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This first chapter about endometriosis (endo) discusses what is currently taught in medical schools about endo, and what most doctors still believe. A new section of this chapter has been added to cover the newest drugs used for treatment. Finally, the most recent addition to the first chapter is the latest information on the link between endometriosis and environmental contaminants. Four years ago, I became aware of the intriguing new ideas of Dr. David Redwine which are presented in the second chapter on endo. Out of necessity another section has also been added that outlines a natural approach to treatment.

In 1600 BC Egyptian writings documented possibly the first case of endometriosis ever recorded in history. However, endometriosis is really a 20th century phenomenon. In the past, endometriosis was either rare or undiagnosed, and modern medicine has only recognized it as a disease entity for the last 100 years. During the last century, endometriosis has risen steadily in importance and incidence. It's now a major cause of pain and disability in women and may be linked to infertility. Yet, in spite of over 80 years of research, very little is known about this disease, what causes it or why it does or does not respond to treatment.

For women, it can be a frustrating, chronic, often painful and unpredictable disease, with no ideal treatment and no cure except perhaps menopause. This disease varies markedly in its extent and behaviour. Some women obtain pain relief and fertility enhancement through surgery and/or hormonal treatments. Others do not.

Endo is normal tissue in an abnormal location. It occurs when some of the tissue that normally lines the inside of the uterus, called the endometrium, grows in parts of the body where it doesn't normally grow. This happens most commonly in the pelvic area, ovaries, tubes, ligaments, outside surface of the uterus, lower end of the large bowel, and on the membranes covering the bladder. Occasionally, endometrial tissue spreads to the small intestines, appendix, bladder, ureters, cervix, vagina, old abdominal scars and navel; and very rarely, to the lungs.

In a strange way, endo behaves like a benign tumour. It can spread, invade and distort otherwise normal tissue. In fact, it acts just like normal placental tissues as they burrow their way into the inner wall of the uterus to set up a nourishment system for the fetus.

According to a widely held theory, these abnormally located tissues are just like those that line the uterus and therefore build up and bleed every menstrual period. Since the blood has no way to leave the body as menstrual blood normally does, it can cause internal bleeding, irritation, and inflammation and the formation of cysts and scar tissue.

If you were able to look inside the pelvis of a woman who has endo, you would most likely see endometrial implants on the ovaries. (40-50 percent of implants occur on the ovaries and tubes.) These implants would look like cysts varying from tiny bluish or dark brown blisters to large chocolate cysts (so called because they are filled with dark clotted blood) up to 20 cm or eight inches in diameter.

You might also see tiny blueberry spots or black spots (so called "powder burns") on the back side of the uterus, on the ligaments supporting the uterus, or on the membrane lining the abdominal cavity or on the lower portion of the large bowel. There might also be scarring in the surrounding tissues and the uterus might be fixed and immobile.

Symptoms Of Endo

In medical school, we were taught that endo begins as increasingly painful periods. The pain was described as a deep seated aching or bearing down or grinding type of pain located in the lower abdomen, vagina and back. The pain was said to be more marked on one side than the other and constant in nature rather than intermittent. According to what we were taught, the pain characteristically started five to seven days before the period, reached a peak at the time of the heaviest flow, and continued with decreasing intensity throughout the whole period and even for a few days afterwards. Then the pain would not reoccur until just before the next period.