Endometriosis and Adenomyosis Explained

This video by Dr. Sarah Zielsdorf, MD, MS explores the complex relationship between endometriosis and adenomyosis, two distinct yet overlapping gynecological conditions. It delves into their shared symptoms, differing characteristics, and potential links to environmental endocrine disruptors. Understanding these conditions is crucial for diagnosis and management.

Dr. Sarah Zielsdorf, MD, MS: Endometriosis and adenomyosis can occur simultaneously. This is an important paper highlighting the fact that this is not just an immune dysfunction that magically transform a patient into just having these conditions. But there is a potential relationship between environmental um endocrine disruptors. This exposure and the development or the acceleration or the disease states made more significant more severe in the development of endometriosis and adenomiiosis.

Endometriosis and adenomiosis exhibit overlapping phenotypes. Adenomiosis has been referred to as quote endometriosis interna end quote due to its resemblance to endometriosis both hisytologically or cellularly and phenotypically. However, as shown in the ven diagram, while these diseases have many common features, they also exhibit a number of differences. In adenomiiosis we have again these glands these endometrial glands within the myometrium of the uterus. We have the clinical signs including bloatedness and enlarged uterus. Proposed causes include differentiation of malarian stem cells, altered lymphatic drainage pathways and displaced bone marrow stem cells. Risk factors include high parity or having multiple children and uterine surgeries. It does occur in women 35 years of age and older typically and hyctomies are used to diagnosis to diagnose and cure disease. Endometriosis is characterized by endometrial glands and stroma outside of the uterus. Proposed causes include retrograde menstruation, metastatic spread, and altered immunity. It commonly occurs in women between the ages of 25 and 45, so younger than menopausal. Risk factors include prolonged menstrual flow, early period onset or monarchy, delayed childbearing, and immune disorders. It's diagnosed by laparoscopy and biopsy and there's no known cure for disease. Both states can be asymptomatic. It's caused by multiffactorial eeologies. In both conditions you have the symptoms of chronic pelvic pain, heavy and painful periods or dismenoria, disparunia or pain during intercourse and reduced fertility. Treatments can include pain medications and hormonal therapies. It's associated with endocrine disrupting chemical exposure and these are diseases of estrogen dominance or estrogen dependence.

I want to just discuss a little bit about endocrine disrupting chemicals. EDC's can be divided into two groups. persistent or organic pollutants or POPs and non-persistent EDCs or NPEDC's. NPEDC's have low fat solubility or low lipid solubility. So they have a short half-life in humans and animals. Whereas POPs, the persistent organic pollutants are highly fatloving chemicals that are not really readily biodegradable. They store in fat. And the development of a variety of reproductive diseases has been found to be associated with both non-persistent EDCs due to their propensity to to love fat and store in fat and a number of other endocrine disrupting chemicals including dioxins and PCBs. These are polycllorinated by fennels which are everywhere. They're ubiquitous in our environment.

And then other endocrine disrupting chemicals such as TCDD and BAP or benzoapyne are byproducts of natural indust industrial processes. So we can't avoid them.

So also EDC's not only store in atapost tissue or fat but they biomagnify within the food chain. Following the initial exposure atapost tissue slowly releases endocrine disrupting chemicals into the bloodstream thereby contributing to the potential for long-term adverse health effects. Persistent EDCs include dioxins found in combustion, waste incineration, volcanic eruptions, forest fires, polycllorinated bifphenels or PCBs or in electrical transformers, microscopic immersion oils, pesticides, carbonless copy paper, electrical insulation. Non-persistent EDCs include bisphenol A or BPA and BPS. Bisphenol S. They're in children's toys, water bottles, canned food liners, dental sealants, receipt coatings, plasticizer and epoxy resins. Not only in this case can they cause endometriosis, natenomiiosis, but also uterine fibroids and polycystic ovarian syndrome. Phalates are in cosmetics and medical equipment, medications, paints, adhesive, personal care products, plasticizers, solvents, stabilizers, parabens also in car cosmetics, pharmaceutical products, preservatives, and finally tricloins. They're in hand sanitizers, mouthwashes, toothpastes. They have antimicrobial properties but also are a potent trigger for polycystic ovarian syndrome and other autoimmune conditions.

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