What is endometriosis? Signs, diagnosis, and treatment explained

Endometriosis is a common chronic condition that affects millions of women worldwide. Despite being a prevalent issue, it often takes an average of nearly seven years to receive a diagnosis. Understanding its symptoms, causes, and treatment options can significantly improve quality of life and management of this long-term condition.

Watch Dr Shree Datta delve into the ins and outs of endometriosis, providing expert insights and detailed explanations on this complex condition.

What is endometriosis?

Endometriosis involves the growth of womb-like tissue outside the uterus. The most common places for this tissue to grow include the ovaries, the area around the womb, and other parts of the pelvis. These tissue growths can lead to a variety of symptoms, making the condition challenging to diagnose and manage.

Recognising the symptoms

The symptoms of endometriosis can vary widely among women, both in type and severity. Common symptoms include:

• Pain before and during periods: Many women experience significant pain in the lead-up to their period, which may be relieved once menstruation begins.
• Pain during intercourse: Women with endometriosis often experience painful sex ranging from mild to excruciating. The pain can feel like sharp stabbing or jabbing sensations, or a deep abdominal ache. This discomfort stems from endometriosis-related adhesions that can fuse the vagina to the rectum, causing deep pain during intercourse.
• Pain during bowel movements or urination: This can be particularly noticeable during the menstrual cycle.
• Bloating and mood changes: These symptoms often occur in the second half of the menstrual cycle, intensifying until the period starts.

Symptoms can differ greatly from one woman to another and can change from one menstrual cycle to the next. Keeping a detailed record of symptoms can aid in diagnosis and management.

What causes endometriosis?

The exact cause of endometriosis is still unknown, but several theories exist:

• Retrograde menstruation: This theory suggests that menstrual blood flows backward through the fallopian tubes into the pelvic cavity instead of leaving the body.
• Surgical scarring: Endometrial cells may attach to surgical incisions, such as those from a hysterectomy or C-section.

Endometriosis can affect various parts of the body, including the bowel, the lining of the tummy wall, and even the lungs.

Diagnosing endometriosis

Diagnosing endometriosis typically involves several steps:

1. Medical history: Your doctor will ask detailed questions about your symptoms, their severity, and how they affect your daily life.
2. Physical examination: A thorough physical exam can help identify abnormalities.
3. Ultrasound: An internal ultrasound can provide insights into the state of your womb and ovaries, though it may not always detect endometriosis.
4. Laparoscopy: This minor surgical procedure is considered the gold standard for diagnosing endometriosis, allowing doctors to view internal organs directly and take biopsies if necessary.

Treatment options

Treatment for endometriosis depends on the severity of symptoms and individual circumstances:

• Pain relief: Over-the-counter painkillers or prescription medications can help manage mild to moderate pain.
• Hormonal treatments: Options such as the contraceptive pill or the Mirena coil can help control hormone levels and reduce symptoms.
• Lifestyle and dietary changes: Holistic approaches, including dietary adjustments and lifestyle changes, can support overall well-being and symptom management.
• Surgical treatments: In severe cases, surgery may be necessary to remove or reduce endometrial tissue.

Each treatment plan is tailored to the individual’s needs, considering factors like symptom severity and future pregnancy plans.

Living with endometriosis

Endometriosis is a long-term condition that can significantly impact a woman’s life. Effective management involves accurate diagnosis, appropriate treatment, and ongoing support. Regular follow-ups with your healthcare provider are essential to ensure that the chosen treatment plan remains effective and to make adjustments as needed.

By staying informed and proactive, women with endometriosis can work with their healthcare providers to manage their symptoms and maintain a good quality of life.

Dr Shree Datta is a Consultant Obstetrician and Gynaecologist with extensive expertise in managing women’s health issues, including high-risk pregnancies, menstrual disorders, and endometriosis. She is dedicated to providing personalised care, employing both surgical and non-surgical treatments to achieve optimal patient outcomes. Dr Datta is also committed to education and patient advocacy, contributing to medical publications and actively participating in healthcare seminars and workshops.