Endometriosis is a common and often misunderstood health condition that affects millions of women worldwide. It is a chronic condition in which the tissue that lines the uterus (called the endometrium) grows outside of the uterus and can attach to other organs in the pelvis, such as the ovaries, fallopian tubes, and bladder. This displaced endometrial tissue can cause pain, irregular bleeding, and fertility problems. It's a complex condition that can be difficult to diagnose & treat, but with increased awareness and better understanding of the condition, women with endometriosis can get the help and support they need to manage their symptoms and improve their quality of life.
What are the symptoms of endometriosis?
Every woman with endometriosis is unique and will experience different symptoms. The severity of the symptoms does not necessarily reflect the seriousness of the condition, but rather where the endometrial tissue is located in the body.
Common symptoms of endometriosis include:
- abdominal or pelvic pain before and during a period,
- heavy periods or irregular bleeding,
- changes in urination or bowel movements,
- feeling bloated,
- fatigue,
- anxiety or depression, and
- infertility.
However, not all women with endometriosis will experience symptoms.
What causes endometriosis?
The exact causes of endometriosis are not fully understood, but there are certain factors that may increase a woman's risk of developing the condition. These include:
- retrograde menstruation (when menstrual blood flows backwards into the pelvis),
- a family history of endometriosis,
- long and heavy periods,
- starting menstruation at a young age,
- having your first pregnancy at an older age,
- immune system issues,
- low body weight, and
- alcohol use.
It is also thought that normal pelvic tissue may turn into endometrial tissue, a process known as metaplasia.
How is endometriosis diagnosed?
Many women with endometriosis do not receive a diagnosis until they are seeking help for infertility or when it is discovered during surgery for another issue. Unfortunately, endometriosis is often missed and it can take several years to receive a diagnosis, with the average time being about 7 years.
To diagnose endometriosis, a doctor will typically ask about symptoms and menstrual history. The only way to confirm the condition is through a laparoscopy and biopsy. Increasingly, specialized ultrasound is being used to make a reliable diagnosis in many cases.
There are four stages or grades of endometriosis, ranging from mild to severe, depending on the extent of the disease. Stage/grade I is characterized by small patches of endometriosis in the pelvis, while Stage/grade II and III involve more widespread disease and scarring. Stage/grade IV is the most severe, with endometriosis affecting most of the pelvic organs.
How is endometriosis treated?
The condition can be treated with a variety of methods, including medication, surgery & complementary therapies such as physiotherapy and psychology. The treatment plan will depend on:
- your symptoms,
- the severity of your endometriosis, and
- whether you wish to become pregnant.
Hormone-based medications, such as the pill or an implant, can help reduce pain and slow the growth of endometrial tissue, but the effects only last as long as the medication is taken.
Surgery is another option and may involve laparoscopic procedures to remove as much of the endometrial tissue as possible. In severe cases, a hysterectomy may be recommended. Complementary therapies, such as physiotherapy and clinical psychology, can also help manage chronic pain and other symptoms.
While most women with endometriosis are able to conceive without medical assistance, about 1 in 3 may experience fertility issues. In these cases, IVF may be helpful. It is important to discuss the pros and cons of all treatment options with your doctor, as endometriosis may recur even after successful treatment.
