Almost twenty years of ordeal. This is what Claire Cathrine says when she talks about the pain she had to endure during her period. “It started at 11 years old. I was vomiting so much it hurt. But the doctors told me: “The rules, it hurts, that’s how it is”. Or that it was all in my head and I was a sissy. » One day, this nurse, now 38 years old, fainted from pain at work. “It was a general medicine intern who said to me: ‘I think you have endometriosis.’ He referred me to Saint-Joseph Hospital [à Paris] where I finally met doctors who listened to me and cared for me. »
As one in ten women of childbearing age – some two million of them in France – and about 200 million worldwide, according to the World Health Organization, Claire Cathrine suffers from endometriosis, a chronic inflammatory hormone-dependent disease, which begins during the first period and fades with menopause. It is estimated that half of the cases of female infertility are due to this condition. However, there is still no cure.
This pathology has long been denied. Described as early as ancient Egypt, menstrual disorders were attributed, in the Middle Ages and the Renaissance, to demonic possession or hysteria, the Greek etymology (hysterikos, “uterus”) of this term being there for many. In 1860, the Austrian pathologist Karel Rokitansky discovered the histology of the disease: cells of the endometrium (the mucous membrane that lines the uterus) located outside of it. But it was the American gynecologist John A. Sampson, in 1927, who gave his name to this condition and provided a theory on its origin: a reflux of menstrual blood through the tubes into the cul-de-sac of Douglas (the fold of the peritoneum located between the rectum and the uterus) which is not evacuated. An extremely common mechanism in women but which does not necessarily lead to the disease.
Concretely, endometriosis is characterized by the presence of endometrial cells which migrate abnormally, during the menstrual cycle, towards the genital organs (ovaries or vagina) and sometimes the rectum, the colon, the bladder…
Problem: these endometrial cells behave exactly the same way as if they were located in the uterus. During each cycle, they will multiply, trigger an inflammatory reaction responsible for intense pelvic pain, even bleeding, but without being destroyed at the time of menstruation. “It was like being stabbed”, remembers Claire Cathrine. Other women mention pain of the type “fracture”, “renal colic” or even“birth without epidural”. Endometriosis can also cause pain during intercourse, defecation or urination, sometimes even neuropathic.
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