Everything you need to know about endometriosis

Endometriosis is a common condition affecting an estimated 200 million people worldwide. Mia Sabat, sex therapist at Emjoy, the sexual wellbeing audio app for women, and Chelsea Bri, an endometriosis coach, are here to help us understand what the condition is.

Mia Sabat: Endometriosis is a chronic, inflammatory disease centred around immune dysfunction. For those that have endometriosis, the tissues that normally line the uterus, known as the endometrium, grow outside of the uterus.

It’s important to understand that endometriosis is not just a reproductive condition: it affects the entire body, and can severely impact the quality of life of those with the condition, although pain and presentation of the condition vary person to person.

The endometrium can grow on the tissue lining the pelvis, as well as the ovaries, fallopian tubes, intestines, bladder, rectum, and peritoneum, as well as other places within the body.

Because the endometrium will continue to act as it would inside the uterus by thickening, breaking down, and bleeding with each menstrual cycle, the condition can become intensely painful because the tissue has no way to exit the body. Instead, it becomes stuck, and can irritate the surrounding tissue, which can lead to cysts, scar tissue and lesions, which lead to adhesions.

As such, endometriosis can be very painful, and flare up during menstrual periods, hormonal fluctuations or dietary triggers. It’s important to note that flare ups don’t just affect the abdomen: endometriosis is an inflammatory condition that affects the entire body, and can cause joint pain, muscle aches and brain fog during flares, too.

Mia Sabat: There are four different stages of endometriosis, although these stages do not determine an individual’s pain levels: someone with advanced endometriosis might have little pain, whilst another with mild endometriosis might have severe pain.

Signs and symptoms of the disorder include pain with periods, intercourse, bowel movements, or urination, as well as pelvic pain and excessive bleeding. It’s also common for those with endometriosis to experience fatigue, diarrhoea, constipation, bloating or nausea, which might flare up during menstrual periods.

Because endometriosis is often accompanied by gastrointestinal issues, many are misdiagnosed with more common conditions like IBS. Endometriosis is a chronic condition, a full-body inflammatory disease, that can last for years, or even an individual's entire life.

Some people with severe endometriosis may struggle with infertility; however, for those with mild to moderate forms of endometriosis, pregnancy is still very possible. If you have endometriosis and are keen to become pregnant, speak to your doctor about the best approach for you and your specific situation.

Mia Sabat: The exact cause of endometriosis is unknown, although there are several theories about potential causes. Some recent studies have found that endocrine disruptors can lead to endometriosis.

It’s also thought that endometriosis is linked to a problem with a person’s immune system, or that it’s caused by endometrial cells spreading through the body through the lymphatic system or bloodstream and ending up somewhere they’re not supposed to be.

The condition also tends to run in families, so it’s been theorised that there is a genetic component to the issue. Unfortunately, none of these things can fully explain why endometriosis happens, so doctors believe it could be caused by multiple, interacting factors. Endometriosis is treatable, but unfortunately there is no cure yet.

Although the cause of endometriosis is unknown, it is clear that the condition has a direct relationship with diet. Many people are able to manage and improve their symptoms by adapting their diet and avoiding foods that increase prostaglandins, which can improve the quality of an individual’s life.

Wider treatments also include the use of painkillers like ibuprofen to manage the discomfort that comes with the condition, or the use of hormonal medicines and birth control to manage the shedding of endometrial cells; this is achieved by limiting oestrogen production as this hormone helps to prevent the tissue from forming.

In more extreme cases, surgery may be used to remove endometrial tissue or to even remove the uterus entirely in order to resolve the condition.

The NHS also recommends that women join endometriosis support groups for information and advice on managing the condition. Be sure that you discuss all your treatment options thoroughly with your GP before moving forward, as it’s important to seek medical advice on everything from elimination diets to birth control on your endometriosis journey.

Chelsea Bri: As an endometriosis coach, I highly encourage individuals to explore acceptance of endometriosis through guided meditation. Taking five minutes every day to focus on your breath, release tension, and accept endometriosis can be incredibly effective in helping you to purposefully allow your life, and your circumstance, to exist as they are.

We must acknowledge the truth of what’s happening to create change, and healing cannot progress without acceptance. If you’re not sure where to begin with guided meditations, Emjoy has a guided, acceptance meditation in their endometriosis wellbeing library that is a great place to start.

I also encourage individuals to embrace affirmations. It can be difficult to trust your body when you struggle with pain. In fact, it can severely damage your self-worth when you feel like your body doesn’t work as it should.

Guided affirmations can help you throughout your self-worth journey, and help you to learn to trust, love and celebrate your body. You might feel silly at first, but the more you repeat positive affirmations, the more your brain and body accepts and embraces them.

Taking what resonates, and leaving the rest behind, will help you to move forward on your healing journey. Here are some powerful affirmations that you can repeat daily to help you get started:

Endometriosis is a complex condition, and if you believe that you may be living with it, we advise that you speak with your GP and seek support. Your doctor will be able to answer any questions that you might have, and offer advice regarding disease management.

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