PAIN EXPLAINED

Expert gynaecologists from King Edward VII’s Hospital in Marylebone explain endometriosis

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 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 a ect them.

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 a ects di erent women in di erent 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

• Pain on passing urine

• Blood in the urine

• Bleeding from the back passage

• IBS symptoms

• Pain and di culty during a smear test

• Fatigue

• Low mood

• Di culty 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, while 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. They may feel around your abdomen and perform an internal vaginal examination. Your specialist may arrange either an internal ultrasound scan or an MRI, to help make a diagnosis based on your symptoms and examination findings. Depending on the results the specialist could recommend that you have a surgical procedure called a laparoscopy, which 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.

Endometriosis treatment

Depending on the severity of your symptoms, there are a few di erent treatments for managing the symptoms of endometriosis to help improve your quality of life. Pain relief can be helpful, especially around the time of your period. 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.

The King Edward VII’s Hospital Gynaecology Department is a leader in gynaecology. They specialise in diagnosis and treatment and offer oneto-one support from our Clinical Nurse Specialist. For more information, contact: Mon- Fri 020 4571 2097 or visit kingedwardvii.co.uk