A recent article from Australia on common symptoms and endometriosis was released recently that followed several thousand women that were both surgically and clinically diagnosed (evaluated separately) with endometriosis and their symptoms to look at associations. There are minimal longitudinal studies available, so this article can be very impactful in raising awareness of the variable, but common, symptoms those with endometriosis experience.
Endometriosis, a chronic gynecologic disorder, is characterized by the presence of endometrium-like tissue outside the uterus. This condition has a profound impact on women’s (XX) lives, often leading to increased hospitalizations, diminished work productivity, and a reduced quality of life. While menstrual symptoms are the most commonly associated with endometriosis, an array of other symptoms can significantly affect the physical and mental wellbeing of women diagnosed with this condition. This article aims to provide an in-depth understanding of the common symptoms associated with endometriosis and their impact on women’s health.
The Prevalence of Endometriosis
Endometriosis is a prevalent health condition affecting approximately 1 in 9 women (11.4%) in Australia by the age of 44 years and in the US the estimation is 1 in 10, though this may be inaccurate due to the significant delay or issues with misdiagnosis. The nonspecific nature and normalization of the symptoms often lead to a significant delay in the diagnosis of endometriosis, with several studies reporting an average delay of 7 to 11 years. This delay in diagnosis results in untreated endometriosis-related symptoms, increased hospitalizations, higher healthcare resource utilization, and potentially reduced success using assisted reproductive technologies. Additionally, some of the overlapping symptoms may be due to the “treatments” offered for symptom management such as hormonal supressive therapies.
Endometriosis and Menstrual Symptoms
Women diagnosed with endometriosis frequently report an array of menstrual symptoms. These may include severe period pain (dysmenorrhea), heavy menstrual bleeding, irregular periods, and premenstrual tension. The association between endometriosis and these symptoms is strong, with the odds ratio for severe period pain being as high as 3.61.
Endometriosis and Mental Health Problems
Apart from physical discomfort, endometriosis can significantly affect a woman’s mental health. Studies reveal a higher incidence of mental health problems, including depression, anxiety, and other mental health disorders, in women with endometriosis. The adjusted odds ratios for depression and anxiety are 1.67 and 1.59, respectively.
Endometriosis and Bowel Symptoms
Bowel symptoms are another common complaint among women with endometriosis. These may include constipation, hemorrhoids or piles, indigestion, or heartburn, bloating, diarrhea, or a combination of these. Additionally, one of the clinical manifestations is dyschezia, or discomfort/pain associated with bowel movements. The adjusted odds ratio for constipation is 1.67, indicating a significant association between endometriosis and bowel symptoms. Additional studies have demonstrated that approximately 90% of those with endometriosis have IBS-like symptoms.
Endometriosis and Urinary Symptoms
Urinary symptoms, such as burning with urination (dysuria) and vaginal discharge or irritation, are also more prevalent in women with endometriosis. The increased odds of urinary symptoms suggest a possible alteration in the pelvic innervation caused by endometriotic lesions.
Endometriosis and Pain Symptoms
Endometriosis is often associated with other forms of pain, including back pain, headaches or migraines, and stiff or painful joints. The adjusted odds ratios for these pain symptoms range from 1.50 to 1.76, further emphasizing the multifaceted impact of endometriosis on women’s health.
Endometriosis and Nonspecific Symptoms
In addition to the symptoms described above, endometriosis is also linked to various nonspecific symptoms. These may include severe tiredness, difficulty sleeping, palpitations, and allergies or hay fever or sinusitis. The association between endometriosis and these symptoms underlines the complex nature of this condition and its wide-ranging effects on women’s health.We need more understanding whether these symptoms are a direct result of the endometriosis, the side effects of treatments, or another related issue.
The Importance of Early Diagnosis
Given the wide array of symptoms associated with endometriosis and their significant impact on a woman’s quality of life, the importance of early diagnosis and treatment cannot be overstated. Early intervention can not only alleviate the physical discomfort associated with the disease but also significantly improve mental health outcomes. Furthermore, it can potentially prevent the development of chronic pain conditions and other long-term health complications.
Conclusion
Endometriosis is a complex condition that affects multiple aspects of a woman’s health. It is associated with a wide range of symptoms, extending beyond menstrual problems to include mental health issues, bowel and urinary symptoms, pain, and other nonspecific symptoms. Understanding these symptoms and their impact on women’s lives is crucial for providing comprehensive care to those diagnosed with this condition. While further research is needed to elucidate the specific mechanisms underlying these associations, the current evidence underscores the importance of early diagnosis and intervention in improving health outcomes for women with endometriosis.
Related reading:
- Understanding fatigue and endometriosis: A Practical No-Nonsense Guide
- Interstitial Cystitis and Endometriosis: Unraveling the “Evil Twins” Syndrome of Chronic Pelvic Pain
- Endometriosis Signs and Symptoms: Everything You Need to Know
References:
- Gete DG, Doust J, Mortlock S, et al. Associations between endometriosis and common symptoms: findings from the Australian Longitudinal Study on Women’s Health. Am J Obstet Gynecol 2023;229:536.e1-20.
