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Endometriosis is a condition that affects 1 in 10 women – that’s approximately 200 million women and girls worldwide!

Endo March is a worldwide campaign focused on raising awareness of Endometriosis and it runs for the month of March.

This year’s aim of Endo March in Australia is to raise awareness of the disease which will hopefully result in a reduction in the delay of diagnosis. It is thought that currently, the average diagnosis delay is 7 to 10 years, meaning a long and stressful journey from symptoms to diagnosis for many.

Below, I have answered some of the common questions about Endometriosis that I hear in my practice. I hope you find the answers useful.

What exactly is Endometriosis?

Endometriosis is a condition that affects some women in their reproductive years. It occurs when the tissue that normally lines the uterus is found outside the uterus. The areas where it is commonly found are the surface of the ovaries, fallopian tubes, and the tissue lining the pelvis.

Why does Endometriosis cause pain?

It is believed that these tissues grow and cause inflammation, scarring and sometimes adhesions. Similar to the lining of the uterus, these implants respond to female hormones such as estrogen. It is not fully understood why it can cause so much pain in some women; however, it is thought that sometimes the implants bleed and the blood cannot escape from the body during the period, so it bleeds directly onto the surface of the surrounding organs and tissues.

Why me? What are the causes of Endometriosis?

There are many theories that try to explain the origin of Endometriosis. One of them explains it via a process called “retrograde menstruation’’. This backward flow of menstrual bleeding through the fallopian tubes and into the pelvis might cause the endometrial cells to implant on abdominal organs.

Research also suggests altered immunity, coelomic metaplasia, and metastatic spread. Newer research is also proposing stem cell and genetic origins of the disease. A 2013 study from the National Institute of Health also supports this*. For instance, women who have a first-degree relative affected by the disease have a seven times higher risk of developing Endometriosis than women who do not have a family history of the disease.

How do I know if I have Endometriosis?

While some people with Endometriosis experience very little pain and no symptoms at all, others have severe pain and several symptoms.

The most commonly reported symptoms are

  • Period pain before and during a period.
  • Pain during or after sexual intercourse.
  • Abdominal, back and/or pelvic pain outside of menstruation.
  • Painful bowel movements or urination.
  • Abdominal pain at the time of ovulation.
  • Heavy or irregular bleeding with or without clots.
  • Premenstrual spotting.
  • Extreme tiredness.
  • Difficulty falling pregnant.

How can I check if I have Endometriosis?

The first thing is to discuss it with your GP. If required, your GP may then refer you to a gynaecologist for further investigations. Sometimes an ultrasound will detect the Endometriosis; however, the only definitive method of diagnosis is through a laparoscopy.

What are the treatment options for Endometriosis?

When considering the treatment plan for Endometriosis, you will need to decide whether your primary goal is to treat pain or maximise fertility.  Drug treatment – Hormone therapies are suitable for mild Endometriosis, or before or after surgery. The aim is to suppress the growth of endometrial cells. Hormone therapies should only be used if you are currently not trying to fall pregnant.  Surgical treatment – A laparoscopy can surgically remove endometrial implants or adhesions that have resulted from Endometriosis. Research suggests that removing Endometriosis surgically can sometimes improve the chances of becoming pregnant.

Will Endometriosis have an impact on my fertility?

In many cases, the presence of Endometriosis impacts on a female’s chances of falling pregnant due to altered ovulation and oocyte (egg) production, luteal phase disruption, the effect on fallopian tubes and in turn embryo transport, and detrimental effects on the endometrium.

However, some women with Endometriosis have fallen pregnant easily.

If surgical treatment does not help, fertility medication and treatments can be considered. Commonly, ovulation-stimulating medication combined with Intra-Uterine Insemination (IUI) is all that is needed to further enhance fertility.

If surgery and IUI have not helped achieve a pregnancy, In Vitro Fertilisation (IVF) can be considered. IVF procedures are often effective in improving fertility, and the decision about whether to opt for this must take into account the age of the patient, severity of the Endometriosis, the presence of other infertility factors and the results and duration of past treatments. Thorough consultation with a fertility specialist is always advisable.

To find out more about Endo March events in Australia, visit here

Image courtesy of Shutterstock.com

  • Thank you for an informative article. Unfortunately doctors think I do have endo, I am in severe pain, day in day out, I just want to be better

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  • Thank you for the thorough and informative article.

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  • My middle daughter suffer with this and when I say suffers…thats exactly what I mean.
    Shes had 2 surgeries and has been told that thus far her fertility has not been affected but of course they cant guarantee anything for the future. Some times shes in so much pain. Its such a horrible thing to watch.

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  • Endometriosis is so common yet sufferers seem to just think it’s typical period pain, the joys of being a female.

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  • my doctor thought i had this but turns out i have a Retroverted uterus, which have similar symptoms

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  • That is really good to be aware of this.

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  • My sister in law had this really bad at age 19. Ended up she had to have a hysterectomy, no kids for get or my brother. Pretty sad

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  • I believe I do have some form of endometriosis. I have experienced extremely painful and heavy periods from my first age 11. So much so that I needed at least a day off school every month to just lie on the couch rubbing my stomach. I just thought it was this way for everyone. Back in those days, Ponstan was the miracle drug as my Mum didn’t want me on the pill. Many years later, the pill did regulate and improve things. I had great difficulty conceiving and it took 4 years, and finally IVF to become a Mum. Things were so difficult we didn’t go back for another try. I am back on the pill to manage post-natal acne which again regulates my period, but when I took a break, the heavy bleeding, pain, etc. returned. I’ve had chats with my GP (a man!), pelvic ultrasounds, etc. not specific to endometriosis. I have regular pain in what feels like my right ovary, but nothing serious enough. It’s just something I live with.

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  • My daughter had endometetriosis over 17 years ago but was lucky enough to get pregnant and had a lovely baby girl. The condition disappeared as is usually the case but 15 years later it reared it’s ugly head and she was in severe pain .It got so bad she had to hAve an operation and is ok now.
    At certain stages of her life she continued to take the pill non-stop so she would not get a period and I was wondering if there is any proof that this could have brought the condition back. It would really be good to know so I can help my other daughter should she try the same thing

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  • Good & clear article !

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  • Great article, pity it was posted in April. I feel very sorry for those women who suffer this complaint.

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  • I found out I had endometriosis when I was trying to get pregnancy. A laparoscopy determined one of my tubes was completely blocked and the other partially blocked.

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  • Shame this article was posted post March

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  • I heard a radio announcer talking about this problem a couple of years. Hers was recurring and she had surgery several times. She got a big surprise when she got pregnant naturally .

    Reply

  • I am an Endometriosis sufferer. I had mine discovered and removed last year. I then fell pregnant a few months later and we now have a beautiful daughter. I have suffered with painful periods since getting them & it got to a point last year I started to get pain all month long and so severe that I would collapse. More women should be listened to by their doctors when they talk about pain associated with their periods.

    Reply

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