What is Endometriosis?
Endometriosis is a common condition it is often linked to infertility, but often women wait a long time before realising they have a problem. Endometriosis is where tissue, similar to the lining in the womb finds itself elsewhere in the body. It is usually found in the pelvis around the ovaries and fallopian tubes.
Health issues caused by Endometriosis
Symptoms vary and this often makes this condition harder to diagnose. Endometriosis can cause issues like;
- pelvic pain
- painful, often irregular heavy periods
- pain during or after sex
- fertility problems.
Women may also experience pain in the bowels, bladder, lower back or the tops of the legs and long-term fatigue.
In some cases, women with Endometriosis do not experience any symptoms.
Endometriosis may cause pain that appears in irregular patterns, often the pain will get worse before and during your period. Often women experience pain all the time, yet for some women the pain may come and go.
It is a very common condition and may affect around 1 in 10 women, although you are more likely to get endometriosis if your mother or sister has it.
Getting pregnant can be a problem for some women with endometriosis. Hormonal treatments are not advisable when you are trying to conceive so considering one of the surgical treatments may be better.
It is important to talk about the possible treatments in detail, every woman is different, and circumstances and severity of the condition will be discussed.
We have a number of treatment options for endometriosis;
This type of treatment reduces or stops ovulation, therefore allowing the endometriosis to shrink from the lack of hormonal stimulation. Some hormone treatments act as a contraceptive pill and will prevent pregnancy, these include;
– The combined oral contraceptive (COC). This comes as a pill or as a patch and used continuously without the normal pill break. This pill typically stops ovulation and temporarily either stops your period or makes them lighter and less painful.
– An Intrauterine System (IUS/Mirena) This helps to reduce the pain and helps to make periods lighter, often women who use IUS don’t get a period at all.
Other hormonal treatments that help with endometriosis are not contraceptives, these include;
– Progestogens, which come in the form of tablets.
– Gonadotrophin releasing hormone agonists (GnRHa). You receive this treatment via injections, implants or as a nasal spray. This treatment option is very effective, yet, they can cause menopausal symptoms, such as hot flushes and are commonly known to reduce bone density.
Having surgery can treat or remove areas of endometriosis. The type of surgery you receive will depend on where the endometriosis is and how extensive it is. This decision may occur when you first get the diagnosis, or you can make a decision later on.
Possible operations include;
Laparoscopic surgery- This is where we remove or destroy patches of endometriosis.
Laparotomy- This option is for more severe cases. This type of surgery is a major operation that requires a cut in the abdomen so that we can remove the endometriosis from the areas it is affecting and provide some symptom relief.
Often the surgery involves removing large endometriotic cysts from the ovaries. This may also include the removal of the ovaries with or without performing a hysterectomy. You will no longer be able to have children after a hysterectomy, yet longer pain relief is more likely to happen with the removal of the ovaries.
Some women have found that these options help with managing endometriosis;
– Exercise, this will help improve your overall wellbeing and often helps to improve some of the symptoms you may experience.
– Cutting out certain foods like dairy and wheat products from your diet.
– Psychological therapies and counselling