occurs when endometrial tissue, which should normally line the inside of the uterus, grows in places it shouldn’t,” Dr Redelinghuys explained. This misplaced tissue can cause a range of symptoms, including chronic pain, heavy menstrual bleeding, and, in severe cases, fertility issues.

The physical and emotional impact of endometriosis can negatively affect patients. “Women with endometriosis often experience severe menstrual pain, fatigue, and in some cases, difficulty with fertility,” Dr Redelinghuys said. He also pointed out the frequent overlap between endometriosis and other health conditions.

“It can co-occur with issues like polycystic ovarian syndrome or multiple cysts on the ovaries, irritable bowel syndrome, or fibromyalgia,” he said. Fibromyalgia is a disorder that manifests with widespread musculoskeletal pain and symptoms like fatigue, mood issues, sleeping challenges and memory loss.

“Because endometrial tissue responds to hormonal changes, it can interfere with the normal function of the reproductive organs, making it more difficult for some women to conceive,” Dr Redelinghuys shared. However, a diagnosis of endometriosis doesn’t necessarily mean a woman won’t be able to have children, as treatments are available.

These can include several different approaches. That includes hormonal therapies through to surgical intervention. “The primary goal of hormonal treatment is to prevent the growth and spread of the endometrial tissue,” he said and added that hormonal treatments are particularly effective in reducing the proliferation of this tissue, which helps manage the pain and discomfort associated with endometriosis.

There is help available

However, women who are trying to conceive may not be candidates for hormonal treatments, as these medications can interfere with ovulation.

“This makes the decision on treatment more complex, as balancing fertility and symptom management becomes the primary concern,” he added. “Surgery removes the endometrial tissue from areas where it has implanted,” Dr Redelinghuys said.

For some women, this can lead to significant relief from symptoms and, in some cases, improved fertility. But surgery isn’t always a viable option. “In certain cases, the endometrial tissue might be in dangerous or difficult-to-reach areas, making surgery too risky,” he said.

Dr Redelinghuys said that while women suffering from endometriosis may feel like it may be a lifelong challenge, it doesn’t have to be the case. “With proper treatment, women can manage their symptoms and, in many cases, live relatively normal lives,” he said. While the road to diagnosis and treatment can be long and frustrating, there is hope. “The earlier we catch endometriosis, the better the outcomes,” he said.

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