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About Endometriosis
Endometriosis is a disease in which tissue similar to the lining of the uterus grows outside the uterus. It usually grows in your pelvis but can occur in almost any part of the body. It can cause severe pain in the pelvis and make it harder to get pregnant. Endometriosis can start at a person’s first menstrual period and last until menopause.
Endometriosis is a progressive and chronic condition, meaning it gets worse over time and may affect how you take part in education, work or sporting activities. About 1 in 9 females in Australia develop endometriosis and it causes tens of thousands of hospitalisations every year.
What causes Endometriosis?
Doctors don’t know what causes endometriosis, but there are some things that put you at greater risk:
Retrograde Menstruation when menstrual blood flows backward into fallopian tubes and pelvis instead of the vagina.
Immune system does not stop the growth of uterine tissue outside of the uterus.
Family History those that have a close relative with endometriosis are up to 7 to 10 times more likely to develop it.
Other possible contributing factors for endometriosis include:
- Long and heavy periods
- Frequent periods or short cycles
- Starting your period before 11 years of age
- Having your first pregnancy when you are older
- Low body weight
- Alcohol use
How is Endometriosis managed?
Endometriosis can usually be treated with medicines, surgery and/or complementary treatments like physiotherapy and psychology. Treatment will depend on your symptoms, severity of your endometriosis and whether you want to become pregnant.
Medicines: for endometriosis include hormone-based treatments such as:
- Oral contraceptive pill
- Contraceptive implant
- Intrauterine device (IUD)
- Gonadotrophin-releasing hormone analogues (GnRHa)
Hormone treatments can reduce pain and the growth of endometrial cells. Hormone therapy is not suitable for women who want to get pregnant. Your doctor may also recommend that you take pain-relief medicines.
Surgery: treatment aims to remove as much of the endometriosis as possible. There are several options, including laparoscopic surgery. Surgery may also be combined with medicines to increase the benefits and help keep your symptoms controlled.
Lifestyle: If you are living with endometriosis, make sure you get plenty of sleep, exercise regularly and reduce stress as much as possible.
What are the most common symptoms of Endometriosis?
Depending on where the endometriosis is, the severity of the symptoms will change.
- Abdominal (tummy) or pelvic pain before and during your period, during or after sex or when going to the toilet
- Pain in your thigh or leg, which may get worse over time
- Heavy periods or irregular bleeding, sometimes with clots, or bleeding for longer than normal or before your period is due
- Bleeding from the bladder or bowel, or changes in urination or bowel movements, such as needing to urinate more often
- Feeling bloated, with or without pain
- Being tired, especially around the time of your period
- Not being able to get pregnant
For some people, the pain is so severe they cannot take part in education, work or sport. Sometimes, the pain of endometriosis is associated with anxiety or depression.
How is Endometriosis diagnosed?
Endometriosis can be hard to diagnose, with an average delay of around 5 to 6.5 years between first having symptoms and getting a diagnosis.
A GP generally will perform a physical exam, take a medical history, order blood tests and any relevant imaging (ultrasound/ MRI) then refer you to an Obstetrician/Gynaecologist who may then perform a laparoscopy.
There are 4 stages of endometriosis: minimal, mild, moderate and severe. The stage depends on the location and amount of endometriosis you have. A higher stage doesn’t always mean you will have more pain.