Endometriosis Excision Specialist in Palo Alto, California
SEVERE PAIN WITH YOUR PERIODS? YOU MIGHT HAVE ENDOMETRIOSIS
How Does Endometriosis Occur?
Endometriosis develops when endometrial-like mucosal cells normally found in the endometrial lining of the uterus begin growing and functioning in other areas or organs of the body. Under the microscope, endometriosis almost always contains the glands and stroma of normal endometrial cells found in the uterus, but it has other features that are very different; that’s why its cells are described as similar to or endometrial-like.
Despite these microscopic differences, endometriotic growths can respond to the monthly fluctuations of female sex hormones, just as normal uterine endometrial cells do in reproductive-aged women and girls. Because of this, endometriosis growths can bleed, shed, and proliferate in concert with a woman’s monthly menstrual and/or ovulatory cycle. This is why the pain usually becomes most acute around menstruation and/or ovulation.
In the broadest terms, many researchers hypothesize that the body’s immune system recognizes that these endometriotic growths are not growing where they should and therefore launches an immune response in order to destroy them. (Others believe that the immune system does not recognize them until it’s too late). As a result of this continued battle between endometriosis and your body’s immune system, the cytokine-prostaglandin response, inflammation, and other immune system factors appear to become chronically dysregulated.
It’s a classic vicious cycle. Partially as a result of this immune response and other factors, severe pain with menstruation, chronic pain independent of menstruation, inflammation, subfertility, infertility, tissue necrosis, and scar tissue (adhesions) can develop. In severe cases, endometriosis causes such extensive damage that serious complications ensue, like life-threatening bowel obstruction, bladder dysregulation, kidney dysfunction, silent loss of kidney (Ureteral endometriosis), collapsed lungs, and destruction of the ovaries and fallopian tubes. Meanwhile, scar tissue formation also damages organs by encasing them together in abnormal ways -in a sense strangling them – which, in severe cases, leads to the so-called frozen pelvis which can cause chronic pain and even loss of organ function.
Like the rogue agents that they are, it appears that these clever little endometriotic growths can also reprogram genetic pathways, allowing them to continue migrating throughout the body and even produce their own hormones, nerves, and blood supply. It’s as if endometriosis is determined to live and will do anything to ensure its own survival. In this sense, endometriosis behaves in similar ways as cancer, even though it’s classified as a benign condition. (Endometriosis is, however, associated with an increased risk of certain cancers). A combination of genetic predisposition, epigenetic mutations, stem cell dysregulation, immune system dysfunction, and environmental triggers have all been proposed as potential factors in the pathogenesis of endometriosis. Through all of these potential pathways, endometriosis can be a progressive disease; that is, it can continue to grow throughout the body and become worse, despite medical and/or surgical interventions and even if the uterus and ovaries have been surgically removed.
Did you know?
Did you know that teenage girls can develop endometriosis as soon as they start menstruating?