Ariel, 10 August, 2022
Dr. Xu shared a case he encountered during his practice on Weibo:
A girl, just in her early twenties, suddenly coughed up blood while taking a shower, and thus was rushed to the hospital for treatment.
After inquiring about her condition and performing a lung CT and an enhanced CT, she was diagnosed with "pneumonia."
However, the situation was far from simple. Not long after the girl was discharged from the hospital, the symptoms of coughing up blood recurred and became even more severe. This puzzled the doctor.
At this time, a message the girl asked a nurse to pass on to her boyfriend revealed a clue to the doctor.
"Could you buy me some sanitary pads? I got my period."
From this sentence, the doctor suspected that the girl might have "endometriosis." Subsequent examinations confirmed the doctor's diagnosis was correct.
We seldom hear about "endometriosis." Why does it cause coughing up blood? What exactly is it? Is it serious?
What is Endometriosis?
The menstruation of women is caused by the periodic shedding of the endometrium, which consists of the epithelial tissue layer and its mucosal layer on the inside of the uterus [1].
"Ectopic" indicates that the endometrium, which should grow inside the uterus, has moved elsewhere. So, where might it go?
Dr. Xu Hao, a medical doctor and neurosurgeon, answered:
"It can appear in any part of the body, such as the kidneys, lungs, intestines, and even the brain and limbs."
Most often, the endometrium still grows in the ovaries, fallopian tubes, intestines, bladder, vagina, etc. Like the girl described in the case above, it's rare for the endometrium to grow in the nasal cavity, brain, or lungs.
These ectopic endometria do not "restrain" themselves just because they are in unfamiliar places.
They still thicken and then gradually shed during the menstrual cycle. Because the shed endometrium cannot be expelled through the normal channel from the vagina, it accumulates in the body, forming cysts and scar tissue. Then, the tissues and organs in the body adhere together, affecting their normal functions.
Symptoms of Endometriosis
From the description above, it is clear that endometriosis is very frightening. But its impact goes far beyond those.
Women with endometriosis endure severe pain, which may occur during menstruation, sexual activity, defecation, or urination.
Patients may also experience nausea, diarrhea, constipation, fatigue, and other symptoms, which worsen during menstruation. Endometriosis can also lead to infertility.
Some women may not have the above symptoms, making it even harder to diagnose the real cause and receive appropriate treatment.
Endometriosis is a relatively common female health issue, affecting about 10% of women globally. However, the misdiagnosis rate for endometriosis is still very high.
One reason is the complexity and variety of symptoms, making it difficult for doctors to quickly identify the cause. Moreover, many people think that menstrual pain is common:
"Menstrual pain? Nine out of ten girls have experienced it. Just endure it. If it's unbearable, take an ibuprofen."
Even sometimes, they suspect the discomfort and pain in their bodies are due to work or other reasons, thinking it's overreacting to see a doctor for such a "trivial matter."
"Which worker doesn't have some pelvic issues?"
"Did I get diarrhea because the food wasn't fresh?"
"Next time, I shouldn't eat too spicy."
These misunderstandings lead to delayed diagnosis.
Furthermore, women with endometriosis do not realize that the "minor ailments and pains" in life are caused by one reason, making it difficult for doctors to diagnose accurately when they cannot fully and specifically describe their symptoms.
So, how can women know they have endometriosis as early as possible?
The most important thing is to pay attention to and care for your body! Besides, if the following situations occur, it is recommended to visit a hospital for examination as soon as possible to rule out the possibility of endometriosis:
① Difficulty in getting pregnant;
② Menstruation lasting more than 7 days;
③ Frequent menstruation;
④ Having family members with endometriosis;
What to Do About Endometriosis
We've said that endometriosis is not a very rare disease, so many women are concerned: "Is this disease formed acquired? Can it be prevented?"
The exact cause of endometriosis is currently unknown, but there are several hypotheses:
① Retrograde menstruation;
② Cell mutation;
③ Hormonal changes;
④ Weak immune system;
⑤ Surgical accidents;
Thus, endometriosis might be caused by congenital reasons or acquired behaviour. Since the exact cause is unknown, it cannot be prevented.
Currently, endometriosis cannot be eradicated but can be alleviated through medication or surgery, though some people may experience recurrence. Still, it provides the possibility of improving the quality of life for patients.
Therefore, there is still a long way to go regarding this disease. We need to be alert to menstrual pain and not just assume it's ordinary dysmenorrhea, enduring discomfort, which leads to worsening conditions. Remember, the pain in your body is sending you a signal; it's time to take care of yourself.
