Current DateOctober 25, 2021

Endometriosis: symptoms, risks, and treatment

In women with endometriosis, getting a good night’s sleep can become a luxury. Knowing what helps and which food is best suited is important to improve your chances of sleeping well.

What is endometriosis?

Endometriosis is a chronic disease in which tissues of the lining of the uterus settle outside the uterus. These foci of endometriosis usually occur in the abdomen on the ovaries, intestines, or bladder. Because this tissue behaves in the same way as the lining of the uterus, the foci of endometriosis grow in the first half of the menstrual cycle to be repelled at the end of the cycle. This can lead to severe pain and inflammation.

If the ovaries are affected, fertility is often restricted. If the intestine or bladder are affected, there may be problems with bowel movements or urination. Affected women suffer from exhaustion, depression, irritability, insomnia, pain in the lower back and abdomen.

Endometriosis symptoms

The symptoms of endometriosis differ per woman. The degree of endometriosis says nothing about the symptoms. Mild endometriosis with serious complaints and severe endometriosis with minor complaints can both occur. The place where the endometriosis is located in the body determines the complaints. In addition to physical complaints, many women also suffer from psychological complaints as a result of this condition.

Therefore, which complaints you get depends on the place where the mucous membrane of the uterus is located outside the uterus. Due to the many and different symptoms, endometriosis is difficult to recognize and it sometimes takes years before the correct diagnosis can be made.

The most common symptoms of endometriosis are:

  • Extreme menstrual pain
  • Pelvic pain
  • Painful sexual intercourse
  • Infertility
  • Fatigue
  • Bloating, diarrhea or constipation around the time menstruation
  • Painful or difficult bowel movements around the time menstruation
  • Pain when urinating around the time menstruation
  • Presence of blood in the urine around the time menstruation
  • Rectal bleeding around the time menstruation
  • Shoulder pain around the time menstruation
  • Psychological complaints
  • Other symptoms surrounding menstruation

If you experience one or more of these symptoms and if you suffer from them a lot, we recommend visiting your general practitioner or specialist to determine if you have endometriosis.

Risks factors for endometriosis

A number of factors increase the risk of endometriosis:

  • Irregular and strong menstruation
  • Pain in the pelvic floor
  • Miscarriages
  • Endometriosis in relatives
  • Poor sleep: endometriosis is often associated with poor sleep. Both falling asleep and staying asleep is a problem for affected women.

Did you know that women who are physically active for more than three hours a week and eat a lot of dairy products are less likely to suffer from endometriosis?

The fact that the disease also affects the night’s rest is very unpleasant. After all, sleep is an indispensable process that also promotes healing. The link between endometriosis, sleep, and pain has been clearly demonstrated in studies. For this reason, sufferers experience depressive moods more often.

Endometriosis Treatment

Treatment for endometriosis involves prescribing drugs to block the production of female hormones, and surgery to remove the lesions. It varies depending on the organs affected by the endometrial fragments present in the abdomen. It is adapted to each case and can therefore vary considerably between patients. 

The management of endometriosis must be carried out by multidisciplinary teams and must be individualized according to the symptoms and patient expectations.

Drug Treatment

In addition to analgesics, intended to relieve painful symptoms, your doctor may prescribe hormone therapy to reduce the level of estrogen in the blood, in order to block the proliferation and bleeding of the endometriosis lesions.

If you are not looking to get pregnant, the treatment of endometriosis most likely will be based on a hormonal treatment by estrogen-progestogen contraception (pill) or by the insertion of a hormonal IUD, delivering levonorgestrel.

Long-term use of NSAIDs ( nonsteroidal anti-inflammatory drugs such as ibuprofen or ketoprofen) should be avoided due to significant gastric and renal side effects. 

Acupuncture, osteopathy, or yoga have shown an improvement in the quality of life and can is often recommended in addition to the medical management of endometriosis.

When the hormonal pill or IUD is insufficient to control the symptoms, your doctor may prescribe GnRH analogs (Gonadotropin-releasing hormone analogs, hormones that stimulate the ovaries). In this case, these drugs must be combined with progestogen and estrogen to prevent the risk of osteoporosis.

Endometriosis Surgery

If the endometriosis is severe and drug treatment insufficient, or if the lesions result in infertility or potentially serious consequences, it may be necessary to remove cysts and adhesions caused by endometrial fragments present in the abdominal cavity.

Surgical treatment for endometriosis can be “conservative ” (when lesions are removed without removing an organ) or “total ” (when the surgeon removes the uterus and ovaries). Only total surgery definitively cures endometriosis. 

After a conservative surgery, recurrences are possible in a few months or a few years, until menopause. Surgical techniques vary and have improved a lot in recent years.

How to sleep better with Endometriosis

The importance Melatonin

Of course, the sleep hormone melatonin plays a role. Changes in melatonin levels affect not only the sleep-wake rhythm and thus sleep, but also fertility. In addition, melatonin is an important pain inhibitor, has an antioxidant effect, and regulates the immune system.

In one study, participants with endometriosis consumed foods that stimulate the production of melatonin. These include foods rich in tryptophan such as dairy products, oats, almonds, peanuts, walnuts, cashews, soybeans, bananas, cherries, salmon, and tuna. Spices such as coriander and cardamom are also rich in tryptophan and have a sleep-promoting effect.

Tryptophan promotes good sleep

The consumption of foods rich in tryptophan was lower in studies in women with endometriosis. And that was clearly related to all the complaints reported by the participants. Lifestyle factors such as smoking, and exercise also had a clear influence on the disease.

Foods that promote sleep when you have endometriosis

  • Dairy products
  • Fish
  • Nuts
  • Bananas
  • Beans
  • Rice
  • Cherries
  • Sour cherry juice
  • Oats and whole grains
  • Tomatoes
  • Chickpeas
  • Kale and green leafy vegetables

Carbohydrates and calcium promote sleep

Carbohydrates such as rice, bread, and potatoes positively affect the formation of tryptophan in the body and improve the quality of sleep. The combination of carbohydrates or tryptophan with healthy fats also promotes sleep, according to studies. Carbohydrate-rich foods with a high glycemic index, such as jasmine rice, helped patients fall asleep faster in one study.

According to studies, sufficient calcium is important for normal REM sleep. If this sleep phase is disturbed, a lack of recovery and lower performance are the result. Vitamin B6 and magnesium are also important for a good night’s sleep. Even a small magnesium deficiency disturbed the quality of sleep in studies. Overall, a healthy lifestyle in any case also promotes the discomfort of endometriosis.

Last Words

Endometriosis is characterized by the presence of abnormal endometrial fragments. Normally, when the egg is not fertilized, the endometrial cells that line the uterus are shed during menstruation and replenished afterward. In endometriosis, these cells are not evacuated properly, spreading and proliferating in unusual areas of the body. 

The most frequent localizations of endometriosis are the ovaries with the formation of cysts, the tubes, the peritoneum, the areas between the bladder, the uterus, and the vagina, and those between the vagina and the rectum. At the time of menstruation, the cells will come off and cause an inflammatory reaction, responsible for severe pain. 

Women can suffer from symptoms that vary depending on the location of the cells: abdominal pain most often, but also digestive pain.

If you recognize yourself in the symptoms mentioned above, please do not hesitate to contact your doctor for a proper diagnosis.