Endometriosis is a condition where the cells that line the womb (uterus) are found elsewhere in the body. The lining of the womb is what is shed during your period but the cells that are found in other parts of your body are unable to leave the body like a period and can cause problems.
Pain in a variety of forms is the main complaint of endometriosis. For example, women may find that they have:
- Painful periods
- Painful sex
- Lower tummy pain (pelvic pain)
- Pain passing faeces or urine
- Difficulty becoming pregnant
- Unusual vaginal bleeding (outside of normal periods)
Why Do I Have Endometriosis?
The causes of endometriosis are still unclear and there have been a few possible theories. One of them includes the concept of “retrograde menstruation ”. This is the idea that during a period, some of the lining falls into the pelvic area through the fallopian tubes and endometrial tissue is deposited in sites other than the womb.
Although the cause is unknown, there are multiple factors that contribute to the condition:
Genetics: For example, endometriosis can run in families – therefore there is a genetic aspect to endometriosis.
Age: It is also rare in women who have gone through the menopause as endometriosis is strongly linked with the female hormone, oestrogen, which falls after menopause. This means endometriosis is more likely in women aged 25 to 40 years old.
How Is Endometriosis Diagnosed?
Your GP will ask questions about your symptoms and address any concerns you may have. To get a confirmed diagnosis of endometriosis, it is best to have a laparoscopy which is a small operation where small cuts are made into your tummy and then a thin camera is inserted to look for evidence of endometriosis patches.
Is there a Cure?
Unfortunately, there is no cure for endometriosis at the moment. However, there are many options available to help reduce the symptoms and improve your quality of life. Your GP will be able to discuss what options are best suited to you.
The treatment options available to you are surgery, hormone treatments and painkillers.
Your GP would not jump straight to offering you an operation. This is because there are many women whose main concern is with the symptoms such as painful periods. In these cases, your GP can offer you initial treatment of anti-inflammatory painkillers such as ibuprofen, mefenamic acid or naproxen.
Painkillers & Hormonal Treatment
These painkillers can also be offered with the combined oral contraceptive pill. The combined pill helps the symptoms of endometriosis by stopping ovulation and therefore reducing the amount of oestrogen in the body.
Hormonal Intra-Uterine System (IUS)
Another treatment that is available is the levonorgestrel-IUS (LNG-IUS, Mirena Coil), which is a small plastic hormonal contraceptive device that is placed within the womb. It is effective for up to 5 years and works by thinning the lining of the womb, abolishing or reducing periods and reducing pain associated with periods.If your symptoms do not improve then other hormonal medications such as GnRH analogues or progestogen hormone tablets can be used.
If you are concerned with your fertility or the severity of your symptoms then a laparoscopy can be discussed, where diagnosis and treatment (where endometriosis patches are removed) can be carried out.
Dr Seth Rankin is founder of London Doctors Clinic