Endometriosis is a condition where the tissue that normally lives in the lining of the womb is found elsewhere in the body. This tissue can be found in many areas of the body, including the ovaries and fallopian tubes, the lining or inside of the abdomen, the bowel or bladder. The tissues react in the same way to those in the womb – thickening and breaking down each month – which can cause pain, swelling and scarring.

What causes endometriosis?

The cause of endometriosis is unknown. It’s a common condition that affects around two million women in the UK, and most of them are diagnosed within childbearing age, or between the age of 25 and 40. The condition is extremely rare in women who’ve been through the menopause. Signs and symptoms will differ from woman to woman, but one of the most common symptoms is long-term pelvic pain, which can last six months or more, and may come before or during your period.

Signs and symptoms include:

  • Pain during and/or after sex
  • Discomfort when going to the toilet
  • Bleeding from your back passage
  • Depression
  • Extreme tiredness
  • Blood in your urine
  • Changes to your period, such as heavy bleeding
  • Difficulty becoming pregnant

If you have any of these symptoms, you should see your GP as soon as possible.

Diagnosis of endometriosis

Your GP will ask you about your symptoms and may ask to carry out a vaginal or rectal examination, which will involve your GP examining your vagina/anus to feel for any abnormalities.

Treatment

One in three women get better within six to twelve months. Other treatment options are dependent on the kind of symptoms you have, and whether or not you want to have children.

Treatment options include pain relief (paracetamol and ibuprofen), hormone treatments and surgery.

If you’re not trying to get pregnant, then a common hormone treatment is the combined oral contraceptive pill or the progestogen-only pill. Other hormone treatments include progestogens such as norethisterone, androgens such as gestrinone, and gonadotrophin-releasing synthetic hormones such as buserelin.

Surgery is a common treatment option for those trying to get pregnant. A gynaecologist will remove the endometriosis by looking inside your abdomen using a narrow telescopic camera and cutting it away with heat from an electric current, laser or helium gas.

Endometriosis and pregnancy

One of the main complications of endometriosis is difficulty in getting pregnant. However, there’s a good chance of getting pregnant if you undergo surgery to remove endometriosis tissue.

To find out more, visit Understanding Endometriosis.

 

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Andrew Drakeley

Mr Andrew Drakeley is the Clinical Director at the Hewitt Fertility Centre, working principally at the Liverpool Women’s site but with managerial responsibility for Knutsford.

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