By Dr Shabrina Fathima | 03 Mar 2021

What is endometriosis?

March marks Endometriosis Awareness Month across the world. Despite improvements in diagnosis and care in recent years, very few people are aware of this potentially serious condition.

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Endometriosis is a potentially serious condition that can affect women of any age. When you have endometriosis, tissue usually found in the womb's lining begins to grow elsewhere around the reproductive organs, such as the fallopian tubes and ovaries.

Endometriosis is a long-term condition that is potentially life-changing for the women it afflicts. However, several treatment options are available to help endometriosis patients manage their condition and any pain they're experiencing.

What causes endometriosis?

The cause of endometriosis is unknown, although the medical community generally accepts that a combination of factors causes the condition to develop.

The following have all been suggested as potential causes. However, there is no definitive evidence that any is singularly responsible or of the significance of their role in how endometriosis develops:

  • Deficiencies in the immune system.
  • Endometrium cells, which make up the lining of the uterus that thickens during the menstrual cycle, spreading through the body via the bloodstream or lymphatic system.
  • Patterns of endometriosis in families and higher instances of the condition among specific ethnic groups have been established.
  • Retrograde menstruation. This occurs when the womb lining flows up through the fallopian tubes and embeds on reproductive organs around the pelvis, rather than leaving the body as a period during the menstrual cycle.

What are the symptoms of endometriosis?

As with many conditions, the symptoms of endometriosis vary between patients. Some women can suffer severe debilitating pain, while others might not have any noticeable symptoms and find their endometriosis easy to manage.

The primary symptoms that do typically exhibit themselves are:

  • Experiencing difficulty in falling pregnant.
  • Sickness, constipation, diarrhoea, or blood in your urine during your period.
  • Pain when using the toilet during your period.
  • Heavy periods.
  • Pain during or after sexual intercourse.
  • Severe period pain that prevents you from working or doing other everyday tasks.
  • Pelvic pain that is typically dull but may become acute or more noticeable during your periods.

When should I see a clinician, and how is endometriosis diagnosed?

You should make an appointment with a clinician if you’re experiencing any of the symptoms of endometriosis. Even if you’re not ultimately diagnosed with endometriosis, your symptoms may be a sign of another illness or condition that requires medical attention. Some clinicians may ask about the pain you're experiencing and your history of symptoms. It is worth keeping a diary logging specific symptoms and whether pain prevented you from going about your typical daily routine.

Due to endometriosis symptoms being familiar with various other conditions, diagnosing it can be challenging. Many women are treated for other conditions on the assumption they don't have endometriosis, sometimes for many years, before they receive a diagnosis.

At your first appointment, your doctor may examine your abdomen and vagina. If they suspect you may have endometriosis following this initial examination, they may prescribe treatments without further testing.

You will typically take prescribed medication for several weeks to ascertain whether it effectively reduces symptoms, relieves pain, and allows you to live your life as close to normal as possible.

If symptoms persist, your clinician may refer you to a gynaecologist for tests, which may include ultrasound scans or a laparoscopy. Laparoscopy is the only means of diagnosing endometriosis with certainty.

What treatments are available for endometriosis?

There is currently no cure for endometriosis. Instead, if you're diagnosed with endometriosis, you will typically be prescribed a range of treatments following consultation with your clinician. Your doctor may advise you to do nothing to see if your symptoms improve themselves in the first instance.

If you do require treatment, this may include:

  • You may be able to manage your endometriosis using over the counter medication. Still, your clinician may prescribe more potent painkillers if you need them.
  • Hormone medicines and contraceptives.
  • Surgery to remove the patches of endometriosis tissue responsible for the most significant pain.
  • Surgery – such as a hysterectomy - to remove part or all of the organs affected by endometriosis tissue.

What problems and complications does endometriosis create?

The most significant complication associated with endometriosis is difficulty in getting pregnant. Some women may even be infertile owing to endometriosis.

While surgery to remove patches of endometriosis tissue can improve the chances of getting pregnant, there are no guarantees.

Other possible problems and complications tend to arise from surgical procedures, including bleeding, infection, and damage to your womb or other organs in the reproductive system.

It is also relatively common for women with endometriosis to experience depression and require mental health support, particularly when the condition leads to significant disruption in their lives.

Getting support when living with endometriosis

Besides helping you access any necessary mental health support, your clinician may also be able to help you find support groups to help you deal with your condition. It is also worth searching for online forums and social media groups yourself. Sometimes the most significant reassurance comes from knowing you're not alone, and some people can relate to what you're going through.

Learning more during Endometriosis Awareness Month

While many people have little to no awareness of endometriosis, it is estimated that 10% of women worldwide are affected by the condition. That's around 200 million people whose lives are potentially being negatively impacted by an unavoidable health condition. For some women, diagnosis can be delayed by as much as ten years due to the lack of awareness of endometriosis!

You can learn more about Endometriosis Awareness Month and the ongoing global campaigns to raise awareness of endometriosis at the EndoMarch website.