The endometrium is the tissue that lines the inside of the uterus (womb). Endometriosis is a condition where endometrial tissue is found outside the uterus in the abdomen. Every month along these areas of endometrial tissue bleed in the abdomen giving rise to inflammation and pain.
If left untreated theses endometrial patches could give rise to infertility (due to blocked fallopian tubes) and adhesions. In the ovary they cause cysts (blood filled bubbles) called ``chocolate cysts
Who gets endometriosis?
About 1 in 10 women have symptoms due to endometriosis which range from mild to severe depending on the extent of disease.
Symptoms develop between the ages of 25-40 and symptoms reduce with pregnancy. Sometimes it runs in families
Estrogen levels fall after the menopause thus reducing the incidence of endometriosis Once the endometriosis has gone with treatment it may recur again in the future
Symptoms of endometriosis
Painful periods. The pain typically begins a few days before the period and usually lasts the whole of the period and subsides after the period.
Bleeding in between periods.
Difficulty becoming pregnant (reduced fertility). This may be due to clumps of endometriosis blocking the passage of the egg from an ovary to the fallopian tube.
Endometriosis is diagnosed either by an Ultrasound scan (if chocolate cysts are seen) and diagnosis is confirmed by a Diagnostic Laparoscopy where the patches of endometriosis are not only seen but can be treated at the same time.
If endometriosis is left untreated, it becomes worse in about 4 in 10 cases. Endometriosis is not a cancerous condition. The main aims of treatment are to improve pain and help the couple to conceive.
1. Painkillers for endometriosis
Paracetamol taken during periods may be all that you need if symptoms are mild.
Anti-inflammatory painkillers such as ibuprofen and diclofenac (not all women can take these tablets, please consult a doctor before use)
2. Hormone treatments for endometriosis
The combined oral contraceptive pill ('the pill')
The intrauterine system (IUS) –special coil: It is not only used as a contraceptive but also greatly reduces or even abolishes bleeding of periods. Once put in place, it can remain effective (for contraception and to ease pain) for up to five years.
GnRH (gonadotropin releasing hormone) analogues- these are given as a course of 3 or 6 injections and are quite effective. Use of these injections however, is limited in young patients where fertility is an issue.
4. Surgery for endometriosis
Laparoscopy is commonly used to treat endometrial patches in the abdomen and also to remove cysts.
If your family is complete, and symptoms are severe, then hysterectomy (removal of the uterus) may be a good option, if all other methods have failed