March is dedicated to raising awareness about endometriosis, a condition that affects 1 in 10 women worldwide. Endometriosis is often misunderstood and underdiagnosed, leading to years of pain and frustration for those affected. This month, let's break the silence, spread awareness, and support those living with this chronic, inflammatory condition.

Endometriosis is a chronic, inflammatory condition where tissue resembling the endometrium (the lining of the uterus) grows outside the uterus, often affecting the ovaries, fallopian tubes, and pelvic tissues. This misplaced tissue behaves like the tissue inside the uterus: it thickens, breaks down, and bleeds during each menstrual cycle. However, unlike the normal menstrual flow, this blood has nowhere to go, causing inflammation, pain, and the formation of scar tissue (adhesions).

Many people think endometriosis only affects the reproductive system. However, endo is a systemic condition that can impact various parts of the body, causing a wide range of symptoms:

• Nervous System: Chronic pain & fatigue due to nerve pathway involvement.
• Muscles & Joints: Chronic inflammation leading to stiffness and pain.
• Gut Health: IBS-like symptoms, including bloating, constipation, and diarrhea.
• Immune & Endocrine System: Autoimmune-like reactions, systemic inflammation, and hormonal imbalances.

Fertility struggles are often what bring attention to endometriosis. When endometrial tissue grows around the ovaries and fallopian tubes, it can impact egg quality, ovulation, and the ability of sperm to meet the egg. Even mild endometriosis can affect fertility, leading to a longer-than-usual TTC (trying to conceive) period. However, many women with mild to moderate endometriosis can successfully conceive and carry a pregnancy to term with early diagnosis and the right treatment.

Emerging research shows a connection between endometriosis and microbiome dysbiosis (microbial imbalance). Patients with endometriosis often exhibit decreased levels of beneficial bacteria such as Lactobacillus and increased levels of potentially harmful microbes like E. coli, Enterococcus, Streptococcus, Gardnerella, and Ureaplasma.

Microbiome imbalances may contribute to endometriosis progression by:

• Triggering inflammatory responses: Harmful bacteria can cause inflammation, worsening symptoms.
• Compromising mucosal barriers: Weakening the body's defenses, making it more vulnerable to infection and inflammation.

Despite the significant impact endometriosis can have on a woman’s health, it often takes 7-10 years to receive a diagnosis due to factors such as misdiagnosis, lack of awareness, and the need for invasive diagnostic procedures like laparoscopy.

Awareness is key to improving the diagnosis and treatment of endometriosis. By spreading knowledge, we can encourage women to seek medical advice, learn about their microbiome health, and advocate for better care.

While there is no cure for endometriosis, early diagnosis and a comprehensive approach to treatment can significantly improve quality of life. Understanding the connection between endometriosis, inflammation, and the microbiome may lead to better treatments and outcomes for those affected.

March is Endometriosis Awareness Month – let’s break the silence and ensure that more women get the care they need.