Correcting a very common myth - Endometriosis does NOT bleed and shed!

[Arcadia-77]

Hi all,

I thought I would share this and hope some of you find it interesting - I did!

As I'm sure you are all aware there are just soooo many myths about Endo especially online. This particular one about endometriosis being exactly the same as endometrium (the lining of the womb) and bleeding during your cycle etc, is used in many places to describe what the condition Endometrisosis is - when it actually isn't even factually correct!

This article was written by Endometriosis Researcher Libby Hopton (who is the Director of Research and Evidence Based Medicine at Vital Health Institute) Libby has collaborated with World renowned Endometriosis specialist Dr David Redwine on several projects including their great informative website endopaedia.info/

"Does endometriosis bleed and shed?

Endometriosis is not the same as endometrium (the tissue that lines the uterus). While endometriosis is more similar to endometrium than any other tissue in the body, they are both different in many ways. One difference is that while endometrium has a basement membrane with a blood supply allowing it to bleed and shed each month, endometriosis does not and therefore can neither bleed nor shed. The chemicals released by the endometriotic glands seen in endometriosis can cause changes in the surrounding tissue. One such change is the growth of new blood vessels in the tissue surrounding the endometriosis (angiogenesis). This does not however happen in all cases and does not actually innervate the endometriotic tissue. Another change that may happen as a result of the chemicals released is that the surrounding blood vessels may rupture and bleed. The pattern of bleeding may change with fluctuations in hormone levels although not necessarily in a strict predictable fashion. This is because endometriotic tissue contains hormone receptors but these receptors do not respond in the same predictable fashion as the hormone receptors in native endometrium.

So..... endometriosis does not bleed and does not shed and disease is not spread from one site to another. But, the glands in this tissue do secrete chemicals that trigger an immune response causing inflammation. Inflammation is a process whereby the blood supply to the site of disease increases. The blood vessels surrounding the lesions of endometriosis become engorged and vasodilate (they get bigger). This can cause little blood vessels to haemorrhage (rupture) and bleeding occurs. Not all lesions are associated with bleeding.

What you'll find in a lot of info on-line is that the author mistakenly assumes that endometriosis is exactly the same as endometrium and therefore their thought process logically brings them to the idea that endometriosis also behaves exactly like endometrium... i.e. that it has a blood supply, that it bleeds and sheds each month and that at menopause the tissue always atrophies and no longer causes any problems. But this is not the case and we know this based on numerous scientific articles identifying differences between endometrium and endometriosis and documenting symptoms of endometriosis and histological findings in women in natural, surgical and medical menopause."

[janeingirona]

Is this the same for adenomyosis?

Or does the fact that it's uterine mean it is endometriotic tissue that has infiltrated the deeper muscle layer (as us the accepted belief)?

If it'ss the latter, then menopause could give relief, right (since the endometrium is regulated by hormones) I've heard that adenomyomas can produce their own oestrogen but if there are lower levels to kick-start the process surely the adenomyoma is less likely to react.

I recently spoke to a highly respected endo specialist in Spain who said menopause would end my misery. And yet I know that others say otherwise (Dr Redwine's take was that insome cases menopause helps).

Does anyone know the science behind to help me understand and make a more informed decision?

Adenomyosis is definitely endo's poor relation; so little info and I think it's because there's the idea that hyster will solve all problems!

[Arcadia-77 in reply to janeingirona]

Hi janeingirona - Sorry I'm unsure about Adenomyosis as you say there is so little information about it available too, extremely frustrating for sufferers.

[Arcadia-77]

Clearly not well understood:

endometriosis-uk.org/unders...

patient.info/health/endomet... (several of us have been in consultations where GP's use this site....)

rcog.org.uk/en/patients/pat...

netdoctor.co.uk/diseases/fa...

Just to name a few!