March is Endometriosis Awareness Month. Are you aware of endometriosis? If you already have intimate knowledge of it, well, maybe we can get you to better understand the science behind it. So, let's talk about a tender subject that affects approximately 10% of women and people with uteruses. But don't worry, we're going to make it interesting and informative (hopefully.)
So, what is endometriosis, you may ask? Well, it's when the lining of the uterus, called endometrial tissue, grows outside of the uterus and into other areas of the body. It can cause a whole host of symptoms, including pelvic pain, heavy menstrual bleeding, and infertility. Yikes, that doesn't sound very fun at all.
But, let's get into the science behind this pesky condition. One theory is that during menstruation, some of the menstrual blood flows back through the fallopian tubes and into the pelvic cavity, where it may implant and grow in other areas. This is called retrograde menstruation. As Dr. Krina Zondervan, a researcher in reproductive health at the University of Oxford, explains, "Retrograde menstruation occurs in up to 90% of women, but not all women develop endometriosis. So there are likely other factors at play that contribute to the development of this condition."
Wait, what? So, basically, anyone with a uterus, or even intersex individuals with uterine tissue in their body, has the potential to experience retrograde menstruation, but only a select few end up with endometriosis? That's wild. Well, it turns out that genetic susceptibility may also play a role. Several studies have identified genetic variations that may increase someone's risk of developing endometriosis. So, if you have a family member who suffers from endometriosis, you may want to keep an eye out for any symptoms and talk to your doctor about ways to manage your risk.
Hormones also play a part in endometriosis. The growth and shedding of endometrial tissue is regulated by hormones, particularly estrogen. People with endometriosis have been found to have higher levels of estrogen in their bloodstream than those without the condition. This may contribute to the growth of endometrial tissue outside of the uterus. But don't worry, there are hormonal therapies that can reduce the amount of estrogen in the body and help manage endometriosis symptoms.
But, here's where things get a little weirder - researchers have also identified a number of other factors that may contribute to the development of endometriosis, including immune dysfunction, inflammation, and environmental exposures. For example, exposure to dioxins, which are chemicals found in some herbicides and industrial products, has been associated with an increased risk of endometriosis.
As a review article in the journal Frontiers in Endocrinology notes, "It is possible that exposure to environmental toxins may contribute to the development of endometriosis by disrupting the normal hormonal balance in the body." So, maybe it's not just your genetics and hormones, but also your environment that can affect your risk of developing endometriosis.
All in all, endometriosis is a complex condition with many possible causes. But, by understanding the science behind it, we can work to find better ways to diagnose and manage it. And, while endometriosis may not be the most fun topic, it's important to talk about and spread awareness so those that suffer from it can get the care they need. So, let's keep the conversation going and continue to support those who are affected by endometriosis.
Source: Hudson N. (2021). The missed disease? Endometriosis as an example of 'undone science'. Reproductive biomedicine & society online, 14, 20–27. https://doi.org/10.1016/j.rbms.2021.07.003
