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July 31, 2008 at 11:52 AMComments: 2 Faves: 0

Why Does Endometriosis Cause Fatigue?

By Smarty More Blogs by This Author

Endometriosis is a chronic and somewhat mysterious disease that affects over 5 million American women and an estimated 89 million women worldwide. It involves the growth of endometrium - a special kind tissue found only in the mammalian uterus - in places other than the uterus. Symptoms are often most pronounced during menstruation, usually affecting women between the ages of 25 and 40.

Symptoms of Endometriosis

The endometrium is a unique tissue. In response to hormones, it grows tissue and blood vessels to prepare for the implantation of a fertilized egg. If an egg doesn't get fertilized, the endometrium breaks down and menstruation occurs as tissue and blood leave the uterus and exits the body through the vagina.

In endometriosis, endometrial growths outside the uterus also respond this way to hormones. However, when instructed by the body to break down, the blood and tissue of the endometrial growth cannot exit the body, resulting in internal bleeding. This internal bleeding can cause inflammation, pain, and create scar tissue within the body. A long list of symptoms has also been associated with endometriosis, including, but not limited to:

  • Very painful cramps, often worsening over time.
  • Chronic pelvic pain.
  • Heavy or long menstrual periods.
  • Nausea and vomiting.
  • Pain during or after sex. Endometrial growths can also materialize outside the vagina, in the body cavity. The normal, mild mechanical damage that occurs in the vagina during sex also pushes on nearby endometrial growths, causing further pain and inflammation.
  • Painful urination and/or bowel movements during menstruation. The inflamed growths resulting from endometriosis can push on neighboring organs, like the bladder and the bowel. When the bladder or colon's expansion is restricted, localized pain results.
  • Infertility. The passing of an egg from the ovaries to the fallopian tubes is a delicate process and can be easily upset by the growth of endometrium on the fallopian tubes.
  • Chronic Fatigue.

Fatigue and Endometriosis

The fatigue associated with endometriosis is much less understood than other symptoms of the condition. The constant inflammation that occurs in endometriosis patients likely contributes to fatigue. Inflammation involves the activation of the immune system, an energy-costly activity; considering how wiped out you feel when you're sick. Fatigue can also be caused by excessive stress, such as that caused by the chronic pain of endometriosis. Yet another hypothesis is that sleepiness is caused by the simple fact that people dealing with chronic pain sleep less soundly. While chronic fatigue isn't curable, there are ways to cope with it.

  • GET QUALITY SLEEP. Make your bed is as comfortable as you can make it (high thread-count sheets, lots of pillows, cushy comforters) so that the sleep you do get is as restful as possible.
  • TAKE IT EASY. Avoid overexerting yourself, which can cause unnecessary fatigue.
  • RELAX. Reduce stress with breathing exercises or meditation.
  • TRY SUPPLEMENTS. It's also important to have a well-rounded, and sometimes supplemented, diet to help your body maintain the nutrients it needs to function.


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  • Fatigue is my worst symptom of endo. I was hyperactive prior to starting my period at 12, after which I became chronically fatigued, pale & generally unwell. My mom fed me iron supplements thinking I was anemic, but blood tests were normal. Thyroid function is normal. When I tried going off my birth control for a few months recently I could barely get out of bed. Since the fatigue is cyclical & gets worse off birth control pills, I suspect a hormonal connection. rnrnI guess it's all a matter of degrees with endometriosis, isn't it? That's what makes it so hard to communicate to doctors & loved ones that this is a REAL disease. Most women experience cramps, fatigue & bloating on their periods at some point--it's the degree of severity that sets us apart.

  • The endometrium is a unique tissue. In response to hormones, it grows tissue and blood vessels to prepare for the implantation of a fertilized egg.

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