More than menstrual cramps

Endometriosis can lead to infertility

Endometriosis can lead to infertility

July 05, 2004|by ANDREA ROWLAND

Millions of women and girls endure monthly pelvic pain so severe that it disrupts their daily activities. Many don't realize they're suffering from an often under-diagnosed disease that might render them infertile and more vulnerable to certain life-threatening illnesses.

Endometriosis - which affects an estimated 5.5 million women and girls in the United States and Canada and countless others worldwide - is a painful, chronic disease of the immune and hormonal systems that can cause pain, infertility, scar tissue formation, bowel problems, irregular menstrual bleeding, nausea and dizziness, according to information from the Endometriosis Association.

"Take it seriously," said Mary Lou Ballweg, 56, a longtime endometriosis sufferer who founded the Milwaukee-based Endometriosis Association in 1980 and now serves as the nonprofit organization's president and executive director. "Women and girls are conditioned that this is 'just menstrual cramps.' It's not. It's so much more."


Women with endometriosis also might face an increased risk for such autoimmune diseases as rheumatoid arthritis and lupus and cancer, Ballweg said. Dr. Michael W. Vernon, professor at West Virginia University's Center for Reproductive Medicine, said more research is needed to understand the link between cancer and endometriosis.

"We cannot prove that the slightly higher incidence of cancer in women with endo is from the endo itself or from the events that may have caused the endometriosis," Vernon said. "That is, a woman's endometriosis may have been caused by PCBs, personal stress, poor health habits/diet or genetic predisposition, and these events, independent of the endometriosis, might be responsible for the slightly higher incidence of cancer that we see in endo patients."

The disease affects females ages 8 to 80, Ballweg said.

At least one in five females suffer from endometriosis, Vernon added.

"It's almost impossible to sit in a room with women and not sit with endometriosis," he said. "Endometriosis is one of the most misunderstood gynecologic diseases, even though it is one of the most common problems we see in our clinics."

Toxins linked to disease

Endometriosis occurs when tissue like that which lines the uterus grows outside the uterus, usually in the ovaries, fallopian tubes or abdominal cavity. The tissue develops into growths or lesions that respond to the menstrual cycle in the same way that the tissue of the uterine lining does - building up, breaking down and shedding every month. But, unlike the menstrual flow, the blood and tissue shed from endometrial growths are trapped in the body, according to information from the Endometriosis Association.

While doctors don't know what causes endometriosis or how it leads to infertility, research suggests that genetics and environmental toxins play a role, Vernon said. The daughters of endometriosis patients have a 50-50 chance of inheriting the disease, he said.

Studies also have linked endometriosis to such environmental toxins as dioxins and PCBs. Dioxins are chemical byproducts of industrial and consumer processes that involve chlorine. Sources of dioxins include waste incineration, metal smelting, chemical and vinyl plastic manufacturing and paper bleaching. Airborne dioxins eventually fall to the ground, contaminating crops and their livestock consumers before accumulating in the bodies of humans who eat the animals, Ballweg said. PCBs, or polychlorinated biphenyls, are dioxin-like chemicals that were used in industrial products before PCBs were banned in the 1970s. Like dioxins, PCBs contaminate water, soil, fish and game, and they build up in human tissue. Some PCBs remain in the environment for more than a century, according to the Endometriosis Association.

"It's in our food that we're exposed to most of the toxins that have been strongly linked to endometriosis," Ballweg said.

Diagnosis and treatment

Females who experience pelvic pain that interferes with daily activities should seek medical help, Vernon said.

Laparoscopy - an exploratory procedure in which a small telescope is inserted into the abdomen through a small incision - is the only way to diagnose endometriosis, but a blood test to diagnose the disease is being developed, he said.

While there is no cure for endometriosis, treatments are available to help reduce pain, shrink or slow endometrial growths, preserve or restore fertility, and delay recurrence of the disease, according to the Endometriosis Association.

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