In this contributed article, Marianne Downing, Pharmacist at Inish Pharmacy, discusses a common yet hidden condition affecting women worldwide.
It’s 6pm on a Monday evening in March and my phone rings. It is my good friend, Ali, who lives in Leeds. Strange – I wasn’t expecting a call from her (we’d usually have to get the diaries out to schedule a call these days!). I knew there was something wrong. Sobbing through her tears, she explained she had been sent home from A+E after waiting 8 hours with excruciating abdominal pain…with no answers. So severe, she was crippled over, vomiting, and crying for help. Describing it as “A category 5 hurricane inside my body”.
What was later to be provisionally diagnosed by her GP…Endometriosis.
This is not a rare incident. Globally, endometriosis affects 10% (approx. 190 million) of those with a womb of reproductive age according to the World Health Organisation. It can affect anyone with a menstrual cycle. It is an oestrogen-dependent inflammatory condition that is chronic, progressive, and debilitating. The impact on mental health and quality of life is unmeasurable, with disruption to school, work, relationships, and future fertility.
So, what is going on? In a healthy uterus (also referred to as endometrium), the inner layer consists of endometrial cells that are contained within the womb. They contract and bleed when certain hormones are released during menstruation. It is these contractions that cause your typical period pain. In endometriosis sufferers, endometrial-like tissues are found outside the uterus i.e in places they shouldn’t be. These tissues are typically found in the pelvis, ovaries, and fallopian tubes. These tissues respond to the circulating hormones the same way, causing bleeding, inflammation, and scar tissue formation. Some even migrate further afield to the bladder and abdominal cavity resulting in painful urination and bowel movements.
While the exact cause of endometriosis is not fully understood, there are several theories that have been proposed which can be found as follows:
- Your horoscope isn’t in retrograde, but your menstruation could be! One theory is called retrograde menstruation. You know when you have your period and the blood flows out of your body? Well, sometimes that blood can flow back through the fallopian tubes and into your pelvic cavity. And, if that blood has endometrial cells in it (which it often does), those cells can start growing in places they shouldn’t, causing endometriosis. How sneaky!
- Your immune system might be taking a nap on the job! Your immune system is responsible for keeping things in check and fighting off viruses and bacteria. But sometimes, it might not recognize endometrial cells that have migrated outside of your uterus and fail to destroy them. This could allow these cells to grow and develop into endometriosis.
- Growing during foetal development! When you were growing inside your mum’s uterus, your reproductive organs were developing too. Sometimes, small bits of tissue get left behind during this process, and these bits of tissue can later develop into endometrial tissue outside of your uterus, causing endometriosis.
Severity of Pain
Most people who have menstrual cycles have experienced some degree of pain – but how much is too much? Endometriosis is characterised by intense pain. The most common symptoms include extremely painful periods (not necessarily heavier), chronic stabbing pelvic pain and severe stomach cramps. Diarrhoea and constipation are also usually experienced, as well as pain during sexual intercourse, mostly felt deep within the pelvis.
Due to the overlapping symptoms with other conditions, endometriosis is often left undiagnosed for years, with an estimated 9 years from first symptom presentation to diagnosis.
Endometriosis can impact fertility, with up to 50% of women experiencing difficulties getting pregnant due to scarring, inflammation, and organ damage. However, not all women will experience fertility problems, and many are able to conceive naturally or with fertility treatments. Treatment options may include fertility medications, assisted reproductive technologies, or surgery.
Sadly, there is currently no cure for endometriosis but don’t worry, there are plenty of treatments available to help manage these symptoms and make life a little more comfortable.
Let’s dive in and explore some interesting ways you can manage your endometriosis through the pharmacy!
First up, let’s talk about one of the simplest and most effective treatments for endometriosis –heat therapy. Heat helps to increase blood flow to the affected area, reducing pain and discomfort. This can be done by using a heating pad, a hot water bottle, or even taking a warm bath. But why not make heat therapy a little more fun by treating yourself to POPMASK Big Hug Self-Heating Patches– a pack of 5 cute and colourful heating pads. Simply stick the patch onto clothing or underwear in your chosen position and feel the gentle warmth all day or all night long for up to 12hrs!
The most well-known treatment option to ease endometriosis symptoms is over-the-counter pain relief medications- paracetamol and/or ibuprofen (NSAIDs). They both work, albeit in different ways, to block prostaglandin production, which are chemicals that cause pain and inflammation, thus reducing it. It is recommended that NSAIDs should be taken a day or two ahead of the expected pain/period, as they work best before the body produces prostaglandins. But remember, always take as directed and consult your pharmacist or healthcare provider to determine the best course of action for you.
Supplements have entered the chat…
Changes to diet and lifestyle can play a major role, also, in maintaining and improving symptoms for endometriosis sufferers. One study found women who ate green vegetables at least twice daily were 70% less likely to suffer from the condition. Sometimes, we don’t receive enough vital vitamins and minerals in our diet for whatever reason, therefore, supplements can be a great alternative.
So, let’s add a little spice to our endometriosis management game with turmeric! Turmeric, with its active ingredient curcumin, has potent anti-inflammatory properties that can help reduce pain and inflammation associated with endometriosis. In fact, one study found a dose-dependent decrease in the number of endometrial-like cells. So, say hello to the world’s first turmeric supplement in oral spray form, with the convenient and delicious BetterYou Turmeric Oral Spray, receiving the recommended daily dose in a few sprays. BetterYou has created Cyclocurmin, a unique encapsulation potent turmeric extract formulation, that easily and quickly absorbs into the soft tissue of the mouth and blood system within minutes.
Well, how about we add a little pizzazz to our supplement game with Magnesium– the ultimate muscle-relaxing, and pain-fighting essential mineral! There is evidence endometriosis sufferers’ fallopian tubes contract irregularly and more spasmodically, so the impressive powers of AYA Magnesium 150mg Tablets with B6 can help alleviate the painful cramps and inflammation associated with these contractions, as well as improve your mood and energy levels. However, as with any supplement, it’s essential to use magnesium responsibly and under the guidance of a healthcare provider. Overconsumption of magnesium can lead to adverse effects, such as diarrhoea, nausea, and cardiac arrest in severe cases.
Hormonal contraception (which can be prescribed by your doctor)
Hormonal birth control is often recommended for women with endometriosis as not only do they help prevent pregnancy, but it can also help reduce pain, regulate periods, and prevent the growth of endometrial tissue. But not all contraception is created equal with many different options available for endometriosis sufferers, so make sure to talk to your doctor and pharmacist about which one might be right for you.
Finally, for those with moderate to severe symptoms or who have not responded well to other treatments, surgery is an effective treatment for endometriosis. Laparoscopy is the most common type of surgery, while laparotomy and hysterectomy are more invasive options. It’s important to consider the potential risks and benefits of surgery, as well as understand endometriosis can recur after the procedure.
In conclusion, if you’re living with endometriosis, know that you’re not alone! You may experience painful periods, fatigue, and difficulty conceiving, but it’s essential to seek help and talk to family and friends. And, if you’re feeling overwhelmed, pharmacists are here to help. We’re easily accessible and always happy to talk. You can visit us in person or give us a call, and we’ll provide advice and recommendations tailored to your needs.
Remember, seeking help is a sign of strength, not weakness.
**EVERYONE HAS UNIQUE HEALTH NEEDS AND CIRCUMSTANCES SO ALWAYS CONSULT YOUR DOCTOR OR PHARMACIST BEFORE STARTING ANY NEW MEDICATION OR SUPPLEMENT**
Inish Pharmacy comprises three independently owned community pharmacies serving Inishowen, and worldwide via Ireland’s best online pharmacy website, inishpharmacy.com. Visit the stores in Buncrana, Muff and Carndonagh for a full range of pharmacy services including dispensing of prescriptions and advice, over the counter products and great offers on toiletries, cosmetics and health related products in store.