Endometriosis fertility index predicts if a woman needs IVF

Endometriosis fertility index predicts if a woman needs IVF

The Endometriosis Fertility Index (EFI) is a good indicator for predicting pregnancy achieved without use of assisted reproductive technology (ART), according to a meta-analysis of 17 studies involving 4,598 women.

Patients with low Endometriosis Fertility Index (EFI) scores may not have a strong chance of a pregnancy achieved without use of assisted reproductive technology (ART), according to a meta-analysis from BJOG.

The Iranian authors of the review in BJOG noted that study results to evaluate the EFI score for predicting non-ART pregnancy have been inconsistent.

The cumulative rate of non-ART pregnancy at 36 months was 10% for women with an EFI of 0 to 2, which significantly increased to 69% for women with an EFI of 9 to 10. Furthermore, compared to women with an EFI of 3 to 4 combined cumulative non-ART pregnancies were 44% for women with an EFT of 5 to 6, and 55% for women with an EFI of 7 to 8. A significant difference existed between all categories.

The odds ratio (OR) for EFI was 1.33 and the summary area under the curve (AUC) was 72%.


The authors stated that the existing revised American Fertility Society (rAFS) score for staging endometriosis has considerable limitations, including arbitrary point scores and wide score ranges within the categories. There is also the “potential for observer error because of numerous morphological presentations, some subtle and microscopic and the timing of the laparoscopy, and whether the staging is performed at laparoscopy or laparotomy,” they wrote.

Furthermore, there is poor correlation between the extent of disease and pelvic pain and rAFS stages align poorly with infertility. For these and many other reasons, EFI has been proposed as having greater predictive power than rAFS for a successful pregnancy, with or without ART, in endometriosis patients.

Specifically, patients with an EFI score of 0 to 3 should be informed as to the low likelihood of non-ART pregnancy; therefore, ART should be strongly recommended.

Women unlikely to achieve non-ART pregnancy or spontaneous pregnancy, based on their EFI score, might be candidates for earlier in vitro fertilization and embryo transfer to prevent treatment delays and increase their chances for pregnancy.

The non-ART pregnancy rate might be linked with duration before attempting ART. For fertility management, EFI can be used as a predictive factor for a spontaneous second pregnancy.

Despite the review concluding that the EFI score is a good predictor for non-ART pregnancy, “these findings should be considered with caution due to the substantial heterogeneity between studies,” the authors said.

Read more: https://pubmed.ncbi.nlm.nih.gov/31967727/

Underweight women with endometriosis at higher risk of preterm birth after IVF

Underweight women with endometriosis at higher risk of preterm birth after IVF

Endometriotic patients who were underweight before conception had a significantly higher rate of preterm birth (PTB) than underweight women without endometriosis, according to the findings of a new study publised in Reproductive BioMedicine Online.

Researchers examined the impact of preconception maternal body mass index (BMI) on neonatal outcomes in women with endometriosis who used in vitro fertilization (IVF). They did not find such a difference with other BMI categories.

The retrospective research, performed in China, included of 7,086 women who delivered a singleton live birth via IVF between December 2006 and December 2017 at the Department of Assisted Reproduction of Shanghai Ninth People’s Hospital, which is affiliated with Shanghai Jiao Tong University School of Medicine.

Of the cohort, 1,111 women were diagnosed with endometriosis by laparoscopy or laparotomy, with 45% having ovarian disease and 55% having pelvic endometriosis. The indication for IVF in 74% of the endometriosis group was endometriosis, with the remaining 26% of patients having concomitant male factor infertility.

In the control group of 5,975 women without endometriosis, the indication for IVF was tubal factor infertility in 77% of patients and male factor infertility in the remaining 23% of cases.

Women in both groups were assigned to one of three predefined BMI groups: underweight (< 18.5 kg/m2); normal weight (18.5 to 24.9 kg/m2); or overweight/obese (≥ 25 kg/m2).

All comparisons were between women undergoing cryopreserved embryo transfer, with all embryos transferred into a more natural uterine environment than would have occurred with fresh transfers after ovarian stimulation. This allowed for the precise role of endometriosis to be determined in subsequent neonatal outcomes.

Following stratification by BMI, underweight women with endometriosis had higher rates of PTB (delivery before 37 gestational weeks) than underweight controls: 14.61% versus 3.28%; P < 0.001. However, normal weight and overweight/obese endometriotic women had PTB rates comparable to normal weight and overweight/obese controls.

One possible explanation as to why endometriosis results in higher PTB rates only in the underweight group is the difference in leptin concentration.Leptin, a product of adipose tissue and responsible for regulating lipid metabolism, can reduce body mass by inhibiting food intake and stimulating energy expenditure,” wrote primary author Yun Wang, PhD, and her colleagues from Shanghai Ninth People’s Hospital.

Leptin signaling can also affect the formation of endometriosis though different pathways and is linked with inflammation in endometriosis.

As is well known, inflammation has been implicated in the mechanisms responsible for term and preterm parturition,” the authors wrote.

Genetics is the other mechanism by which a low BMI impacts incidence of PTB. In addition, the genetic factors affecting BMI might be connected to the pathological process of endometriosis, which could result in preterm delivery.

Another finding of the study was a significant interaction between endometriosis and maternal BMI and PTB (P for interaction < 0.05). However, after accounting for potential confounding factors, the PTB rate remained consistently higher in the low BMI subgroup of women with endometriosis: adjusted odds ratio (aOR) = 4.66; 95% confidence interval (CI): 2.54 to 8.57.

Furthermore, the study detected no differences in the rate of early PTB, low birthweight, macrosomia, small for gestational age and large for gestational age between women with endometriosis and controls for any preconception category of BMI.

Overall, the findings underscore the importance of maintaining normal weight in women with endometriosis.

Read more: https://pubmed.ncbi.nlm.nih.gov/32171707/

Source: https://www.contemporaryobgyn.net/endometriosis/maternal-bmi-and-neonatal-outcomes-endometriotic-women-undergoing-ivf

Endometriosis and migraine strongly linked

Endometriosis and migraine strongly linked

There is a significant association between migraine and endometriosis, according to a French case-control study.

They suggest that in clinical practice, women of reproductive age who suffer from migraine should be screened for endometriosis criteria in order to optimise the medical and therapeutic care of this condition.

Studies have shown a significant association between migraine and endometriosis, but no study had explored the relationship between migraine and endometriosis phenotypes: superficial peritoneal endometriosis, ovarian endometrioma, and deep infiltrating endometriosis.

The researchers conducted a case-control study using data collected from 314 women aged 18 to 42 years who had undergone surgery for benign gynecological conditions between January 2013 and December 2015.

All women completed a self-administered headache questionnaire according to the IHS classification. Cases: 182 were women with histologically proven endometriosis and 132 controls were women without endometriosis.

According to the study results:

  • Migraine prevalence in cases was significantly higher compared with controls (35.2% vs. 17.4%).

  • The risk of endometriosis was significantly higher in migrainous women (OR = 2.62; 95% CI = 1.43–4.79).

  • When endometriosis phenotypes were taken into account, the risk of ovarian endometrioma and deep infiltrating endometriosis were significant (OR = 2.78; 95% CI = 1.11–6.98 and OR = 2.51; 95% CI = 1.25–5.07, respectively).

  • In women with endometriosis, the intensity of chronic non-cyclical pelvic pain was significantly greater for those with migraine (visual analogic scale (VAS) = 3.6 ± 2.9) compared with the women without headache (VAS = 2.3 ± 2.8, p = 0.0065).

With an estimated global prevalence of 14.7%, migraine is the most disabling neurologic disorder and the third most common illness worldwide

Like endometriosis, women in their reproductive and most productive years are more commonly affected with migraine.

Increased exposure to menstruation is a known risk factor for endometriosis just as menstrual migraine and menstrually-related migraine (with prevalence varying from 4%-70%) are common subtypes of migraine in women.

Danazol (a synthetic androgen for managing endometriosis) has been reported to reduce the frequency of migraine attacks.

Read more: https://journals.sagepub.com/doi/10.1177/0333102419893965

Is endometriosis hereditary?

Is endometriosis hereditary?

Women with endometriosis may be more likely to have a close relative with the disease. However, research into the potential link is still developing.

Endometriosis is a complex condition. Many factors beyond heredity may increase a person’s risk of developing it.

Is endometriosis hereditary?

More research is necessary to determine if endometriosis has a hereditary component.

Preliminary research suggests that endometriosis may have a hereditary component. However, it is unlikely that genetics are the only or the most influential risk factor.

A 2010 study included 80 participants with endometriosis and 60 without it. Those with endometriosis were more likely to have a relative with the condition.

About 5.9% of participants with endometriosis had a first-degree relative with the condition, compared with just 3% of those without the disease.

While the likelihood of having a relative with the condition was almost doubled in the endometriosis group, the absolute risk was very low.

The study did not find significant differences in symptoms when they compared women with endometriosis and a family history of the disease and those with endometriosis but no family history.

There are many complicating factors. For example, many doctors were ill-informed about endometriosis until recently, and they often missed the diagnosis. Research indicates that as many as 70% of cases in the 1970s were undetected.

This means that mothers and other relatives of people with endometriosis may have had the condition but never received a diagnosis.

Is there an endometriosis gene?

Researchers continue to look for specific genetic causes of endometriosis.

One potential target is a variant of a gene called transforming growth factor β1 gene-509C/T. However, a 2012 meta-analysis of prior research did not find a significant link between this gene and the condition.

A 2019 review has listed more than two dozen genes that various studies have linked to endometriosis. The researchers have failed to demonstrate that any specific gene inevitably causes the condition.

Instead, researchers suggest that interactions between genes and the environment may play a role. According to a 2016 review, epigenetic factors may play a role in endometriosis. These are factors that regulate gene expression.

A person with a gene that increases the risk of endometriosis may not develop the disease without exposure to certain epigenetic risk factors, such as stress or pollution.

Because family members often live in similar environments, epigenetic risk factors may be shared within a family.

Other endometriosis risk factors

A woman with endometriosis may experience periods that occur unusually frequently and last longer than 7 days.

Women with endometriosis may be more likely to have had their first periods before the age of 11 and more likely to experience infertility.

Beyond the potential genetic link, a range of factors may increase the risk of developing endometriosis, including:

  • alcohol use

  • advanced age

  • lifestyle and environmental factors, such as stress, exposure to pollution, and exposure to hormone-disrupting chemicals

The risk of endometriosis increases with age. This may stem from accumulating effects of lifestyle and environmental factors. Or, it could be that genes linked with endometriosis change with age.

Severe pain during your periods and sex could be a signal of endometriosis

Severe pain during your periods and sex could be a signal of endometriosis

The cramps you get during your period can be tough. If you suffer from endometriosis though, the pain could be so strong that it could affect your daily routine. Severe pain during intercourse could also be a sign of endometriosis. In both cases, you should speak to your doctor.

Could endometriosis be the cause?

For many years, women thought that strong pain during their periods or during intercourse is normal, but it is not.

Two of the most common symptoms of endometriosis are:

  • severe pain during your periods (dysmenorrhea)

  • painful intercourse (dyspareunia), meaning persistent or recurrent pain that occurs during or after intercourse.

Endometriosis is notoriously difficult to diagnose. The symptoms of endometriosis are similar to other gynecological conditions.

One in 10 women have endometriosis and many are not diagnosed

One in 10 women are affected by endometriosis and often there is a delay of diagnosis for 7-12 years, as endometriosis’ symptoms are similar to other gynecological conditions. Many women with endometriosis remain undiagnosed.

What is endometriosis?

Endometriosis is a gynecological disorder in which tissue similar to the tissue that normally lines the inside of your uterus (the endometrium) grows outside your uterus. The right tissue at the wrong place.

In endometriosis, the endometrial-like tissue acts as endometrial tissue would. It thickens and then breaks down and bleeds in each menstrual cycle.

The ectopic endometrium has no way to exit your body, so it becomes trapped. When endometriosis involves the ovaries, cysts called endometriomas may form.

Surrounding tissue can become inflamed, eventually developing scar tissue and adhesions (abnormal bands of fibrous tissue that cause the internal organs to stick to each other).

Endometriosis can cause strong pain, especially during menstrual periods and very often during the sexual act. Another common symptom of endometriosis is infertility. Fortunately, effective treatments are available.

Endometriosis or normal menstrual cramps?

Menstrual cramps are common and usually can be treated with over-the-counter medication or home remedies. Endometriosis is associated with pain that women call “killer cramps”. Some women say it feels like “their insides are being pulled down”.

Endometriosis pain often stops young women from going to school or having a social life. In adulthood often the pain gets worse and in many cases, they miss days from work.

Endometriosis or “normal” pain during sex?

Painful intercourse can occur for different reasons, ranging from structural problems to psychological concerns. But is also the cardinal symptom of endometriosis. Especially deep dyspareunia.

If dyspareunia is persistent, you should talk to your doctor.

Other symptoms of endometriosis include:

  • Very long or extremely heavy periods

  • Migraines

  • Bleeding between periods

  • Fatigue

  • Nausea

  • Diarrhea

  • Infertility. Surgery can remove the extra tissue, which may make it easier to get pregnant. You may decide to use assisted reproductive techniques like in vitro fertilization(IVF) to help you conceive

  • Painful bowel movements

  • Leg pain that can make it hard to walk. Endometriosis can affect nerves that connect to your groin, hips, and legs.

  • Severe backache. The uterus and ovaries are near your back and endometriosis pain can affect your back too.

4 diet tips to help you fight endometriosis

4 diet tips to help you fight endometriosis

Endometriosis is a challenging condition to deal with. Chronic pain has a physical and emotional toll on your well-being.

One in 10 women are affected by endometriosis and many do not have a diagnosis for 7-12 years, as endometriosis’ symptoms are similar to other gynecological conditions. Many women with endometriosis remain undiagnosed.

Fortunately, there are steps that can be taken to help with the pain of endometriosis and improve your quality of life. Simple changes in you diet can make you feel better.

Eating the right foods may provide some protection against endometriosis. The role of diet in endometriosis has been investigated in recent years due to the influence of diet on some of the processes linked to the disease, such as inflammation, prostaglandin metabolism, and estrogen activity.

Eat more fresh fruits and vegetables and less red meat

Add more fresh fruits and vegetables in your diet. Stocking your refrigerator with pre-washed and cut fruit and vegetables can help you eat more of both.

Cut down red meat. Research has shown a link between endometriosis and diets that are low in fruits and vegetables and high in red meat.

Some experts think the high amount of fat in meat like beef encourages your body to produce chemicals called prostaglandins, which may lead to more estrogen production. This extra estrogen could be what causes excess endometrial tissue to grow.

A higher intake of fresh fruit and green vegetables reduced the relative risk of endometriosis by 40 percent, while a high consumption of beef, other red meat, and ham increased relative risk by around 80 to 100 percent.

Boost omega-3 fatty acids intake

Eat more foods high in omega-3 fatty acids like salmon, mackerel, flaxseeds

and walnuts. A study showed that women who ate the highest amount of omega-3 fatty acids were 22% less likely to develop endometriosis compared to women who ate the least amount.

Reduce trans fats

Eat less trans fats. Research has shown that women who ate the most trans fats had a 48% higher risk of developing endometriosis than those who ate the least, so the type of fat you eat matters.

Avoid alcohol and caffeine

Drinking caffeinated coffee and soda seems to increase your chances of developing endometriosis, although researchers aren’t sure why. If you find that caffeine worsens your symptoms, switch to decaf.

Women who drink a lot of alcohol may be more likely to get endometriosis. Drinking might also make your symptoms worse. Alcohol raises estrogen levels, which could lead to more painful symptoms.

Diet rich in phytoestrogens may reduce risk of endometriosis

Diet rich in phytoestrogens may reduce risk of endometriosis

Higher consumption of phytoestrogens (plant-derived estrogens found in soy and other foods that are similar to the female hormone estrogen) is associated with a reduced risk of endometriosis, an Iranian case-control study suggests.

Phytoestrogens are naturally-occurring plant compounds that share a similar chemical structure and function to the estrogens found in the human body.

Foods rich in phytoestrogens include soy, fruits, vegetables, spinach, sprouts, beans, cabbages, and grains.

The effect of diet on hormonal activity, inflammatory markers, and the immune system means that the food choices women make might play a key role in the development of endometriosis. Further, endometriosis has been shown to be related to prolonged exposure to the hormone estrogen in the absence of progesterone.

The main classes of phytoestrogens include isoflavones, coumestans, lignans, and flavonoids. Isoflavones, produced almost exclusively by the members of the bean family, are found in soy. Coumestans may have anticancer effects, while lignans have antitumor and antioxidant effects in mammals. Flavonoids, which also have antioxidant effects, are plant pigments that help give fruits and vegetables their color.

In women with endometriosis, phytoestrogens have an anti-estrogenic effect, meaning they can counter the activity of estrogen. Lignan and isoflavones can be converted in the gut into hormone-like structures.

By binding to estrogen receptors, phytoestrogens can stimulate the production of sex hormone-binding globulin, reducing the ability of the natural free estrogen to interact with estrogen receptors. Further, phytoestrogens can reduce inflammation through many mechanisms, including decreasing the production of inflammatory molecules.

In this study, the researchers assessed the link between phytoestrogen intake and endometriosis risk. The team studied 78 women with endometriosis and 78 with a normal pelvis, all infertile, recruited at the Arash Hospital, in Tehran, Iran. The two groups were matched for multiple parameters, including age, body mass index (BMI), education, marital status, occupation, and income.

The participants’ diets were recorded using a 147-item validated food frequency questionnaire, between May 2016 and February 2017. The type of phytoestrogen in each dietary item was then analyzed using data from the U.S. Department of Agriculture.

The results showed that a higher intake of phytoestrogens was associated with a reduced risk of endometriosis. A greater intake of total isoflavones (specifically the sub-groups formononetin and glycitein) was associated with a decreased endometriosis risk, as was an increased intake of coumestrol. Similar results were found with a higher intake of lignan, specifically the sub-groups secoisolariciresinol, lariciresinol, and matairesinol.

Among food groups, only isoflavin, lignan, coumestrol, and phytoestrogen in dairy products, and coumestral in fruits were related to a reduced endometriosis risk.

“The phytoestrogen content in diet is dependent on environmental and genetic factors for example variety, harvest, food processing, cooking and growth locations,” the researchers noted. “Up to now, Iranian dietary phytoestrogen has not been measured.”

The researchers said that the results, overall, suggest that the impact of phytoestrogens on the level of hormones, and immune and inflammatory markers, is likely to “play an important role in the control and prevention of many diseases.”

“Due to the inflammatory nature of endometriosis and the effect of hormones on the progression of the disease, the role of phytoestrogens consumption in the progression and regression of the disease should be assessed in future works,” they concluded.

The study was published in the International Journal of Fertility & Sterility.

Read more: http://ijfs.ir/journal/article/fulltext/dietary-phytoestrogen-intake-and-the-risk-of-endometriosis-in-iranian-women-a-case-control-study.html

Ovarian cysts negatively affect number and quality of eggs in women with endometriosis-associated infertility

Ovarian cysts negatively affect number and quality of eggs in women with endometriosis-associated infertility

Pain and infertility are two main symptoms of endometriosis. It is estimated that women who suffer from endometriosis are 30-50% more likely to be infertile.

The mechanisms of endometriosis-associated infertility are still unknown. It may be caused by the formation of endometrial lesions on ovaries, anatomical distortions in the pelvis, hormonal imbalance or the inferior quality of the eggs.

Researchers assessed the quality of oocytes (eggs) in women with infertility associated with endometriosis and found that the number and quality of eggs they produce are negatively affected by ovarian cysts, thus also affecting the outcomes of assisted reproduction.

The quality of a woman’s eggs is particularly affected when a large ovarian cyst (endometrioma) sometimes called chocolate cyst has a diameter larger than 3 cm.

Surgical removal of ovarian cysts does not restore the ovaries’ capacity to produce eggs, the study suggests. “Endometriomas negatively affect the quality of oocyte and ovarian reserve, whereas endometriomas after cystectomy, have a deleterious and sustained effect on ovarian reserve” according to the researchers.

Infertile reproductive-aged women, between 29 and 40 years who underwent IVF and ICSI procedures participated in the study, conducted between 2018 and 2019 by scientists at the Medical Institute of the RUDN University and Nova Clinic, a center for reproduction and genetics, in Russia.

The women were divided into three groups. Group 1 included 50 patients with recurrent endometriomas, the ovarian cysts related to endometriosis. Group 2 included 50 women who had undergone surgical removal of endometriomas. Group 3, the control group included 30 patients without endometriosis, but who had tubal factor infertility.

Oocyte quality was determined across all IVF / ICSI cycles. The researchers assessed the number of antral follicles (ovarian follicles with the potential to release an oocyte) which were counted by ultrasound. They counted the number of oocytes collected from each woman and evaluated the main morphological characteristics of the oocytes.

The results showed that both groups of women with endometriosis-associated infertility had fewer antral follicles, indicating a lesser ability by the ovaries to produce oocytes, in comparison with the control group. Fewer oocytes were recovered from the ovaries of endometriosis patients.

The morphological analysis further revealed that endometriosis patients produced more immature oocytes -ones at early stages of development called metaphase I or germinal vesicle stage. These women also produced less high-quality oocytes, those in metaphase II, which are ready for fertilization. This indicated a decline in the quality of the oocytes. Such deterioration was observed from ovaries containing larger endometriomas of more than 3 cm in diameter.

Individual analyses demonstrated that 25% of the oocytes extracted from an ovary containing an endometrial cyst had structural changes and various signs of degenerative changes.

At the same time, it was more difficult to induce the maturation of oocytes in the lab to a stage they are ready for fertilization when they were collected from endometriosis patients.

The study, “Oocyte quality in women with infertility associated endometriosis” was published in the journal Gynecological Endocrinology.


Therapeutic potential of ginseng component for endometriosis

Therapeutic potential of ginseng component for endometriosis

An active ingredient of the ginseng medicinal plant may suppress endometriosis by regulating cell death and blood vessel formation processes in the endometrium or lining of the uterus, a study in cells from patients suggests.

Endometriosis has long been considered a disease of uncontrolled and aberrant growth of endometrium tissue outside of the uterus, but the exact molecular mechanisms disrupted in this disorder remain unknown.

Research indicates that there is not just one single molecular culprit, but several signaling pathways that contribute to the disease mechanism of endometriosis, including ones involved in cell proliferation, cell adhesion and programmed death (apoptosis), blood vessel formation (angiogenesis), and immune function.

The protein complex NF-kappaB (NF-kB) is involved in such processes, and has been shown to favor the development and maintenance of endometriosis by preventing cell death and stimulating proliferation of various cell types, like endometrial and endometriosis-related cells, as well as inflammation.

Ginsenoside Rg3 is a main effective component extracted from ginseng, which is a Chinese medical herb,” the scientists wrote.

In rats, the compound was seen to inhibit the development of new endometriosis lesions, reduce the volume of existing lesions, and halt the formation of new blood vessels. Nonetheless, the effects of Rg3 on endometriosis-related cells from people is still poorly understood.

Investigators at the Women Health Center of Shanxi and Children’s Hospital of Shanxi, in China, evaluated this compound on human endometrial cells in a lab dish.

Endometrial tissue samples were obtained from six women (ages 28-40 years) with ovarian endometriosis and regular menstrual cycles. Using tissue from their endometrial lesions, scientists grew endometrial stromal cells, or connective tissue cells found in the endometrium, in the lab.

Cells were then treated with five distinct doses of Rg3 (0, 25, 50, 100, and 150 mg/mL) and the compound’s effects were evaluated at 24, 48 and 72 hours post-treatment.

Ginsenoside Rg3 was found to stop the cells from spreading in a time- and dose-dependent manner, with higher doses being associated with lesser cell proliferation.

Scientists reported that after “48, 72h, 100 mg/mL and 150 mg/mL of concentration of Rg3 inhibited the viability of human ectopic endometrial cells,” which was found to be statistically significant in comparison to untreated cells.

Rg3 also significantly lowered levels of the NF-κB p65 subunit and the protein TNF-α in diseased cells, suggesting the NF-κB pathway plays a role in the mechanism of endometriosis. Of note, women with endometriosis are known to have very active NF-κB and high serum levels TNF-α, a potent NF-κB inducer.

A significant decrease in the concentration of vascular endothelial growth factor (VEGF), which stimulates new blood vessel formation, and a significant increase in the levels of caspase 3, a protein that regulates the apoptosis process, were also seen after Rg3 was used.

When TNF-α was administered together with Rg3, the latter was able to neutralize TNF-α-induced changes, including cell death and blood vessel formation.

Our results indicate that Ginsenoside Rg3 suppresses endometriosis by reducing the viability of human ectopic [outside of the normal location] endometrial stromal cells involving the nuclear factor-kappaB signaling pathway,” the researchers concluded.

NF-κB signaling pathway may be a potential target in the process of the Rg3 treatment for endometriosis,” they added.

The study, “Ginsenoside Rg3 attenuates endometriosis by inhibiting the viability of human ectopic endometrial stromal cells through the nuclear factor-kappaB signaling pathway” was published in the Journal of Gynecology Obstetrics and Human Reproduction.

Source: https://bit.ly/2qqvB4H

Can endometriosis cause leg pain?

Can endometriosis cause leg pain?

By I.Soussis MD

Experts have only recently begun to recognize how widespread leg pain may be in women with endometriosis. Usually endometriosis patients experience extremely painful, heavy periods, pain after or during sexual activity (called dyspareunia) and pelvic pain. When endometriosis growths though impact the nerves surrounding the pelvis, they can cause pain in the legs, hips and buttocks.

As many as 50 percent of women with endometriosis may experience some form of leg pain, according to a 2016 study. 

Diagnosing endometriosis-related leg pain can be tricky because of a wide range of other medical conditions that are better understood and easier to diagnose can also cause leg pain.

During regular menstruation, the uterus lining sheds and leaves the body through the vagina. This happens in response to changing hormone levels. When endometrial tissue grows outside the uterus, the cells still shed, but they cannot leave the body, causing painful symptoms.

In some cases, endometrial tissues grow in and around the many nerves that travel through the pelvis and hip. Abnormal growths can put pressure on the pelvic nerves. This may cause pain and numbness in the hips, buttock, and legs. 

Nearly all of the documented cases of leg pain associated with endometriosis involve abnormal growths on the sciatic nerve or one of its branches.The sciatic nerve is considered the largest and longest nerve in the human body. It begins in the lower back, runs through the pelvis, and down the leg into the foot, branching into several smaller nerves along the way. Pressure on this nerve can cause pain in the lower body.

The sciatic nerve provides sensation to most of the lower portion of the body. Pressure on the sciatic nerve can, therefore, cause a lot of different symptoms, most commonly pain, numbness, and tingling that radiates into the following areas: 

  • outside of the leg
  • back of the thighs and calf
  • knee
  • sole, heel, and top of the foot 
  • hips 
  • buttock

Everyday tips for finding relief include:

  • gentle stretching focusing on the buttocks, thighs, calf, and feet muscles
  • gentle exercise, such as yoga, swimming, or walking can often help ease inflammation. 
  • counter pain medications and pain-relieving topical treatments on painful areas can ease inflammation and pain. 

Patients have seen good results when they eat:

  • fruits and vegetables rich in fiber and antioxidants (such as leafy green vegetables, berries, and citrus fruits).
  • lean meats and nuts that contain anti-inflammatory compounds, such as omega-3 (such as fish, walnuts, almonds, sesame seeds)

Also, when they avoid:

  • foods linked with inflammation (such as red meat, alcohol, heavily refined or preserved foods)

Drinking a lot of water also helps. Dehydration can intensify inflammation and pain throughout the whole body. Alternative therapies, such as acupuncture and massage therapy have proven to be effective for some endometriosis patients who experience leg pain.

Source: https://www.medicalnewstoday.com/articles/321457.php 


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