Painful periods and and painful sex are not normal
Endometriosis (pronounced “End-oh-meet-ree-oh-sis”) and 'un-affectionately' known as "Endo", is relatively common, with an estimated 10% of women in Australia suffering from the condition.
It occurs when tissue similar to the lining of the womb (uterus) starts to grow in other places, such as the lining of the pelvis or sticking to organs in the pelvis such as the ovary or fallopian tubes.
Endometriosis can affect women of any age, but is most common in women in their 30s and 40s.
It is a long-term condition, which is not life-threatening but can have a significant impact on the quality of life of those afflicted, due to the debilitating pain and other symptoms that it causes.
Although endometriosis is currently not ‘curable’, once a diagnosis is made, treatments are available.
Symptoms of endometriosis
The symptoms of endometriosis can vary. Some women are badly affected, while others might not have any noticeable symptoms. Some women have endometriosis and don’t know about it.
The main symptoms of endometriosis are:
pain in your lower tummy, back or pelvic pain– usually worse during your period
period pain which is so severe that stops you doing your normal activities
pain during or after sex
pain when peeing or pooing during your period
feeling sick, constipation, diarrhoea, or blood in your pee during your period
difficulty getting pregnant
You may also have heavy periods; you might use lots of pads or tampons, or you may bleed through to your clothes.
There is a variation of endometriosis called adenomyosis which is where the lining of the uterus is mixed in with the muscles of the uterus. Adenomyosis can also cause heavy painful periods.
For some women, endometriosis can have a big impact on their life and may sometimes lead to low mood or even depression. This is because it can cause long term pain and be debilitating. There is often a delay in the diagnosis being made.
Can your GP diagnose endometriosis?
See your GP if you have symptoms of endometriosis, especially if they’re having a big impact on your life. Download the symptom diary and keep track of symptoms as they affect you.
This will be helpful to your GP and/or gynaecologist when an assessment is being undertaken. Any of our doctors at Clinic 66 will be able to do an initial assessment for endometriosis.
It can be difficult to diagnose endometriosis because the symptoms can vary considerably, and many other conditions can cause similar symptoms. That is why making a diagnosis can be tricky and a diagnosis may be delayed.
Your GP should take a history and do an examination which will involve feeling your abdomen and possibly doing an internal gynaecological examination.
Your GP may recommend that you try “the pill” or other hormonal treatments, or suggest further investigation such as imaging with ultrasound.
The best way of diagnosing endometriosis is to have a laparoscopy. A laparoscopy is where a surgeon or gynaecologist passes a thin tube through a small cut in your tummy so they can see any patches of endometriosis tissue. This is the only way to be certain you have endometriosis, and needs to be done in a hospital under a general anaesthetic.
What treatments are available for endometriosis?
There’s currently no cure for endometriosis, but there are treatments that can help ease the symptoms which include:
Help with simple management of pain, such as warm packs, gentle exercise
Pain relievers – such as ibuprofen, paracetamol and mefenamic acid
Hormone medicines and contraceptives – including the combined pill, progestogen tablets such as dienogest, the contraceptive patch or hormonal IUD, and other hormonal medicines
Surgery to cut away patches of endometriosis tissue and any scar tissue
An operation to remove part or all of the organs affected by endometriosis – such as surgery to remove the womb (hysterectomy). This is usually the last resort.
Your doctor will discuss the options with you. Sometimes they may suggest not starting treatment immediately to see if your symptoms improve on their own. Usually, there is a stepwise approach to treatment to see what works best for you.
What are the risks of having endometriosis?
The biggest problem is that endometriosis can affect your quality of life, primarily due to the pain, and cause you to have days off study or work. It can also affect your sex life if it is painful to have sex.
Sometimes the areas of endometriosis bleed and cause scarring internally. This may require surgery to remove or divide the damaged tissue.
Endometriosis may cause scarring in the fallopian tubes and stop them from transporting an egg during the menstrual cycle.
This may impact on fertility and cause a delay in falling pregnant naturally or an ectopic pregnancy.
Surgery may help fix the scar tissue and help you conceive naturally, but IVF may also be an option if you have been trying for a while.
Do you suspect you may have Endometriosis? Take the Questionnaire...
This questionnaire includes some of the important questions that your GP will ask you whilst investigating your symptoms.
This is by no means a complete diagnostic tool, but simply a 'starting point' to help identify the next steps in your prognosis.