Endometriosis explained

Posted on 22 August 2013

Endometriosis is a fairly common condition that affects about one in 10 women during their reproductive years. We find out more about this debilitating condition. We chat to Dr Viljoen at Mediclinic George and Geneva.

What is endometriosis?
The uterus is lined with something called endometrium, which is shed during menstruation. When a woman has endometriosis, this lining is found outside of the uterus – the most common place is usually in the abdomen or pelvic cavity, but these ‘patches’ of endometrium can attach to the ovaries, fallopian tubes, large bowl and bladder, too.

What symptoms should I look out for?
Symptoms usually include pain in the lower part of your abdomen, which usually begins a few hours before your period starts. For some women, this pain starts a few days or even a week before and can last the whole period.

Other symptoms include:
–    Painful intercourse, either during and or after.
–    You may have abnormal periods – either heavy or irregular. Heavy bleeding is often a common symptom, but some women experience light periods, too.
–    Bladder problems can occur if the endometriosis attaches to your bladder. You may find passing urine painful or blood in your urine. These symptoms may worsen during your period.
–    You may have bloating, diarrhoea, constipation or pain if you have patches on or near your bowel.

If I have endometriosis, why are my periods so painful?
The pain you’re experiencing is most likely because the endometrium trapped in your pelvic cavity breaks down before and during your period, just like the lining of your uterus. This bleeding tissue is unable to get out of your body and so causes the pain.

How is endometriosis diagnosed?
Your doctor will first do a physical examination, as sometimes spots of endometriosis can be felt. If your doctor is unable to find anything through a physical exam, you’ll be sent for a laparoscopy. This procedure is done under general anaesthetic and your doctor will use a small telescope to have a look inside your abdomen. It’s fairly non-invasive and you’ll be back at work in a few days depending on the severity of endometriosis.

Are there different degrees of endometriosis?
Yes there are – mild, moderate and severe.
•    If you have mild endometriosis, there will be a few patches scattered around your pelvic cavity with no scarring.
•    Moderate endometriosis appears as larger patches that are more wide spread. These patches can be attached to your ovaries, fallopian tubes or uterosacral ligaments. Sometimes cysts will form.
•    Severe endometriosis occurs when most of the organs in your pelvic cavity are affected. Often the fallopian tubes are blocked.

How is endometriosis treated?
Your doctor will discuss the various treatment options. If you’ve undergone a laparoscopy, your doctor will be able to remove the patches of endometrium that are causing the pain. Usually after laparoscopy and removal of the patches of endometriosis, you will either be encouraged to fall pregnant or go on a hormonal therapy to minimise the chance of the endometriosis growing again.

Unfortunately there is no permanent cure and treatment options include painkillers (like non-steroidal anti-inflammatory drugs), hormonal therapies (like the oral contraceptive pill), progestins and gonadotropin-releasing hormone analogues.

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The information provided in this article was correct at the time of publishing. At Mediclinic we endeavour to provide our patients and readers with accurate and reliable information, which is why we continually review and update our content. However, due to the dynamic nature of clinical information and medicine, some information may from time to time become outdated prior to revision.