Endometriosis is a surprisingly common condition that involves tissue behaving in a similar way to the lining of the womb. However, in the case of this sometimes distressing condition, the tissues is outside the womb.
While there are several areas of the body where this tissue can develop, the most common areas include the vagina, the ovaries and behind the uterus.
What are the symptoms of endometriosis?
Endometriosis is usually a chronic condition that results in particularly heavy and painful periods. As well as causing pain and discomfort in the back and abdomen, it can lead to lethargy and depression. And in some severe cases it can cause fertility problems. Unfortunately, the symptoms can vary between women, which means they can be mistaken for a range of other issues.
What are the causes of endometriosis?
While there is no definitive explanation about the cause of endometriosis, there is a theory that it is the result of the womb lining failing to leave the body fully during a period. Instead, it attaches itself to the pelvis or reproductive organs and continues to function in the same way as the womb itself.
Once the lining has embedded itself, its cells continue to operate as normal. They will grow during the menstrual cycle, and begin to bleed once a month. However, womb lining anywhere else in the body has no way of exiting, so it simply remains in place and the problems starts all over again, month after month.
What are the possible treatments for endometriosis?
A gynaecologist will take the time to look at your specific case, and decide the best course of treatment based on a number of issues:
• How old you are
• Whether or not you’re trying to address fertility problems
• Your attitude towards a surgical solution
• The success or failure of previous treatments
In some cases, the symptoms may be so mild an inconsequential there may be no need for treatments. Indeed, about a third of women recover from the condition naturally. If the symptoms don’t improve – or worsen over time – your gynaecologist will talk through several treatment options with you.
The usual pain relief used is an anti-inflammatory such as ibuprofen, as it can ease swelling and relieve the associated pain in most cases. You may also be advised to take paracetamol if ibuprofen leads to other symptoms such as nausea and diarrhoea. If your pain becomes particularly severe, there is a chance that you may be given a prescription for codeine, but this may lead to constipation which can actually make the pain and discomfort you’re experiencing worse.
If you aren’t trying for a baby, there’s a chance that you may offered a course of hormones. They can be administered intravenously, orally or sometimes with a patch. The aim is to stop your body producing oestrogen so the womb lining doesn’t thicken. However, this won’t rid your body of the problem permanently, and it won’t address situations where endometriosis has caused the fusing of organs.
If endometriosis is stopping you from getting pregnant, or you’re keen to find a permanent cure that doesn’t involve hormone treatments, there are three main surgical solutions available to you.
Laparoscopy: The most common way to surgically remove womb lining from areas of the body is with a laparoscopic procedure. Sometimes referred to as ‘keyhole surgery’, this involves three or four small incisions and the use of a laparoscope to remove the womb lining without open surgery. A small tube inside the body sends images to a TV screen – which the surgeon will use to guide a series of delicate instruments to the affected area. Although this procedure is conducted with a general anaesthetic, the recovery time in hospital is often just one day.
Laparotomy: Where the endometriosis is more severe and widespread, it may be necessary for a surgeon to make a larger incision and remove the misplaced womb lining directly. This may be recommended in a situation where some of your organs have fused together, but you still want to try for a baby in the future.
Hysterectomy: Although rarely a necessity, a hysterectomy may be recommended if you have no plans to have children in the future. While the removal of your entire womb may seem like a severe step, it will drastically reduce the chance of endometriosis returning in the future. The symptoms of endometriosis range from mildly irritating to excruciatingly painful. By talking through your symptoms with a gynaecologist you’ll be able to choose the treatments that are right for your personal circumstances.