Endometriosis is a common disease that can affect up to 1 in 7 women, girls and those assigned female at birth1. It often takes time to detect, taking on average, 6.5 years to be diagnosed with this condition.1 It’s important to know more about the symptoms, impact, causes and complications, as well as how to treat and manage it so that those people who suffer from it can get the help they need.
Endometriosis is a condition in which body tissue that is similar to the lining of the uterus grows outside the uterus in other parts of the body.2 Commonly affected areas include the ovaries, fallopian tubes and the tissue that lines the pelvic cavity.2 However, it can occur in almost any part of the body, including the skin, joints, brain and lungs.1
While the cause is unknown, what is known is that endometriosis tissue behaves as the lining inside the uterus (womb) would. This means it grows and thickens before breaking down and bleeding when you have your period in response to the menstrual hormone cycle.2 As this tissue in endometriosis grows outside of the uterus, it can lead to pain, inflammation, scarring, lumps (nodules), and sometimes the formation of adhesions (a band of scar tissue that can join different body tissues together)3 with each menstrual cycle.
Endometriosis can start with a person’s first menstrual period and last until menopause occurs.4 It is a progressive and chronic condition that can affect fertility, and it can also affect each person differently. While pain is a common symptom of endometriosis, the severity of symptoms varies from person to person and is often related to the location of the disease rather than the extent of it.5
Some symptoms include:3,5,6
Some people with endometriosis might also experience other symptoms, such as: 3,5,6
Although the specific cause of endometriosis is still unknown, there are some factors that can put someone at a greater risk of having it, such as: 5,6
If it can take up to six or more years to be diagnosed with endometriosis, it’s likely no surprise that it can be a difficult condition to diagnose. The diagnostic delay tends to be due to the symptoms of endometriosis mimicking other conditions, such as ovarian cysts or pelvic inflammatory disease, and even irritable bowel syndrome (IBS).2,4 However, the basis for suspecting the disease can consist of a careful history of a person’s menstrual symptoms and chronic pelvic pain.4 A doctor might also refer those suspected of having endometriosis for an ultrasound, MRI scan or a laparoscopy.3 Most people are diagnosed after having a laparoscopy, which is keyhole surgery that is performed under general anaesthesia to see if there is any endometrial tissue in the pelvis.6 The tissue can then get tested to check for endometriosis.3
Although no treatment can cure endometriosis, treatment will depend on the person’s symptoms, the severity of the disease, and whether or not pregnancy is desired. There are a variety of medications, such as non-steroidal anti-inflammatory drugs (NSAIDs) and analgesics (painkillers), that can be used to help manage endometriosis and its symptoms.4 There are also hormone-based treatments, such as the oral contraceptive pill, a contraceptive implant or an intrauterine device (IUD), that can be considered3; however, these methods may not be suitable for anyone who wishes to get pregnant.
During laparoscopy it may be possible to remove some or all of the endometriosis tissue which can often lead to significant symptom improvement.3 It is possible, however, that the condition recurs, meaning the tissue again grows and develops outside of the uterus. Laparoscopy also carries a risk of adhesion formation. In severe cases of endometriosis, a hysterectomy may be recommended, but this doesn’t always cure pain symptoms. It is possible to combine surgical options with medications or hormone therapy to keep the symptoms of endometriosis controlled and improve outcomes.3,6
Other therapies that might help manage period pain and inflammation associated with endometriosis include pelvic floor physiotherapy, a healthy diet with lots of plant-based foods and fish, massage, regular exercise, mental health support, and alternative medicines like acupuncture.6
Although there is no ‘best’ treatment for endometriosis, and there are advantages and disadvantages of each treatment type, it’s important to be informed of the different kinds of treatments, as well as their possible side effects and/or complications. A doctor would always be able to guide you as to the best treatment options in your specific circumstances.
Endometriosis can affect a person’s quality of life due to the severe pain, fatigue, depression, anxiety, and even infertility that it can cause.4 Those who suffer from extreme pain may also miss out on school or work, leading to social and economic implications.4
If you think that you might have symptoms of endometriosis, it’s important to seek out a consultation with your healthcare practitioner. You can also access Teladoc Health’s Expert Medical Opinion (EMO) service, which provides you with an in-depth review of your medical condition by virtually connecting you with a network of local and international experts, all from the comfort of your home.
If you would like to book a consultation but are unsure if you can access Teladoc Health services, submit a form here, and a Member Engagement Coordinator will respond shortly.
References:
2. Mayo Clinic – Endometriosis
3. Health Direct – Endometriosis
4. World Health Organisation – Endometriosis
5. Jean Hailes for Women’s Health – Endometriosis
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