Endometriosis is a gynaecological medical condition whereby the tissue that forms the lining of your uterus grows outside of the uterine cavity; the lining is known as the endometrium.
The endometrium begins to grow on other parts of the body such as the ovaries, bowel and the tissue that lines the pelvis. Known as an endometrial implant, the tissue is usually localised to the pelvic region, but it is possible for it to spread to other parts of the body.
Tissue that is trapped in your pelvis can cause: irritation; scar formation; severe pain during your periods and fertility problems.
Causes of endometriosis
Unfortunately, the exact causes of endometriosis are unknown; however, possible reasons include:
- Problems with menstrual flow: Menstrual blood doesn’t flow out of the vagina, rather, it enters the fallopian tubes and pelvis.
- Genetics: Endometriosis can be inherited. If you have a close family member with endometriosis, you may develop the condition.
- Surgical scars: Procedures such as a C-section or a hysterectomy can move endometrial cells around the pelvic area.
- Weak immune system: Complications with the immune system can stop destruction of extrauterine endometrial cells.
- Foetal development: Studies have shown endometriosis can develop in a foetus. Should you wish to terminate the pregnancy, we offer a safe abortion service.
There are four stages of endometriosis:
- Minimal: Small lesions and slight implants on your ovaries and pelvic lining; there may be inflammation as well.
- Mild: You can expect light wounds and shallow implants on the pelvic lining and ovaries.
- Moderate: The implants will be deeper on the ovary and pelvic lining and more lesions may also occur.
- Severe: At this stage, the implants are very deep on the pelvic lining and the ovaries; lesions may also occur on your bowels and fallopian tubes.
Many times, endometriosis has no symptoms. However, when symptoms are present, they may include:
- Painful periods (dysmenorrhea)
- Painful bowel movements or urination, especially during menstruation
- Abnormal or heavy bleeding during periods
- Painful sex
- Difficulty becoming pregnant
- Other symptoms include: fatigue, diarrhoea, constipation, bloating or nausea
As mentioned earlier, there is no cure of endometriosis, but there are a number of treatments available to control the symptoms. These include:
Pain medications: Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen can be used as a pain reliever.
Hormonal contraceptives and therapy: Hormonal therapy can be used to lessen the amount of estrogen that is created in the body; the aim is to prevent menstruation. This will reduce the amount of bleeding in the lesions, which in turn decreases the amount of inflammation, scarring and the forming of cysts. Hormones include:
- Contraceptives such as birth control pills, patches, and vaginal rings
- Gonadotropin-releasing hormone (Gn-RH) agonists and antagonists (elagolix sodium/Orilissa, leuprolide/Lupron and Synarel)
- Progestin-only contraceptives. Speak to your doctor about which options are best for you
- Danazol – a medication that reduces oestrogen production
Conservative surgery: In certain cases, surgery is needed to remove as much of the endometriosis as possible. However, there are a number of factors to consider so it’s imperative that you discuss the available options with your doctor.
How Marie Stopes can help you
Marie Stopes is the global leader in women’s sexual and reproductive health. We offer confidential consultations where you can discuss your concerns with a nurse. Please book an appointment or call us on: 0800 11 77 85. Here is some more detailed information about our women’s clinics.