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Expert insight: Gynaecologist answers 6 questions about Endometriosis

 

Looking for more information on Endometriosis? Our Consultant gynaecologist, Ms Anne Henderson gives us the lowdown on this chronic condition, from the symptoms to the treatment options.

 
Do you know much about Endometriosis? Now’s your chance to learn more about this condition that currently affects 1 in 10 women in the UK.
 

Our consultant Gynaecologist has answered 6 questions about endometriosis:

 

What is endometriosis?

 
Endometriosis is a surprisingly common gynaecological condition which is still poorly understood despite many years of scientific research. It is thought to affect between 10-20% of the population in varying degrees of severity. It can cause widespread symptoms throughout a woman’s life.

 

What causes endometriosis?

 
The actual cause of endometriosis is not fully understood but we do know the following:

 

  • There is an increased likelihood that women will suffer from the condition if other female members of their family e.g. mothers and sisters are also affected. This suggests that there is a direct genetic link to the condition.

 

  • Endometriosis is much less common in women who have never menstruated i.e. never had periods. There is thought to be a link with menstrual blood passing through the fallopian tubes into the pelvis during a period. The blood is extremely irritant and can cause inflammation and then damage to the delicate organs within the pelvis, including the ovaries and bowel.

 

  • Most women will experience retrograde menstruation such as this but do not suffer from endometriosis. There is probably a deficiency in the immunity system in sufferers which increases the risk of tissue damage.

 

What are the symptoms of endometriosis?

 
Symptoms can vary hugely, and some women are completely asymptomatic i.e. have no problems at all. The commonest symptom is the pelvic pain. This tends to occur with a period (dysmenorrhoea) and can also occur with intercourse (dyspareunia). Some women also experience more generalised pain. This usually indicates more severe and widespread endometriosis. Bowel symptoms including pain and rectal bleeding are less common but can also happen. As can generalised bloating particularly during periods. There is also an increased risk of infertility, particularly if the endometriosis affects the ovaries and fallopian tubes. Surprisingly, heavy periods are not necessarily a symptom of endometriosis. In fact, many sufferers have light or moderate periods.

 

When should you seek advice from their GP?

 
As a rule, any adverse symptoms which persist for longer than three months should be discussed with a GP and investigated where necessary. This timescale will exclude women who are less likely to have problems such as endometriosis. Women who experience persistent problems, particularly when symptoms such as period pain fail to respond to standard painkillers are more likely to have underlying pelvic pathology, including endometriosis.

 
The diagnostic process starts with a detailed history and pelvic (internal) examination. In many cases, it can be possible to detect the condition on that basis. Most women will go on to have some form of imaging such as a pelvic ultrasound scan and/or MRI scan. Although not all cases of endometriosis can be detected even with this. If there is a suspicion of endometriosis, then most GPs would refer the patient to a local consultant gynaecologist for further investigations. In the end, the only conclusive way to make the diagnosis is to carry out diagnostic laparoscopy under anaesthetic. This involves having a telescope with a camera attached inserted into the abdomen to view all the organs. This is known as the “gold standard” for diagnosis of endometriosis. It can also help the surgeon assess the extent and severity of the condition as well.

 

What are the treatment options?

 
There is no cure as such but with special care, most women can achieve a balance where their symptoms are manageable. Underlying problems, such as infertility, can also be treated. Management ranges from simple painkillers (such as Paracetamol and Ibuprofen), hormonal treatments (such as the combined pill, Mirena coil and GnRH analogues) to more radical intervention with surgery. Surgery is usually carried out laparoscopically and can be challenging for the surgeon. There are now specialist Endometriosis Centres being set up throughout the country. Women can have expert treatment at these by fully trained endometriosis surgeons.
 

 

Where can I get further information on the internet?

 
There are several excellent UK-based websites to review:
 

 

 
Thanks for Ms Anne Henderson for this informative article! If you are concerned about any symptoms, then it’s important to always consult your GP for medical advice. For more insights on Endometriosis, take a look at this article where EndoWarrior Sally talks about living with endo.

 
Photo cred:  Daria Nepriakhina

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