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Endometriosis   is a condition where the cells that line the womb (uterus) are found elsewhere in the body. The lining of the womb is what is shed during your period but the cells that are found in other parts of your body are unable to leave the body like a period and can cause problems.

Symptoms

Pain in a variety of forms is the main complaint of endometriosis. For example, women may find that they have:

• Painful periods
• Painful sex
• Lower tummy pain (pelvic pain)
• Pain passing faeces or urine
• Difficulty becoming pregnant
• Unusual vaginal bleeding (outside of normal periods)

Why Do I Have Endometriosis?

The causes of endometriosis are still unclear and there have been a few possible theories. One of them includes the concept of “retrograde menstruation ”. This is the idea that during a period, some of the lining falls into the pelvic area through the fallopian tubes and endometrial tissue is deposited in sites other than the womb.

Although the cause is unknown, there are multiple factors that contribute to the condition:

Genetics: For example, endometriosis can run in families – therefore there is a genetic aspect to endometriosis.

Age: It is also rare in women who have gone through the menopause as endometriosis is strongly linked with the female hormone, oestrogen, which falls after menopause. This means endometriosis is more likely in women aged 25 to 40 years old.

How Is Endometriosis Diagnosed?

Your GP will ask questions about your symptoms and address any concerns you may have. To get a confirmed diagnosis of endometriosis, it is best to have a laparoscopy which is a small operation where small cuts are made into your tummy and then a thin camera is inserted to look for evidence of endometriosis patches.

Is there a Cure?

Unfortunately, there is no cure for endometriosis at the moment. However, there are many options available to help reduce the symptoms and improve your quality of life. Your GP will be able to discuss what options are best suited to you.

Treatment Options 

The treatment options available to you are surgery, hormone treatments and painkillers.

Painkillers

Your GP would not jump straight to offering you an operation. This is because there are many women whose main concern is with the symptoms such as painful periods. In these cases, your GP can offer you initial treatment of anti-inflammatory painkillers such as ibuprofen, mefenamic acid or naproxen.

Painkillers & Hormonal Treatment

These painkillers can also be offered with the combined oral contraceptive pill. The combined pill helps the symptoms of endometriosis by stopping ovulation and therefore reducing the amount of oestrogen in the body.

Hormonal Intra-Uterine System (IUS)

Another treatment that is available is the levonorgestrel-IUS (LNG-IUS, Mirena Coil), which is a small plastic hormonal contraceptive device that is placed within the womb. It is effective for up to 5 years and works by thinning the lining of the womb, abolishing or reducing periods and reducing pain associated with periods.If your symptoms do not improve then other hormonal medications such as GnRH analogues  or progestogen hormone tablets can be used.

Surgical Intervention

If you are concerned with your fertility  or the severity of your symptoms then a laparoscopy can be discussed, where diagnosis and treatment (where endometriosis patches are removed) can be carried out.

Dr Seth Rankin is founder of London Doctors Clinic

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Dr. Seth Rankin

Dr Seth Rankin, has worked for the NHS since 2004 and is a former Clinical Commissioner. He launched London Doctors Clinic (LDC) in 2014 and is now treating over 3,000 patients per month. The company has practices across nine major commuter hotspots in London including Liverpool Street, Waterloo, Oxford Circus, London Bridge, Victoria, Kings Cross, Paddington, Canary Wharf and Fleet Street. LDC offers tourists, residents and commuters affordable and convenient access to GPs, when patients are finding it difficult getting an appointment with their local doctor. Dr Rankin says “I’m a huge fan of the NHS and there is no doubt it is a world class service. However, thousands of Londoners avoid going to the GP because they are time poor and don’t like to ask for time off work. Our aim is to provide a professional service, similar to those available in many other countries, that is easy to use and is far less potentially time consuming and stressful than a drop-in centre.” Originally from New Zealand, Dr Rankin grew up in Papua New Guinea (his parents were missionaries) and later worked in Australia for a few years before coming to the UK. He says “when I came to London I was struck by how difficult it was to get an appointment with a GP. While the Australian & New Zealand systems are far from perfect, it felt as if there was a doctor on every corner and it was always easy to get an appointment, but in the UK private doctors seemed intrinsically linked to the very wealthy. I felt there was a gap in the market for a new type of affordable GP service that could help Londoners and people visiting the capital, and also ease the burden on the NHS”. Before launching LDC, Dr Rankin already had a reputation as a successful doctorpreneur, representing 23 clinics as an NHS Clinical Commissioner and growing the Wandsworth Medical Centre to over 16,500 patients. He is the also co-founder of London Travel Clinic, which has eight centres in London providing travel vaccines, medications and advice to Londoners.