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Your guide to endometriosis

Endometriosis affects one in 10 women and is when the lining of your womb grows in other places such as your ovaries and fallopian tubes. We explain why it occurs, its symptoms and the complications that can endometriosis can cause and how it can be treated. 

Endometriosis is a long-term condition that can affect women of any age. It can have a significant impact upon your quality of life. We take a look at the causes, symptoms and treatments available.

Endometriosis is a long-term condition that often causes severe pain. It can affect women of any age. It is disorder in which the tissue that forms on the lining of the womb (uterus) begins to grow in other parts of the body. This endometrial tissue can grow on:

  • Ovaries
  • Fallopian tubes
  • The tissues that hold the womb (uterus) in place

Because this tissue is the same as the cells that line the womb, it reacts in a similar way during the menstrual cycle — it thickens, then breaks down and bleeds. However, this blood does not have a way of leaving the body, so it becomes trapped, leading to inflammation and pain. Surrounding tissue can also become irritated, which may lead to scar tissue.

There is no cure for endometriosis. However, there are a range of treatments that can help you to manage the symptoms and endometriosis pain.

At present, the cause of endometriosis is not known. There are a range of theories that suggest possible causes. These include:
  • Genetics: It may be passed down from mother to daughter, and it affects certain ethnic groups more than others.
  • Retrograde menstruation: Part of the womb lining flows up through the fallopian tubes and embeds itself on the organs in the pelvis.
  • Problems with the immune system: The body’s natural defence against infection fails to fight off endometriosis.
  • Lymphatic or circulatory spread: Endometrial cells are thought to travel round the body through the lymphatic system or in the bloodstream
  • Environmental causes: Toxins in the environment may affect the body, causing endometriosis.

However, none of these theories fully explain why women develop endometriosis.

Endometriosis symptoms can vary. They range from very mild symptoms that are barely noticeable to severe pelvic pain. The main symptoms include: Endometriosis can have a huge impact on your quality of life, which can affect your mental health and leave you with feelings of depression.

If you have signs of endometriosis, you should see your doctor as soon as possible, particularly if they are having an impact on your life. Endometriosis diagnosis can be difficult and your doctor may seek to rule out other conditions that cause similar symptoms first.

During the examination, the doctor will ask you about your symptoms and may perform a pelvic examination. They may refer you to a gynaecologist for some further tests, including:

Ultrasound scan: This may be a transvaginal ultrasound or an abdominal ultrasound. Both can help your doctor identify cysts that are associated with endometriosis.

Laparoscopy: This is a surgical procedure that allows the surgeon to look inside your body using an instrument called a laparoscope. It allows the surgeon to identify endometriosis tissue and is the only way to be certain that endometriosis is causing the symptoms.

Endometriosis can have an impact on your ability to become pregnant, although it is not fully understood why it does affect your fertility. And not all women with the condition will have difficulties becoming pregnant.

Certain treatments for endometriosis may improve your chance of becoming pregnant, but there is no guarantee.

If the endometriosis occurs in or near the ovaries then some women may develop adhesions. These are areas where endometriosis tissue has joined different organs together.

Sometimes ovarian cysts may develop. These are fluid-filled cysts that grow in the ovaries. If they grow to a large size then they can become very painful.

Endometriosis can also affect the bladder or bowel. You doctor may refer you to a specialist if these two organs are affected. In both cases, your doctor may recommend surgery to treat these conditions.

Endometriosis can be a difficult condition to deal with, both physically and emotionally, so it is advisable to seek out help from a support group.

The condition can be difficult to treat because there is no cure for it. The treatments available are aimed at easing the symptoms, so you can lead a normal life. Your doctor or gynaecologist will discuss the different treatment options with you.

The first course of action is to treat the pain. Anti-inflammatories, such as paracetamol or ibuprofen, can be taken to see if they reduce pain.

Your doctor may suggest hormone treatment to limit or stop your body from producing oestrogen. This can reduce the amount of endometriosis tissue that the body produces, which can reduce some of the symptoms.

The main hormone treatments include:

Hormone treatments can help relieve the milder symptoms associated with endometriosis. The main benefit is that they can be used over long periods of time.

Hormone treatments do carry some side effects, including:

  • Bloating
  • Mood changes
  • Irregular bleeding
  • Weight gain

However, the main side effect of hormone treatments is that they can reduce your chance of becoming pregnant. 

Surgery is also an option to treat the symptoms. It can be used to remove the tissue. There are two types of endometriosis surgery - a laparoscopy and a hysterectomy. 

A laparoscopy, which is more commonly known as keyhole surgery, involves making a small cut into the abdomen. This allows the surgeon to insert a device called a laparoscope. This is a small flexible tube that contains a camera, which sends images to a monitor.

Then using a variety of tools, the surgeon can either destroy or remove the endometriosis tissue. The procedure is carried out under general anaesthetic.

Laparoscopic surgery is the most common surgical procedure used to treat endometriosis symptoms.

The other surgical option is a hysterectomy, which is a major operation that will have a significant impact on your body.

During this surgical procedure, the womb (uterus) is removed. You will only be offered this option if other treatments have not worked and you have decided not to have any more children.

Hysterectomies cannot be reversed and, though unlikely, endometriosis symptoms could return after the operation.

A consultation with an experienced gynaecologist is often the quickest and simplest way to resolve your problem.

They will be able to diagnose the cause of your pain and talk with you about the best treatment options for your specific situation.

An appointment with an experienced Consultant at your nearest BMI hospital can be helpful. They will assess and diagnose the cause of your symptoms and then discuss any suitable treatment options for your specific situation. To schedule your visit, book a specialist appointment online today. 

We partnered with pioneering research charity Wellbeing of Women to produce our Women's Health Matters 2021 report.

Wellbeing of Women help improve pregnancy care, IVF outcomes and the risk of childbirth complications for women through their ground-breaking research. Women's Health Matters 2021 provides a comprehensive analysis of ten of the most common gynaecological conditions misdiagnosed or misunderstood for years at a time. Infertility, debilitating chronic pain, the onset of associated conditions and severe depression are common effects of living with a gynaecological condition without access to the right care. Yet despite this, education and awareness around women’s health is lacking.

Millions of women in the UK continue to suffer in silence while waiting for a diagnosis, unsure of how best to manage their pain or seek help.

The aim of this Women's Health Matters is to tackle taboos in women's health by sharing the hard-hitting stories of other women living with these conditions, as well as:

  • Insightful commentary by specialist Consultant gynaecologists;
  • Information about what to look out for, diagnostic testing and effective treatment options for each condition;
  • Links to trusted support networks across a range of conditions;
  • Expert insight shared by Wellbeing of Women, ground-breaking research charity and advocate for increased awareness of women's health; and
  • Much more. 


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