Endometriosis 101

Endometriosis is a condition in which cells that are usually found in our uterine lining are found elsewhere in the body and function in the same way as they would inside the uterus.

For those that menstruate, every month hormones are released that cause us to build up cells in the lining of our uterus in preparation for an egg to be fertilised and implant in the uterus. If fertilisation doesn’t occur, this lining breaks down and is shed via a period each month. 

For those with endometriosis, the cells which grow outside of the uterus react in the same way. However, there is no exit (period), which leads to inflammation inside the body and the development of scar tissue.

Typical symptoms of endometriosis are:

• Moderate to severe period pains
• Fatigue
• Painful penetrative intercourse (sex)
• Pain passing urine or bowel movements
• Heavy periods
• Diarrhoea or constipation
• Bloating
• Difficulty getting pregnant
• Pain during ovulation
• Spotting between periods
• Back pain

As the symptoms of endometriosis can be broad and overlap with other conditions, endometriosis can be difficult to diagnose. This means a number of women are misdiagnosed, and proper treatment is delayed. Recent research suggests that it can take an average of 7.5 years to receive a diagnosis.

Unfortunately, scans and blood tests cannot diagnose endometriosis. To receive a definitive endometriosis diagnosis, a laparoscopy must be performed. This is where a camera (laparoscope) is inserted via the navel to the pelvis. This camera looks for signs of endometriosis.

If you have symptoms of endometriosis, visit your GP and be sure to explain your symptoms with as much detail as possible. Advocating for yourself may be uncomfortable, but it’s important to ensure you are receiving the correct care for your needs as soon as you can.

Causes:

We are unsure what exactly causes endometriosis. However, it is thought to run in families. It is also thought to relate to issues with immune health.

Management:

Unfortunately, endometriosis is a life long condition, without a cure. However, it is possible to manage symptoms.

Management of endometriosis can differ depending on age, severity and type of symptoms and whether you are ready to conceive.

Pain relief:

Over the counter pain medication can help ease some symptoms. Warm baths and hot water bottles can also help ease pain.

Hormones:

As endometriosis responds and grows when exposed to the female hormone oestrogen, hormone treatments can help influence the production of oestrogen in the body and ease symptoms. 

• Combined oral contraceptive pill: this contains a mix of oestrogen and progesterone, and suppresses ovulation. This impacts the production of female hormones, leading to shorter, lighter periods. It therefore makes a great choice for those with mild symptoms. However, the pill often has a number of side effects, so it can be a case of trial and error to find the right pill for you.
• Intrauterine System (IUS): Often known as the hormone coil. This device can help support symptoms by releasing progestogen locally into the uterus.
• Progestogens
• GnRH analogues
• Testosterone derivatives

Testimonials:

Over a period of 6 years, I had come to the conclusion that I had “normal” period pains, and that I just needed to get on with it. After several GP visits, with each dismissive doctor telling me to take an ibuprofen and carry on, that it was just part of being a woman, take another STI test because of your age, it must have all been in my head. It wasn’t until I was taken to hospital with debilitating cramps, and what felt like an uncontrollably heavy flow, my mum told me enough was enough. I was lucky enough to be able to afford to see a private gynaecologist, and the same day had tests on the suspicion that I had endometriosis. This was confirmed and treated via laparoscopy, hysteroscopy, IUI and the contraceptive pill. I wish I had had the courage to have been insistent that something was wrong, rather than suffer in silence, believing someone else telling me what was normal with my own body.