DRHOOK- Womb woe: Periodic disorder painful, hard to cure

Cloris Leachman is very funny. High Anxiety proved it. Remember those pointy breasts as Nurse Diesel? Still, I didn't know how raunchy she could be until I saw her roast Bob Saget. Oooh, child! 

Then she kept the censors for Dancing with the Stars jumping every time she was on air this past season because they didn't know what obscene, profane thing would come out of her. She was like Madonna on Letterman times four.

Cloris is 82 years old with many medical problems (as she mentioned on the first Dancing episode), but she moved as long as the young and vibrant Julianne Hough. It goes to show that age has nothing to do with perseverance. Hough, the professional dancer, was taken out by surgery for endometriosis. But then, as it's a competitive show, Lacey Schwimmer also announced she has endometriosis!

Is endometriosis that common?

Five million American women have endometriosis. Actually, it's hard to say how many really do because quite a few have it but don't have symptoms. For example, up to seven percent of women who are getting their tubes tied are found to have endometriosis. 

On the other hand, nearly half of all teenage girls with chronic pelvic pain or menstrual problems are found to have endometriosis during exploratory laparoscopy.

Endometriosis is a weird disorder because we aren't really sure how the endometrial tissue (normally found within the uterus) ends up outside the uterus. Maybe it migrates out through the Fallopian tubes? It might just develop within the pelvis and abdomen because of cells "transforming" into endometrial tissue. It could be from altered immune cells because endometriosis is associated with autoimmune inflammatory disease, hypothyroidism, fibromyalgia, and allergies.

We all hate pain– and that's the main issue, especially during the menstrual period, because bleeding occurs not only in the uterus but also wherever the tissue might migrate: ovaries, around the appendix (like Julianne Hough), sigmoid colon– but also really anywhere including the breasts, arms, legs, lungs, and spine. 

Cases of bruises under the skin have been attributed to endometrial tissue there! 

Pain is most common in the pelvis, and it can mimic Pelvic Inflammatory Disease (PID)– except there is no evidence of a sexually transmitted disease. For some, the pain is continuous, not occurring only during menstrual periods, making everyday a Midol day. 

More than pain, endometriosis is associated with infertility, discomfort during sex, and chronic fatigue. Because adhesions can occur (like scar tissue connecting internal tissues and organs), there can be bowel and bladder problems. 

Endometriosis occurs almost exclusively in females of reproductive years because endometrial tissue thrives on ovarian hormones. It seems to attack tall thin women in their mid-20s to mid-30s. Delayed pregnancy appears to be a risk factor, so professional women appear to have endometriosis more.

Surgery is the only cure because the tissue must be removed. When I was a medical student, I saw cases of endometriosis within the abdominal cavity and attached to different organs. But it was like mining for silver, because it's impossible to search every inch for endometrial tissue. 

How do you know if you get it all? How do you know that more won't grow elsewhere? Ultrasound and MRI can locate endometriosis regions, but often a woman with endometriosis will need more than one laparoscopy.

Hopefully with the growing awareness of endometriosis, there will be more research to find out the cause and the cure. We need to see our Dancing with the Stars ladies kicking, spinning, and jumping to the music– not in response to pain.

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Dr. Hook cracks a joke or two, but he's a renowned physician with a local practice. Email him with your questions.

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