What is endometriosis?
Endometriosis is a very common yet painful condition, affecting around 1 in 10 people with a uterus. It is characterised by the endometrium (the lining of the uterus) growing outside of the uterus, usually in the pelvic area. It can grow on the bowel, bladder, ovaries, fallopian tubes or on other organs. As your body bleeds during menstruation, so do these cells, causing inflammation, pain and scar tissue in the area.
How is endometriosis diagnosed?
Unfortunately, endometriosis is difficult to diagnose. Currently, the only way to diagnose the condition is through laparoscopy, where a thin telescope is inserted through the belly button while the patient is under general anaesthetic. During the procedure, the doctor can see inside the abdomen to identify and remove the abnormal tissue that is believed to contain endometriosis. The tissue is then sent off to a laboratory to confirm the diagnosis.
What are the symptoms of endometriosis?
Endometriosis pain can be debilitating, however some people with the condition won’t experience any symptoms at all. Some have pain mostly around the time of their period, whereas others may experience it all month long.
Some of the common endometriosis symptoms include:
- Abdominal or pelvic pain leading up to and during your period, or during ovulation
- Deep abdominal or pelvic pain during sex or when going to the toilet
- Heavy periods or irregular bleeding, including bleeding or spotting between periods
- Trouble getting pregnant
- Fatigue and nausea
- Constipation or diarrhoea
Possible complications of endometriosis
Over time, endometriosis can cause the pelvic organs such as the bowel, bladder, uterus, ovaries and fallopian tubes to fuse together, which can result in a lot of pain and discomfort. Endometriosis may also cause infertility.
In mild cases, no treatment may be required, but the condition should be observed closely by a doctor to pick up on any changes.
Where treatment is required, there are a few options but there is no ‘cure’. These options may be used individually or combined.
- Medication - over the counter pain relievers such as paracetamol, or non-steroidal anti-inflammatory medications such as ibuprofen may be used to treat the pain associated with endometriosis.
- Hormone therapy - fluctuations in hormones during the menstrual cycle can affect endometriosis, making it more painful during certain times of the month or causing it to worsen over time. Using hormone therapy such as the contraceptive pill helps to suppress the condition to reduce pain and risks of progression and complications.
- Surgery - Endometriosis may be removed through laparoscopic (keyhole) surgery, or more major surgery in complicated cases.
- Complementary medicine - acupuncture and Chinese herbal medicine is a popular choice for those wanting to take a more natural or less invasive approach to treatment.
Causes and prevention of endometriosis
The causes of endometriosis are not clear, and it is believed to be somewhat linked to genetics.
There is also a condition known as “retrograde menstruation”, which is believed to cause endometriosis. This is where the menstrual flow moves backwards into the fallopian tubes and into the pelvic area. The cells can build up on the pelvic organs and can turn into endometriosis over time.
You may be at higher risk of developing endometriosis if:
- You experience heavy or long periods
- If you have short menstrual cycles (with more frequent periods)
- You postpone pregnancy until later in life
- You have a compromised immune system
- You have low body weight or are obese
- You consume a lot of alcohol or have an unhealthy diet
There are some steps you can take to reduce your risk of developing endometriosis:
- Maintaining a healthy diet and active lifestyle, including aerobic exercise regularly
- Having children - childbearing is believed to prevent endometriosis
- Maintain a healthy weight and immune system