Endometriosis
What is endometriosis?
Endometriosis is a painful disorder where tissues that lines the womb is found outside of the uterus and in other parts of the body.
The tissue would be found in the abdomen, on the ovaries, fallopian tubes, but it can also be found:
- in the bladder;
- in the bowel;
- in the vagina;
- in the cervix and
- in the vulva
In rare case of endometriosis, growths can be found in the lungs, the diaphragm and other locations.
What causes endometriosis?
The cause of endometriosis still remains unknown. Some experts suggest that endometriosis occur due to a process called retrograde menstruation. The menstrual blood flows back through the fallopian tube into the pelvic cavity instead of leaving the body through the vagina. Another theory for the cause of endometriosis is that hormones transform cells outside of the womb into cells similar to those of the lining of the uterus (endometrial cells).
What are the main symptoms of endometriosis?
The symptoms of endometriosis can differ, with some women affected more than others. These include:
- Period pain that is not relieved with painkillers.
- Heavy periods.
- Infertility.
- Pelvic pain.
- Pain during and after sexual intercourse.
- Pain when going to the toilet.
- Blood in the stool.
- Fatigue.
- Gastrointestinal upsets – diarrhoea, constipation and feeling nauseous.
The main way to diagnose endometriosis, is by laparoscopy. This is when a camera is inserted into the pelvis via a small incision in the stomach. Then the camera is used by the surgeon to see the pelvic organs and look for signs of endometriosis.
Scans, blood tests and internal examinations, even if they have normal results, are not a conclusive way to diagnose endometriosis.
Diagnosing endometriosis can be difficult because its symptoms are very similar to other common conditions, i.e. adenomyosis, fibroids, pelvic inflammatory disease and irritable bowel syndrome (IBS).
How do you treat endometriosis?
Currently, there is no way to cure endometriosis but there are treatments that ease the symptoms. These include:
- Anti-inflammatory painkillers and pain management strategies.
- Hormone medicines and contraceptives – the combined pill, the contraceptive patch and the intrauterine systems (IUS), i.e. mirena coil.
- Surgery.
What is involved in surgery for endometriosis?
Surgery for endometriosis can be beneficial but unfortunately symptoms may recur. There are different types of surgery depending on symptoms and treatment goals, including fertility. Surgery aims to remove or destroy the deposits of endometriosis. The endometriosis can be cut out by the surgeon or or it can be destroyed using heat and laser. More complex surgery may involve different organs of the body that are affected by endometriosis, such as the bowel, bladder, or ureters. This type of surgery can involve a more holistic approach which would involve different specialists including a gynaecologist, colorectal surgeon and a urologist.
The most radical endometriosis surgery may involve having a hysterectomy, which is the removal of the womb and/or oophorectomy, which is the removal of the ovary.