ENDOMETRIOSIS: WHAT IS IT AND HOW IS IT TREATED?

Severe period pain? Pain during sex? Pain when you poo? If these symptoms sound familiar to you then you may have a condition called endometriosis.

On average, a diagnosis takes around 7.5 years from the onset of symptoms, so it’s important for women to understand what endometriosis is and how it might affect them. In this article, expert gynaecologists from King Edward VII’s Hospital in Marylebone explain the condition and potential treatment options.

What is endometriosis?

Endometriosis is a condition that causes tissue from the lining of the womb to migrate to other areas of the pelvic cavity such as the fallopian tubes and ovaries. It can also migrate further to the outside of the bowel and bladder.

This tissue then behaves in the same way as it would inside the womb – it builds up and then breaks down and bleeds. When this tissue bleeds in the womb, it leaves the body in the form of a period. When it bleeds in other areas of the pelvic cavity, it builds up, forming cysts, scar tissue and inflammation.

Endometriosis signs and symptoms

Endometriosis affects different women in different ways. Some may have severe endometriosis but not experience any symptoms, whilst other women may only have minimal endometriosis but experience severe symptoms.

The most common presenting symptoms are:

• Severe period pain

• Painful sexual intercourse

• Painful bowel movements

Other symptoms of endometriosis include:

• Pelvic pain

• Ovulation pain

• Back, loin & leg pain

“Some may have severe endometriosis but not experience any symptoms, whilst other women may only have minimal endometriosis but experience severe symptoms”

• Pain on passing urine

• Blood in the urine

• Bleeding from the back passage

• IBS symptoms

• Pain and difficulty during a smear test

• Fatigue

• Low mood

• Difficulty getting pregnant

Endometriosis does not cause heavy periods. However many women with endometriosis have a condition called adenomyosis.

Some women may experience many, or all, of these symptoms, whilst others may experience a small number of them.

Getting an endometriosis diagnosis

If you have any of the symptoms above and you think you may have endometriosis, it’s important to speak to your GP who can begin the process of you getting a diagnosis.

It will help to write down your symptoms and when you get them (in relation to the time of your period) so that you can discuss them properly with your GP. Your GP will ask you some questions about your symptoms and your periods. They may also feel around your abdomen and may perform an internal vaginal examination.

Your specialist may arrange either an internal ultrasound scan or an MRI in the first instance, to help make a diagnosis based on your symptoms and examination findings. Depending on the results (as all surgery as some risks associated with it) the specialist could recommend that you have a surgical procedure called a laparoscopy.

A laparoscopy is the only way to get a definitive diagnosis of endometriosis. Your specialist will be looking for scar tissue and lesions caused by endometriosis within your pelvic cavity.

Although the scarring caused by endometriosis can be surgically removed, there is no cure for the condition, only management. Even after surgery, the condition can still cause symptoms such as painful periods and further scarring may eventually build up. However, optimised surgery combined with appropriate ongoing medical management should help limit the effects of any ongoing symptoms.

Endometriosis treatment

Depending on the severity of your symptoms, there are a few different treatments for managing the symptoms of endometriosis to help improve your quality of life.

Whether or not you’ve had surgery to help you deal with your endometriosis, pain relief can be helpful, especially around the time of your period. This can mean taking non-steroidal antiinflammatory drugs such as ibuprofen from your pharmacy or a drug called mefenamic acid.

Using heat pads or a hot water bottle on your abdomen can also help to relieve pain, along with paracetamol. You may also benefit from hormone manipulation through the oral contraceptive pill, the minipill or a Mirena device..

Some women may be recommended a hysterectomy in conjunction with excising the endometriosis, particularly if you have associated adenomyosis or very severe endometriosis.

The important thing is to know you are not alone in your journey and to reach out to medical professionals if you are in pain.

More information

The King Edward VII’s Hospital Gynaecology Department is a leader in gynaecology. They specialise in diagnosis and treatment and offer one-to-one support from our Clinical Nurse Specialist.

For more information, contact: Mon- Fri 0203 930 1392 or visit kingedwardvii.co.uk