What is Endometriosis?
Endometriosis is a medical condition when endometrial tissue (tissue like the uterine lining), or endometrium, grows outside the uterine body. Common regions of misplaced growth are across the ovaries, bowel and tissues that line the pelvis. Very rarely, the endometrium can grow beyond the pelvis. The cyclic hormonal changes of the menstrual cycle impact this misplaced endometrium to make it inflamed and painful. The abnormal tissue that breaks down in each cycle has no way out and becomes stuck in the pelvis [1].
Causes of Endometriosis
The exact cause of endometriosis remains unknown, but several theories have been proposed to explain its origin. Retrograde menstruation is the most widely recognised and accepted theory: it occurs when menstrual blood contains endometrial cells flows back up through the fallopian tubes into the pelvic cavity instead of exiting the body. These retrograde cells implant and grow in the pelvic cavity [2, 3].
Another proposed theory is that the illness is due to peritoneal cells, which line the inside of the abdomen, transforming for some unknown reason into endometriotic cells, either because of inflammation or hormonal factors [4].
Immune dysfunction is also a possible cause. In this case, the body’s immune system fails to recognise and destroy the endometrial tissue growing on the exterior of the uterus.
Hormonal imbalance, particularly progesterone resistance, is another factor that has been linked to endometriosis [5].
Genetic factors could also be involved since endometriosis tends to run in families; some researchers think that the endometriosis risks in some families could be due to predisposing genetic factors in those families. [6]
Finally, environmental toxins were identified as a possible risk factor, but this link is still controversial and needs to be confirmed by further research [3].
Risk Factors of Endometriosis
There are several different ideas about what causes endometriosis; in reality, a combination of these factors almost certainly plays a role. One of the strongest risk factors is having a family history of the condition. If you have an aunt, sister, daughter, mother, or friend with endometriosis, your risk is 7 to 10 times more than that of those without a family history of the condition [7].
Another notable cofactor is early age at menarche and a long and heavy menstrual cycle – all characteristics associated with prolonged exposure to menstruation and a heightened risk for endometriosis [7, 8].
Additionally, alcohol consumption, oral contraceptive use and environmental factors such as polychlorinated biphenyls and dioxin are risk factors for endometriosis [8].
Additionally, dietary habits play a role. Increased risk has been linked to consuming products rich in transunsaturated fatty acids, fats in general, red meat, and alcohol [9].
Immune system disorders can also increase your disease risk. Lowered immunity, when the immune system doesn’t suppress misplaced endometrial tissue, could make you more likely to develop lesions, inflammation and scarring [7].
Genetic factors appear to be an important component of the risk: epidemiological studies have found that around half the risk of endometriosis is genetic [10].
Finally, various other reproductive health factors that might be associated with an increased level of exposure to menstruation (such as a reduced cycle length, longer duration of flow or reduced parity) are all associated with an increased risk of endometriosis [11].
Can You Die From Endometriosis?
Endometriosis is a condition where tissue similar to the lining of the uterus grows outside the uterus, often causing painful symptoms. However, it's important to note that endometriosis is not fatal.
Only in severe cases, endometriosis can ultimately result in fatal consequences, if not properly addressed. There is a slight chance that endometriosis may obstruct blood flow to the intestines. Bowel perforation can result when left untreated, and a lack of blood supply to the intestine can lead to fatal consequences [12].
Another potentially fatal complication is an ectopic pregnancy, which occurs when a fertilised egg implants in the womb outside the vagina, usually in the fallopian tube. This can rupture it and cause internal bleeding [12].
But in fact, these complications are both uncommon and effectively treatable. Notably, a study reported that women with histologically verified endometriosis had lower all-cause and cause-specific mortality rates than a reference cohort – including lower mortality for cancer and heart disease [13].
In conclusion, although endometriosis can cause serious complications, such as infertility, it usually isn’t a life-threatening disease. If you have endometriosis and experience severe symptoms, it is advised to seek medical attention as soon as possible.