10 Facts About Endometriosis

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Eye-popping pain. Bloating. Heavy periods. Infertility. These are all symptoms of endometriosis, a chronic ailment that is believed to affect up to one in 10 women between the ages of 15 and 49. It can also take a serious toll on patients' mental health. Here's what you need to know about this condition.

1. THE NAME DOESN'T REVEAL MUCH ABOUT THE CONDITION.

Endometriosis, or endo, for short, gets its name from endometrium—the thin layer of tissue that lines a woman's uterus. "Endo is a condition in which endometrial-like tissue grows outside of the uterus, typically in the pelvic area," says Kristin Patzkowsky, M.D., an assistant professor of gynecology and obstetrics at the Johns Hopkins University School of Medicine. Common sites for endometrial growths, called lesions, include the ovaries, fallopian tubes, outer surface of the uterus, and the ligaments and other tissues that hold the uterus in place. The number of lesions can vary and range in size from a few millimeters to grapefruit-size.

2. DOCTORS AREN'T SURE WHAT CAUSES ENDOMETRIOSIS.

The most widely accepted view is that endometrial tissue relocates to other parts of the body during a woman's period. Here's a quick review of the female reproductive cycle: Each month, under the influence of the hormone estrogen, the endometrium thickens and swells in preparation for a potential pregnancy. If pregnancy doesn't occur, the endometrium sheds and flows out of the body. This bloody discharge is menstruation, commonly known as a period. But sometimes menstrual blood flows backward, passes through the fallopian tubes, and enters the pelvic cavity—what doctors call retrograde menstruation. This backward flow can carry endometrial tissue to places far afield of the uterus, such as the digestive tract, lungs, and even the brain. It's been proposed that these transplants set up shop in their new locations, where they continue to respond to the cyclical influences of estrogen by swelling and bleeding each month, and causing the pain associated with endo.

There's an issue, though: Almost all women experience retrograde menstruation, so according to Patzkowsky, doctors don't know why some get endo and others don't. Some researchers think an imbalance in reproductive hormones might be to blame, while others suggest that a faulty immune system—which would normally curb the growth of endometrial cells outside their normal locale—may be responsible. Risk factors for endo include long periods (more than seven days), short cycles (less than 27 days), and having a family member who has endo.

3. PAIN IS A CLASSIC SYMPTOM …

Some women with endo feel pain in the back or chest, and others experience discomfort during or after sex or have painful, heavy periods. Since the pelvic region serves as a crossroads for a variety of organ systems, discomfort when urinating or having bowel movements is common. Some endo sufferers have a concurrent—but not the same—condition called adenomyosis, in which endometrial tissues grow into the muscular wall of the uterus. Endo can also cause large painful cysts on a woman's ovaries, called endometriomas. Often called "chocolate cysts," due to their dark, chocolatey appearance, endometriomas are noncancerous, fluid-filled growths that typically form deep within the ovaries. Mysteriously, some women experience no pain at all, Patzkowsky says. One study found that nearly 90 percent of women with endo experience depression and anxiety. According to some mice studies, it's possible that endo reprograms the brain, making women more vulnerable to mental health problems—although other researchers think the depression and anxiety are more to do with the pain and fertility problems.

4. … AND SOME WOMEN CAN EVEN EXPERIENCE INFERTILITY.

As many as half of all infertile women have endo, and up to 50 percent of women with endo are infertile—but doctors aren't sure how the condition affects a woman's ability to get pregnant. Endo lesions can block or scar a woman's reproductive organs, making it harder for the egg and sperm to meet up, but it's also possible that the scarring prevents the endometrium from developing properly each month, preventing implantation. Other theories suggest that the inflammatory milieu that accompanies endo creates an unfavorable environment for pregnancy.

5. MANY WOMEN WITH ENDO GO UNDIAGNOSED.

Up to one in 10 of all pubescent girls and women worldwide have endo. In the U.S., that translates to some 6.5 million females of reproductive age. Some experts say the number is higher because many women go undiagnosed. That's because some women confuse the pain of endometriosis with normal period pain, and others just don't talk about it. On the other hand, "Not all menstrual pain is endo," Patzkowsky says.

6. THERE ARE SEVERAL WAYS TO LOOK FOR ENDO, BUT ONLY ONE WAY TO BE SURE.

The first step is usually a pelvic exam. The doctor will feel for cysts or areas of scar tissue behind a woman's uterus, in an area called the Pouch of Douglas, a common site of endometrial lesions. If the doctor suspects endo, an ultrasound or MRI will often provide more information. The only sure way to diagnose endo, however, is laparoscopy with biopsy—a minimally invasive surgical procedure that allows a doctor to view a woman's internal organs using a small camera and take tissue samples (biopsies) for testing. Laparoscopy is considered the gold standard of endo diagnosis.

Diagnosis also involves determining the stage of the disease based upon the location, size, and depth of the lesions; the presence and size of endometriomas in the ovaries; and the presence of scar tissue. Most women have mild scarring and only superficial lesions, indicating that they have minimal or mild endo. Women with endometriomas and more severe scarring have moderate or severe endometriosis.

In an odd twist, "The stages don’t necessarily correlate with the types of symptoms or degree of pain a woman experiences," Patzkowsky says. For some women, a further element of diagnosis is determining her likelihood of getting pregnant, using the Endometriosis Fertility Index [PDF], a scoring system that considers a woman's age, reproductive and infertility history, and endo severity to predict her chances of conceiving.

7. TREATMENTS AIM TO REDUCE THE SIZE OF THE LESIONS.

If a woman with endo doesn't want to get pregnant, her doctor might prescribe hormonal treatments to reduce the amount of estrogen in her body. Extended cycle and continuous cycle birth control methods reduce or eliminate the number of periods a woman has, blocking the cyclical effects of estrogen. If pregnancy is the goal, however, a woman's doctor might briefly prescribe gonadotropin-releasing hormone agonists—hormone-blocking drugs that induce a sort of temporary menopause that stops a woman's production of estrogen and can often decrease the size of endo lesions. The treatment period typically lasts several weeks to a few months. When the treatment ends, the woman's body will begin to produce estrogen again, providing her a brief window of time in which she has a chance of getting pregnant before the lesions return.

Surgery to remove endo lesions is also an option, but only in severe cases or in situations when a woman can't take hormonal therapies or hormones haven't been successful in the past.

8. ENDO IS COSTLY, AND NOT JUST IN DOLLARS.

Quality-of-life assessments don't accurately capture the toll endo takes on women: Findings from a 2011 study of more than 1400 women with endo found that women lost more than 11 hours of work each week chiefly due to reduced productivity (not absence). A second study, conducted in 2012, estimated that endo costs an affected woman more than $10,000 per year, comparable to diabetes, Crohn's disease, or rheumatoid arthritis. Endo also interferes with sexual pleasure and satisfaction.

9. AN ENDO DIAGNOSIS DOESN'T HAVE TO FEEL LIKE THE END OF THE WORLD.

Many women with endo lead full lives. Northern Irish politician Naomi Long and Australian swimmer Emily Seebohm, an Olympic gold medalist, have shared their personal trials with the condition. Women with endo get pregnant, too, and often have successful pregnancies. "Endo does not equal infertility," Patzkowsky says. Women with endo often find that support groups are helpful, and there's even an app (or two) to help. One advocacy group has organized a worldwide endo march to raise awareness of the disease and promote research.

10. NEW ENDO RESEARCH IS FOCUSED ON IDENTIFYING BIOMARKERS.

Future endo research is focused on not only furthering understanding of the causes and other aspects of the disease, but also on developing non-hormonal therapies to aid in treatment and identifying biomarkers—indicators in blood or easily accessible tissue samples—that can speed diagnosis. Some scientists liken endo to cancer because it has different subtypes that may have different causes, requiring an integrated approach to understanding the genetic, hormonal, metabolic, and molecular factors that influence endo development and progression.

6 Dreaded Tasks That Are Actually Great For Managing Stress

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High levels of the stress hormone cortisol can wreak havoc on your body. (According to a recent study on middle-aged adults, stress not only impairs memory but may even cause the brain to shrink!) Thankfully, some commonly dreaded activities can help reduce your frazzled state.

1. Washing the Dishes

According to a 2014 study published in the journal Mindfulness, a “mindful” approach to dishwashing could reduce stress. “A sample of 51 college students engaged in either a mindful or control dishwashing practice before completing measures of mindfulness, affect, and experience recall,” the study states. “Mindful dishwashers evidenced … increases in elements of positive affect (i.e., inspiration) [and] decreases in elements of negative affect (i.e., nervousness)." In other words, with the right mindset, zoning out in front of a sudsy sink is basically Nirvana.

2. Decluttering Your Home

Research suggests that clutter is more likely to stress out women. In 2010, a study in the Journal of Personality and Social Psychology looked to see how married couples dealt with (and felt about) messy homes [PDF]. “The wives in the study who perceived themselves as having a cluttered home or a home that needed work tended to have increased levels of cortisol throughout the day,” Emilie Le Beau Lucchesi wrote in The New York Times. "Those who weren’t feeling cluttered, which included most of the men in the study, had cortisol levels that tended to drop during the days.” So tidy up!

3. Exercising In A Group

Working out can feel like a chore, and exercising with a group can be a tad embarrassing—especially if you’re not on the same fitness level as everybody else. But according to research in the Journal of the American Osteopathic Association, exercising with a group is more beneficial at reducing stress than working out alone. “Researchers found that working out in a group lowers stress by 26 percent,” according to the press release. Go ahead and book that spin class!

4. Sniffing Your Partner’s Laundry

No sane person puts “sniff your significant other's dirty socks” on their to-do list, but perhaps they should. A 2018 study published in the Journal of Personality and Social Psychology shows that sniffing a loved one’s clothes can reduce stress. In the study, 96 women sniffed one of three scents—a neutral smell, their romantic partner’s scent, or the scent of a stranger. The stranger’s smell caused cortisol to spike. But their partner’s smell? It reduced stress.

5. Dwelling On Your Failures

The title of this study, which appeared in the journal Frontiers in 2018, says it all: “Writing About Past Failures Attenuates Cortisol Responses and Sustained Attention Deficits Following Psychosocial Stress.” According to the study, “[W]riting about a previous failure may allow an individual to experience a new stressor as less stressful, reducing its physiological and behavioral effects.” It sounds paradoxical, but the next time you're facing a crazy situation, just reflect on a time when it all went wrong—and things might not feel so bad.

6. Singing For All to Hear

For the shy and tone-deaf, singing in a group might be a anxiety-fueled nightmare—but they should try it anyway. A pilot study presented at the Society for Neuroscience conference last year showed that, in people with Parkinson's disease, singing in a group can reduce heart rate, blood pressure, and cortisol levels. (Researchers cautioned that this is preliminary data.) The findings jibe with a 2016 study from Drexel University that found, no matter your skill level, making art usually reduces cortisol levels [PDF].

Nearly Half of American Adults Don't Know Their Own Blood Type

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If you know your blood type, you’re better off than nearly half of Americans. Of the 1004 adults in the U.S. who answered a recent Quest Diagnostics survey, only 57 percent said they knew whether they have type A, B, AB, or O blood.

This is roughly the same number of people who could recall their childhood phone number (55 percent), the survey revealed. By comparison, 74 percent of respondents remembered their lengthy Wi-Fi password, and 75 percent knew how much money was in their bank account.

For many, other personal health information was even murkier. Fewer than two in five people knew their cholesterol or blood sugar levels. Considering that these details provide important insights into one’s risk for certain diseases, survey administrators said this is a cause for concern.

“With consumers increasingly engaged in their own and their loved ones’ health care, it’s critical that they ‘know their numbers’—and have those numbers readily accessible—to ensure productive communication with their healthcare provider for both routine and critical care,” Cathy Doherty of Quest Diagnostics said in a press release.

With the exception of emergencies, at which time you may receive a universal donor's O-negative blood, doctors will almost always conduct blood typing and cross-matching tests to determine your blood type and identify minor antigens in your blood before conducting a transfusion or surgery.

It’s still important to know your blood type for other reasons. Newborn babies, for example, can develop hemolytic disease if their Rh blood type (meaning whether it's positive or negative) doesn’t match their mother's. And depending on your blood type, you may also have an increased risk for blood clots, heart disease, certain types of cancer, and even severe diarrhea and mosquito bites.

If you know your blood type, you’re also in a better position to donate blood and help people in need if there’s a natural disease or emergency, or if blood banks simply have a low supply. O blood tends to be the highest in demand (and O-positive is the most common blood type), but blood banks may issue public notices from time to time if they need a particular type.

If you’re unsure of your blood type, clinical labs like Quest Diagnostics offer blood type tests. You can also order test kits online from Amazon.

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