What is endometriosis?
Endometriosis refers to when the cells that line the uterus (The Cells that are shed during a period) are outside of the uterus. Common areas for this to occur are on the ovaries, tubes and lining of the pelvis including the supporting ligaments of the uterus. Adenomyosis is a version of endometriosis where these endometrial cells are actually in the muscle wall of the uterus rather then the lining.
How common is endometriosis?
Endometriosis affects up to 1in 5 women in the reproductive age group.
How Symptoms does endometriosis cause?
The most common symptom of women with endometriosis is pain (with periods, intercourse, pelvic/back pain, bowel pain). The amount of disease present does not necessarily correspond to the amount of symptoms i.e. women with minor symptoms may have significant disease present and women with small amounts of disease may have major symptoms. Heavy periods, irregular bleeding, premenstrual spotting, bloating and infertility are some of the other more common symptoms.
What is an Endometrioma (also known as a chocolate cyst)?
An endometrioma is a localised collection of endometriotic tissue within an ovary, which has caused a collection of old blood to accumulate within a cyst in the ovary. This old blood (which accumulates from repetitive bleeding into the ovary) looks just like liquid chocolate (hence the term ‘chocolate cyst’). These cysts usually require surgery to resolve.
Why does it cause pain?
Every area of endometriosis acts just like the tissue inside the uterus. This means when you are having a period all the smaller deposits of endometriosis are doing the same thing. This causes an inflammatory reaction, scarring and pain (and also relates to why this can contribute to infertility).
How is it diagnosed?
There is no blood test or x-ray or ultrasound that can definitely diagnose endometriosis. The only sure way to do this is via laparoscopy. Treatment can also be performed at the same procedure.
What treatment is available?
Medical and surgical treatments are available. Most medical treatments focus around minimising menstrual bleeding. These include the contraceptive pill (usually in a continuous period-skipping regime), Progestagens (such as Visanne, Provera or Mirena), Danazol, GnRH analogues (Zoladex or Synarel), Non steroidals, Complementary treatments (acupuncture, yoga, exercise, diet) are also often utilised to help recovery and assist symptom relief.
Mostly performed as a laparoscopic (key Hole) procedure and involves excising endometriotic tissue or cysts /adhesions is the mainstay of treatment in helping fertility and pain.
Unfortunately there is no ‘cure’ for endometriosis and despite initial effective treatment up to 20% of women have a recurrence of symptoms within 5 years, which may necessitate a further change in treatment strategies.
Your unique circumstances, history and requirements will all be taken into consideration to provide a number of therapeutic options for you. Please feel free to ask questions during your consultation regarding any or all of the above areas.