Why is endometriosis so difficult to treat?

Endometriosis is a complex disease that is often delayed in diagnosis. Including different symptoms that can be attributed to other conditions, it is often treated late or in the wrong way. But how do you know if you suffer from this gynecological problem? How to detect the typical signs of it? What can you do to relieve the pain it causes? Let's talk about endometriosis!

What is endometriosis?

Endometriosis is a chronic gynecological disease. It is characterized by the presence of endometrial tissue (the lining of the uterus) outside the uterine cavity. Depending on the case, this tissue can attach to different reproductive organs such as the fallopian tubes or ovaries. It can also invade other adjacent areas such as the rectum and bladder. Unfortunately, this problem is often diagnosed very late and it can sometimes take more than 10 years to identify its existence!

Why is it sometimes difficult to diagnose this condition?

Varied and non-specific symptoms

The symptoms of endometriosis are quite varied and easy to confuse with those related to other gynecological problems (pelvic inflammatory disease, ovarian cysts, etc.). Some people do not feel any signs of the condition and it is then discovered by chance during a routine medical examination or an annual pap smear. However, among the typical signs of endometriosis, we find:

• severe pain in the lower abdomen, usually increased during menstruation;
• particularly disabling dysmenorrhea (painful periods);
• heavy periods;
• dyspareunia (painful intercourse);
• infertility (endometriosis is the leading cause of infertility in women);
• chronic fatigue.

Variable pain and sometimes atypical manifestations

Pain is of course the symptom most often mentioned by people suffering from endometriosis. But, here again, things are not so simple. Indeed, the significant development of a uterine lining (the endometrium) outside the uterus can cause unbearable pain in one individual, while it will be almost painless in another. It is therefore very complicated to draw up a precise clinical picture allowing endometriosis to be diagnosed with certainty. And this, without counting the atypical signs of the disease!

Apart from the characteristic manifestations, unusual symptoms can indicate endometriosis. For example, this pathology can be associated with digestive disorders related to irritable bowel syndrome (IBS): alternating periods of diarrhea and constipation, nausea, vomiting, abdominal cramps. When this is the case, the diagnosis of endometriosis is even more delayed, as stomach aches are attributed to digestive disorders, and not to the latter.

It can also manifest itself as blood in the urine or lower back pain. In very rare cases, the endometrial tissue manages to implant itself in the respiratory system, causing difficulty breathing, or in the nervous system, causing migraines or neuropathies.

The impact of endometriosis on intimate comfort

1 in 10 people with a uterus have endometriosis, and nearly half of that population suffers from dyspareunia. Beyond extremely painful periods and infertility issues (in 30% to 40% of cases), endometriosis often results in pain during penetrative sex. The good news is that there are therapies and tools that can help restore intimate comfort in people who suffer from this symptom.

Insufficient understanding and knowledge of the disease

Although endometriosis affects many people, it is currently unknown why it occurs or what triggers it. The fact that the type and intensity of symptoms vary greatly from one individual to another and are sometimes not characteristic of a gynaecological condition also tends to delay the identification of the disease.

In addition, the definitive diagnosis is largely based on performing an exploratory laparoscopy. This is an examination during which a camera is surgically inserted into the abdomen to directly observe the organs. This allows confirmation that the endometrial tissue has invaded organs where it is not supposed to be. Unfortunately, due to its complexity and cost, this examination is only performed late and after the failure of other therapeutic approaches.

At the same time, the medical community is sometimes not very aware of this type of problem. When a person consults their doctor with lower abdominal pain aggravated by menstruation, the first reflex is often to classify this symptom as painful periods. In addition, although research on endometriosis has intensified in recent years, it has long been neglected, which has slowed the development of diagnostic methods and treatment strategies.

What can be done to relieve endometriosis-related problems?

A treatment that is sometimes complex to define

Unfortunately, there is currently no real cure for endometriosis. Prescribed treatments are primarily aimed at managing discomfort and preventing the progression of the disease, without being able to eradicate it. Due to the diversity of symptoms and feelings, treatment must also be personalized. What works for one person does not always work for another. This sometimes makes it more difficult to develop an effective treatment.

The different medical options

To relieve the symptoms of endometriosis, different approaches can be used, or even combined:

• Use pain medications, usually nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen, to manage pain.
• Implement hormonal therapy: prescription of oral contraceptives or insertion of a hormonal IUD to control or eliminate menstruation. Taking the pill can also help diagnose endometriosis when it provides relief.
• Surgery to remove excess endometrial tissue and repair any lesions: This procedure is performed as a last resort, as it is not only invasive but also often doomed to failure.

What you can do on your side

To relieve symptoms, in parallel with the therapeutic management of endometriosis, be sure to adopt a healthy lifestyle by exercising regularly, which helps relieve some pain. At the same time, adopting a balanced diet rich in fiber helps limit inflammatory phenomena and combat digestive disorders that can aggravate the disease.

You can also turn to gentle therapies such as physiotherapy or acupuncture. Finally, take care of your mental health, which is often very affected by this inconvenient disease. Take up yoga or meditation, seek support from your loved ones, practice activities that you enjoy, etc. And if your endometriosis is having a serious impact on your sex life, try to apply the advice we share with you in this article .

Find a specialist who suits you!

Having a strong impact on daily well-being and affecting what is most intimate, endometriosis must be treated by a professional who knows what they are talking about. This is why, if you do not find the listening you expect and think you are suffering from this condition, it is important to consult a specialist. Turn to gynecologists who are aware of this issue and above all insist on making yourself heard if your disorders do not seem to be sufficiently taken into account when you talk about them. Do not hesitate to seek several medical opinions if necessary.