Today marks the beginning of Endometriosis Awareness Month. Endometriosis is a condition that affects 1 in 9 women of reproductive age. Regardless of age, background or lifestyle, endometriosis can affect any woman and girl, transgender, non-binary or gender-diverse individual assigned female at birth.
One of the primary aims of Endometriosis Awareness Month is to increase the public’s awareness of endometriosis with the aim of reducing the time it takes for those suffering with endometriosis to be diagnosed. Presently the average time it takes individuals to be diagnosed with endometriosis is 7 to 12 years.
Below I answer some of the most commonly asked questions about endometriosis that I hear in my practice. I hope you find the answers useful.
What is endometriosis?
Endometriosis occurs when cells from inside the uterus (womb) begin to grow outside the uterus causing pelvic pain and other disturbances. It is a common female health condition affecting 1 in 9 women.
What causes endometriosis?
There is no definitive answer yet as to the cause, but some of the leading theories are metaplasia (where endometrial tissue replaces other types of tissues outside the uterus), or retrograde menstruation (the backward flow of menstrual bleeding through the fallopian tubes and into the pelvis which might cause the endometrial cells to implant on pelvic organs). Other theories believe the cause could be: lymphatic or vascular distribution of endometrial fragments; immune system dysfunction; or environmental toxins. There is evidence, however, that endometriosis is likely to be genetic with first-degree relatives of women with the disease more likely to develop it.
How do I know if I have endometriosis?
Many people I see who have endometriosis have lived with it for many years and have just thought what they were experiencing was just their “normal”. Some of the more common symptoms to look out for are painful heavy menstrual periods, painful intercourse, period pains or spotting, pelvic pain, lower back pain, painful bowel movements/urination, or trouble falling pregnant. If you are experiencing some of these symptoms it is worthwhile checking in with your GP as a start.
What do I need to do to get rid of endometriosis?
Unfortunately, there is currently no cure for endometriosis but it can be treated in several ways, depending on the severity of the condition and whether the primary goal is to treat pain or maximise fertility.
- Medication is the least-invasive treatment but is only suitable if you are currently not trying to fall pregnant. The medication works by suppressing the pituitary gland and the secretion of hormones (oestrogen) that may be causing the endometriosis.
- Surgical procedures such as a laparoscopy (keyhole) can work to surgically remove endometrial implants or adhesions (scarring) that result from endometriosis. Surgical treatment is the best option for increasing fertility.
- Assisted Reproductive Technology (ART) can be considered if surgical treatment has not helped. Commonly, ovulation-stimulating medication combined with Intra-Uterine Insemination (IUI) is all that is needed to further enhance fertility. In Vitro Fertilisation (IVF) may be recommended when the fallopian tubes have been irreversibly damaged, and if surgery and IUI have not helped achieve a pregnancy.
Will endometriosis impact my fertility?
While some women with endometriosis fall pregnant easily, unfortunately, many do not.
Endometriosis is found to be present in approximately 50% of cases who have been unable to conceive after trying for 12 months. The impact on fertility is thought to be due to the endometriosis causing some distortion of the anatomy resulting in blockages or changing the function of the fallopian tubes. In many cases, endometriosis can alter ovulation/egg production, cause menstrual cycle disruption, impact the fallopian tubes and in turn embryo transport, and have detrimental effects on the endometrium (womb lining). A laparoscopy surgical procedure is normally required to confirm the diagnosis of endometriosis and several treatments can help set you on the right path to achieve a pregnancy either naturally or with assisted reproductive technologies.
For more information visit Endometriosis, what you need to know