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What is Endometriosis?

What is Endometriosis?

Endometriosis is a painful condition in which endometrial tissue will grow outside the uterus often in the pelvic area.

With this condition, the endometrial like tissue acts as normal endometrial tissue would – thickens, breaks down and bleeds with each menstrual cycle, but this tissue has no way to exit the body and therefore it becomes trapped.

Due to the tissue becoming trapped it then causes the individual a lot of pain.

What causes Endometriosis?

The exact cause of endometriosis is not certain but there are a number of possible explanations as to why it occurs.

One explanation is retrograde menstruation, this is when the menstrual blood containing endometrial cells flows back through the fallopian tubes into the pelvic cavity instead of out the body. These endometrial cells will then stick to the pelvic walls and surfaces of pelvic organs, they continue to grow and thicken over time, they then bleed over the course of each menstrual cycle.

Another cause could be the transformation of peritoneal cells. This process is when the hormones or immune factors promote the peritoneal cells (cells lining the inner side of your abdomen) into endometrial like cells.

What are the common symptoms of Endometriosis?

The primary symptom is pelvic pain which is often associated with menstrual periods, although many will experience cramping during their menstrual periods.

Many suffering with endometriosis will typically describe the menstrual pain far worse than usual – pain also tends to increase over time.

Other symptoms may include:

  • Painful periods (dysmenorrhea) that is not relieved by painkillers
  • Pain with intercourse – during or after sex is common
  • Pain with bowel movements or urination – experience these symptoms during a menstrual period
  • Excessive bleeding – occasional heavy menstrual periods or bleeding between periods
  • Infertility – endometriosis is first diagnosed in those seeking treatment or infertility
  • Other signs and symptoms – experience fatigue, diarrhoea, constipation, bloating or nausea especially during menstrual periods

How is Endometriosis diagnosed?

The specialist will perform a procedure known as Laparoscopy. This is when a laparoscope (small camera) is inserted into the abdomen to look directly at the tissues. This will show the location, size and extent of the growth. The procedure will typically be carried out under a general anaesthetic.

This technique is the most accurate way of diagnosing as the specialist can see exactly what is going on.

How is Endometriosis treated?

There are a number of treatment options available.

One option available is surgery, the options are categorised as conservative surgery and radical surgery.

Conservative surgery will aim to recover or destroy the deposits of endometriosis and this will usually be carried out via a laparoscopy.

Radical surgery involves either having a hysterectomy (removal of the womb) and oophorectomy (removal of the ovaries).  Radical surgery will be considered for a number of reasons, the decision to have either of these procedures is a big one to make and they are essentially irreversible therefore it is advised that all options should be considered.

Another option that is available is hormone treatment. Treatments that fall under hormone are used to act on the endometriosis and stop its growth, the treatment will either put an individual woman into a pseudo pregnancy or pseudo menopause.

The drugs that mimic pregnancy include a combined oral contraceptive pill, progestogens, Mirena IUS.

The drugs that mimic menopause are GnRH analogues.

Finally, there is an option to take pain relief medication. Pain from this condition will vary from either being acute or chronic.

Effective drugs for treating each condition are available, simple painkillers for acute pain these include ibuprofen, aspirin and naproxen.

For chronic pain, it may be recommended that you using a combination of painkillers and other therapies to get some sort of relief.

Who to see for help?

Here at The New Foscote Hospital, we have a number of gynaecologists that specialise in the diagnosis and treatment of endometriosis.

If you feel as though you are experiencing any of the symptoms above give us a call on 01295 252281 or email us at appointments@foscote.hospital.

To see more about our gynaecologists and other gynaecology treatments offered click here.