What is Endometriosis?
Affecting at least one in ten women, endometriosis occurs when the cells that line your uterus move to other parts of the body, and cause complications. When pregnancy does not occur each month, the body sheds these cells (the endometrium) through menstrual bleeding. Sometimes however, these cells can migrate to other areas, such as the pelvis, where they will still respond to messages from the ovary; filling and bleeding without going away. This condition can affect any woman with functional ovaries, from the beginning of puberty until menopause, and rarely goes away before then. The goals of treating endometriosis are to control and lessen the symptoms, rather than to ‘cure’ them.
What Are the Signs and Symptoms of Endometriosis?
The causes of endometriosis are not fully understood, though women with a mother or sister who has it are more likely to get it as well. Some women will experience severe symptoms, and some will experience no symptoms at all. The two main symptoms are recurrent pain where the cells have grown, and trouble getting pregnant. This pain is usually cyclical, coming and going with your period, and for many women, the first thing they will notice is worsening pain during periods, or during sex.
Detecting endometriosis can be tricky, and though telling your doctor about worsening period pains can be a starting point, the only way to know for sure is through a laparoscopy. This is a surgical procedure where your gynaecologist inserts a small telescope through your belly button to look at the organs within your pelvis. The surgeon will take pictures, and often samples, to confirm if you are indeed suffering from the condition.
How is Endometriosis Treated?
Treatment of endometriosis often includes both medication and surgery. Most who deal with endometriosis will require both of these options at different stages of their lives. The choice of treatments is dependent on the severity of your pain, where it is located, and if you are attempting to get pregnant. It is important to note that many effective treatments for endometriosis are also contraceptive in nature.
Medication can include pain relief medicines or analgesics, such as Naprosyn or Ponstan. These can be in the form of oral tablets or injections.
You may also be treated with hormone-based options, such as:
- Oral contraceptives (the pill), which can settle the activity of endometriosis by stopping ovulation and reducing estrogen levels in the pelvis. By running packets of the pill together to functionally ‘skip’ periods, women can also reduce the number of painful periods they have; it should be noted however, that this will not cure endometriosis, only make it less uncomfortable.
- Mirena, an inter-uterine device shaped like a T, which releases a hormone like progesterone into the body. This has been shown to reduce both the pain and activity of endometriosis over time for many women.
- Other types of progesterone-like hormones, released by medicines like Dienogest, which can reduce the regrowth rate of endometriosis if taken daily.
- GnRH-agonists, or implants that can ‘switch off’ the release of reproductive hormones in women. It is unusual to use such medicines for more than a few months, as there can be long-term side effects, and they can induce a menopause-like state that women might find unpleasant.
A more difficult or time consuming method of treatment can be surgery. The type of surgery depends on present symptoms and the location of the endometriosis, but is most often a laparoscopy. Your surgeon will locate, diagnose and treat your endometriosis- they may cut or burn the growth off. This can be simple or very complex, and if you consider this option, it is vital to have a clear understanding of the nature and purpose of any planned surgery. For more information, visit the website for The Royal Australian and New Zealand College of Obstetricians and Gynaecologists; you can find information on laparoscopies under the search function.
For more information on Endometrosis, view The Royal Australian and New Zealand College of Obstetricians and Gynecologists guidelines.
If you are experiencing the symptoms of Endometriosis, make an appointment with Dr.Nicole Stamatopoulos here.