Endometriosis: The Silent Disorder

Endometriosis is an often painful disorder in which tissue similar to the tissue that normally lines the inside of your uterus — the endometrium — grows outside your uterus. Endometriosis most commonly involves your ovaries, fallopian tubes and the tissue lining your pelvis. Endometrial tissue may spread beyond pelvic organs in some cases.

Endometrial growths, much like the lining inside the uterus during menstruation, may also become inflamed and bleed, causing the tissue to remain trapped in the body. It can further lead to the growth of scar tissue, as well as cause adhesions of fibrous tissue sticking together.

Endometriosis is a problem more women suffer from than any of us realize. Many women suffer in silence, and even more women suffer without really knowing what is wrong. It affects 1 in 10 women and is a painful disease affecting women in their reproductive years and can lead to infertility.

As an endometriosis warrior myself, I can definitely say that endometriosis affected me emotionally, in my case, not just because of the constant pain but also because it is unbearable pain that no one can see, and because endometriosis is not very commonly known amongst women and people in general, I sometimes felt that people did not take me seriously, which was a very isolating experience in an already vulnerable state.

“Pain is the most common symptom, and women with endometriosis may experience many different levels of pain.”, says Dr Hanelie Pienaar of Wilgers Life Hospital, a specialist gynecologist with a special interest in endometriosis.

Other symptoms may include:

  • Very painful menstrual cramps. The pain may get worse over time.
  • Chronic (long-term) pain in the lower back and pelvis
  • Pain during or after sex. This is usually described as a “deep” pain and is different from pain felt at the entrance to the vagina when penetration begins.
  • Intestinal pain
  • Painful bowel movements or pain when urinating during menstrual periods. In rare cases, you may also find blood in your stool or urine.
  • Bleeding or spotting between menstrual periods.
  • Infertility, or not being able to get pregnant.
  • Stomach (digestive) problems. These include diarrhea, constipation, bloating, or nausea, especially during menstrual periods.

Although the exact cause of endometriosis is not certain, possible explanations include:

  • Retrograde menstruation. In retrograde menstruation, menstrual blood containing endometrial cells flows back through the fallopian tubes and into the pelvic cavity instead of out of the body. These endometrial cells stick to the pelvic walls and surfaces of pelvic organs, where they grow and continue to thicken and bleed over the course of each menstrual cycle.
  • Transformation of peritoneal cells. In what is known as the “induction theory,” experts propose that hormones or immune factors promote transformation of peritoneal cells — cells that line the inner side of your abdomen — into endometrial-like cells.
  • Embryonic cell transformation. Hormones such as estrogen may transform embryonic cells — cells in the earliest stages of development — into endometrial-like cell implants during puberty.
  • Surgical scar implantation. After a surgery, such as a hysterectomy or C-section, endometrial cells may attach to a surgical incision.
  • Endometrial cell transport. The blood vessels or tissue fluid (lymphatic) system may transport endometrial cells to other parts of the body.
  • Immune system disorder. A problem with the immune system may make the body unable to recognize and destroy endometrial-like tissue that’s growing outside the uterus.

Treatment options

Not all treatments work well for all women with endometriosis. Also, endometriosis symptoms may return after the treatment is stopped or, in the case of surgery, as more time passes after the procedure.

Some treatment to relieve pain may include hormone therapy, pain medications, surgical treatments, certain massages to relieve stress and inflammation, and pelvic floor physiotherapy. There is also other at home treatments like a hot water bottle, following a healthy balanced diet etc

According to Margarita Loannou, Spa operations manager from Legacy Balance Spa Group South Africa, the Muscle Ease Treatment that is available at The Leonardo Spa is an ultra-relaxing treatment, with its gentle warmth and fragrant scent of lavender flowers that helps you gently reduce stress and ease pain. With a combination of light strokes, pressure and stretching, this very original body massage using Thai-inspired warm pouches filled with lavender flowers, eliminates tension knots one by one and restores balance to the whole body.

Living with chronic pain, especially of such a sensitive nature can take a toll on your emotional state, leading to stress, anxiety, and depression, therefore if you are struggling with your diagnosis, please seek professional help. There are also support groups both online and physically where you will find information, as well as other women who share your experience so that you do not have to feel alone.

Endo Warriors South Africa NPC: https://www.facebook.com/endowarrior/

South African Endometriosis Support: https://www.facebook.com/groups/1319002964863357/


  • Dr Hanelie Pienaar
  • Dr Isabel Deist
  • Margarita Loannou from Legacy Balance Spa Group South Africa
  • Mayo Clinic


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