Silent Endometriosis: Complexity, Symptoms, Causes, Diagnosis, and Treatments
Endometriosis is a long-term condition characterized by the growth of the uterine lining-like tissues outside the uterine cavity, causing pain and fertility problems.
According to the WHO, it affects up to 10% of women at their reproductive ages between 15 and 44.
Women with Endometriosis can experience numerous symptoms, but it can also be asymptomatic and present silently in a few cases.
As per a 2010 Journal of Assisted Reproduction and Genetics study, 20% to 25% of Endometriosis cases are asymptomatic.
Thus, it can be named “silent” Endometriosis.
Asymptomatic Endometriosis is present without being noticed and leads to more adverse consequences in the absence of medical treatments.
But does it progress without being noticed or often misdiagnosed because of less knowledge?
This comprehensive article aims to illuminate silent Endometriosis, including its symptoms, causes, complications, diagnosis, and treatment.
What is silent Endometriosis
Silent Endometriosis can be understood as Endometriosis with no overt (easily observable) symptoms.
There are also chances that symptoms are present in milder form, or women may have different symptoms than expected.
Endometriosis can also remain underdiagnosed or misdiagnosed due to less knowledge of the underlying causes or their resemblance with other conditions.
Thus, making the diagnosis of the condition is difficult.
How silent Endometriosis differs from Endometriosis
The overview below briefly describes the differences between silent Endometriosis and symptomatic Endometriosis.
| Aspects | Silent Endometriosis | Symptomatic Endometriosis |
|---|---|---|
| Causes | When uterine-like tissues develop outside the uterus cavity | Development of uterine-like tissue outside the uterine cavity |
| Symptoms | Absent or milder symptoms | Intense pain during menstrual bleeding, rectal bleeding, urination problems, infertility |
| When symptoms are noticed | When trying to conceive and failing multiple times | Mainly around menstruation |
Silent Endometriosis symptoms
As the name suggests, it is often without showing explicit symptoms that contribute to developing Endometriosis in body part.
There are no specific symptoms of asymptomatic Endometriosis in women, or the symptoms are misdiagnosed for other medical conditions, such as Irritable Bowel Syndrome.
As an example, in most cases, intense and crippling menstrual pain is advocated to be normal by many physicians, and patients tend to believe this irrespective of their severe condition.
Further, urinary problems caused by Endometriosis are mistaken as bladder problems. They are treated similarly instead of looking for a deeper cause.
Collectively, these misdiagnosed symptoms and delays in treatment can elevate the risk of Endometriosis progression to severe stages.
This can lead to potentially negative consequences affecting the quality of a woman’s life.
Also Read: If you want to learn the symptoms of Endometriosis in detail, read “9 Endometriosis Symptoms to Prevent Delay in Treatment.”
Complications of silent Endometriosis
The major complications of Endometriosis without symptoms are elaborated as follows:
Infertility
As per the American Society for Reproductive Medicine, the prevalence of infertility in women with Endometriosis is as high as 30% to 50%.
Endometriosis can affect fertility due to the following reasons:
- Painful sexual experience leading to difficulty in conceiving
- Release of an impaired egg from the ovary
- Inhibited transfer of the egg
- Blockage of the sperm to the fallopian tubes
- The altered ovarian reserve
- Changes in the quality of the embryo
- Altered immune system functioning
- Scarred fallopian tubes
- Impaired implantation
Miscarriage
As mentioned earlier, untreated Endometriosis can affect implantation, immune system functioning, and the quality of the embryo.
The changes in these can contribute to miscarriage in women.
Recurrent miscarriages are one of the indications of Endometriosis, which makes it difficult for women to implant and have a healthy pregnancy.
Moreover, if Endometriosis is developed in the ovaries, also called Endometrioma, it can severely affect the ovarian reserve and egg quality.
Also, Endometriosis lesions in the fallopian tube can make it no longer functional to guide the egg to the uterus.
Thus, causing the implantation of an egg in the wrong location and increasing the risks of Ectopic pregnancy.
Also Read: To get intricate knowledge about the effect of Endometriosis on pregnancy, read “The Complex Relationship Between Endometriosis and Pregnancy.”
Diagnosis of silent Endometriosis
It is difficult to establish a precise diagnostic procedure to diagnose Endometriosis symptoms when they are asymptomatic.
However, women can consult a healthcare practitioner and seek diagnostic tests for the early detection of infertility.
A doctor can conduct the following tests in women with Endometriosis:
- Pelvic examination test
- Ultrasound for Endometriosis
- Magnetic Resonance Imaging (MRI)
- Laparoscopy
Endometriosis can affect the levels of certain hormones, which can also indicate the presence of Endometriosis if the condition is asymptomatic.
Women can ask for the current levels of the following hormones to diagnose Endometriosis if they suspect its presence:
- Cytokine production: During an inflammatory reaction, the level of Cytokine production rises. It can be caused by other factors, too, but it can provide a clue about Endometriosis
- Anti-Mullerian Hormone (AMH): AMH is a marker of ovarian reserve. If it is low, it can be an indication that Endometriosis is the cause
- Follicular Stimulating Hormone (FSH): FSH is another hormonal marker, and its elevated level can be an indication of Endometriosis
- Prolactin level: The levels of Prolactin are significantly higher in women with Endometriosis than women without the condition
Prolactin greater than 17.5 ng/ml can differentiate between women with or without Endometriosis
Prolactin levels greater than 20.08 ng/ml can differentiate between mild Endometriosis stages I/II and moderate to severe stages III/IV
Silent Endometriosis treatment
The Endometriosis treatment depends on the severity and stage of the condition.
In mild to moderate Endometriosis, Intrauterine Insemination (IUI) with ovarian stimulation can significantly increase the likelihood of pregnancy.
In women with severe Endometriosis, the prioritization of the treatments includes surgical treatment and Assisted Reproductive Technology.
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Conclusion
Endometriosis can be present in a woman’s body for many years without being detected and showing any overt signs and symptoms.
Though both symptomatic and asymptomatic Endometriosis are caused by the development of uterine-like lining, silent Endometriosis does not show visible symptoms.
Asymptomatic Endometriosis can be detected after certain complications, such as infertility or recurrent miscarriages.
Endometriosis can be diagnosed with laparoscopy and pelvic examination tests. Further, the levels of certain hormones can also indicate the presence of Endometriosis.
Based on the severity of the condition, a healthcare practitioner can take multistep treatment for a faster recovery.
Though the condition may get troublesome for many women, its early diagnosis and treatment are effective in alleviating the symptoms and seeking solace.
Frequently Asked Questions
Can you get pregnant with silent Endometriosis?
In silent Endometriosis, women may face difficulties in conceiving and getting pregnant. The condition is often without symptoms or milder symptoms. It can elevate the risks of damage to the reproductive system and functions, causing difficulties in conceiving or implantation. Thus, it can lead to infertility or recurrent miscarriages.
What are the symptoms of silent Endometriosis?
As the name suggests, silent Endometriosis has no symptoms, or symptoms are so mild that they can remain undetected for longer. Unlike symptomatic Endometriosis, chances are that a woman can have a normal life without painful symptoms. However, it may cause difficulty in conceiving.
Can you have Endometriosis without knowing it?
Yes, you can have Endometriosis without knowing it. It is referred to as silent or asymptomatic Endometriosis. Up to 20% to 25% have asymptomatic Endometriosis, as per a 2010 study. In this condition, a woman may have Endometriosis and not experience associated symptoms.
What are the signs of silent Endometriosis?
The signs of silent Endometriosis include infertility and recurrent miscarriages. The condition can present silently in a woman’s body and cause severe damage to the reproductive system without treatment. Women can consult a healthcare practitioner and seek early diagnosis to improve their chances of getting pregnant.
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