Amanda has been battling with (dysmenorrhea)menstrual cramps since she started her periods at thirteen. Her mother and aunts try to console her with their own cramp stories every time. You know, just one of the things women go through.
The severity of Amanda’s condition was registered in their heads the day Amanda collapsed at school because of cramps. Little did they know that Amanda had endometriosis. Dysmenorrhea is one of the major symptoms of the disease.
What is endometriosis?
Endometriosis is a disorder where the tissues that make up the linking of the uterus begin to grow in other places like the fallopian tubes, the ovaries and even the intestines. Endometriosis is prevalent among teenage girls and middle aged women. Most of these women are first diagnosed with primary endometriosis in their teenage years. A good number of them grow with it until the later years of their lives because their symptoms as teenage girls as waved off as just menstrual cramps.
To fully understand endometriosis, one needs to understand the menstrual cycle well. During the course of a girl’s menstrual cycle, the uterine lining builds up with tissues and blood vessels. This happens because the uterus is ready to receive an egg that will be released by the ovaries. If coitus(sexual intercourse) does not occur, the uterus sheds the tissue and the blood. This shedding is what makes the menstrual blood. This process takes a period of 28-30 days and it is controlled by a girl’s sex hormones.
Because the endometrial implants, (the abnormal growths that cause endometriosis are called endometrial implants). The blood vessels and tissues that shed to form the menstrual blood also make up the abnormal growths, this implies that the hormones also affect them in the course of the menstrual cycle.
“However, in the uterus, if the egg isn’t fertilized, the extra tissue and blood leave a girl’s body in the form of menstrual fluid. With endometriosis, though, there’s nowhere for the accumulating blood and tissue to go once the implants start to break down. This causes irritation of the surrounding body parts, which can cause pain. With continued build up and irritation, the symptoms of endometriosis tend to become more painful over time”.Stephen Downshen. MD at TeensHealth.
Causes of Endometriosis
The exact cause of endometriosis is not known. Below are a few speculative causes according to Mayo Clinic.
- Retrograde menstruation. In retrograde menstruation, menstrual blood containing endometrial cells flows back through the fallopian tubes and into the pelvic cavity instead of out of the body. These endometrial cells stick to the pelvic walls and surfaces of pelvic organs, where they grow and continue to thicken and bleed over the course of each menstrual cycle.
- Transformation of peritoneal cells. In what’s known as the “induction theory,” experts propose that hormones or immune factors promote transformation of peritoneal cells — cells that line the inner side of your abdomen — into endometrial-like cells.
- Embryonic cell transformation.Hormones such as estrogen may transform embryonic cells — cells in the earliest stages of development — into endometrial-like cell implants during puberty.
- Surgical scar implantation. After a surgery, such as a hysterectomy or C-section, endometrial cells may attach to a surgical incision.
- Endometrial cell transport. The blood vessels or tissue fluid (lymphatic) system may transport endometrial cells to other parts of the body.
- Immune system disorder. A problem with the immune system may make the body unable to recognize and destroy endometrial-like tissue that’s growing outside the uterus.
Symptoms of Endometriosis
A lot of symptoms are associated with endometriosis. I will name the five major symptoms.
- Pelvic pain associated with menstrual cramps
- Dysmenorrhea(painful menstruation)-This is the commonest symptom of endometriosis. It is not unusual to experience menstrual cramps. But when the cramps become very painful and begins to feel like your intestines would pull out the very next minute, you should call on your doctor.
- Excessive bleeding during menstruation- Some girls have naturally heavy periods. These periods are usually very heavy on the first two days. When the bleeding continues till the end of the period, you should be worried.
- Painful sexual intercourse- Sex is meant to be a pleasure and not torture. Feeling sore after sex especially when your lubrication level was quite high deserves some questioning.
- Lower back pain.
Some women are more susceptible to endometriosis than others. Some examples are:
- Girls that started their periods very early.
- Girls whose menses are unusually heavy and continues for over a week.
- Girls with low Body Mass Index.
- Girls with very short menstrual cycles.
You should note that these girls with higher susceptibility are at higher risks of getting endometriosis. It does not mean that “every girl that falls into this category will get endometriosis”.
No symptom should be ignored. Other diseases like PID(Pelvic Inflammatory Disorder), Ovarian Cysts and cancers share very similar symptoms with endometriosis. This is why you should see the doctor for the slightest change in your cycle and for any unusual menstrual cramp.
Girls with endometriosis are encouraged to join support groups where they meet other girls, share their stories, research and heal together. A good example of such support groups is the Endometriosis Association. Below is an heartwarming quote from Ashley, a girl in Endometriosis Association who had her first symptoms at ten.
There is so much you can do! There are so many people who are still clueless about endo and how it strikes young women at such early ages. I think a first step would be to talk to your friends and educate them about this disease.
– Ashley, first symptoms at 10 years old