Could endometriosis be causing your painful periods?
Quick facts
- Endometriosis develops when tissue that is similar to the lining of the uterus grows in places outside the uterus.
- This tissue thickens, bleeds and sheds with your menstrual cycle, causing the surrounding, normal tissue to become irritated and swollen. It can also cause organs to fuse together.
Why should I care about endometriosis?
Leaving the condition untreated can lead to symptoms worsening with time. Receiving the right diagnosis and treatment can also empower you to make informed decisions around your fertility.
Who gets endometriosis?
Endometriosis affects at least 1 in 10 women. In 2-5% of cases, it can continue after menopause, though symtpoms usually lessen. This is because the endometriosis tissue usually needs oestrogen to grow (and levels of oestrogen drop during menopause).
What are some other risk factors?
Age
Though endometriosis can develop in your teens, it most commonly affects women in their 30s and 40s.
Family history
Your chances of developing endometriosis increase if someone in your family has had it.
Pregnancy
Women who haven't had children have a higher risk of developing endometriosis. This is due to the impact of hormones on the condition.
Menstrual issues
If your periods are heavy, or your period started at an early age, these are factors that could put you at risk.
Can endometriosis impact my fertility?
An estimated 60-70% of women with endometriosis can get pregnant spontaneously. Even in cases where fertility is affected, many women can still conceive with assistance, either through surgery to remove endometriosis or through methods such as IVF.
In the general population, miscarriage occurs in around 1 in 5 pregnancies. For those who have endometriosis, the risk increases to around 1 in 4.
What symptoms should I look out for?
Speak to a doctor if you’re experiencing:
- Pain in your lower tummy or lower back
- Pain during your period that stops you doing your normal activities
- Pain during or after sex
- Pain when peeing or pooing during your period
- Heavy periods
- Feeling sick during your period
- Experiencing constipation, diarrhoea, or blood in your pee or poo during your period
- Difficulty getting pregnant
How is endometriosis diagnosed?
Despite it being the second most common gynaecological condition in the UK after fibroids, it takes an average of 7.5 years for a woman to receive a diagnosis for endometriosis. While awareness of the condition is growing, its symptoms are often confused with other conditions or dismissed as normal period symptoms.
Pelvic exam
Your doctor might initially perform a pelvic exam, using their hand to feel for abnormalities in your pelvic area. These could be cysts on your reproductive organs or scars behind your uterus.
Ultrasound
A device called a transducer is pressed against your abdomen and/or placed inside your vagina to see if cysts can be seen. As with a pelvic exam, an ultrasound doesn’t confirm you have endometriosis.
Laparoscopy
This is the only way to definitively know if you have endometriosis. The procedure allows a surgeon to view the inside of your abdomen while you are under general anesthesia. A tiny incision is made in your tummy and a viewing instrument called a laparoscope is inserted to capture images of potential endometrial tissue.
Your surgeon may take a tissue sample (biopsy) to do further tests and might also decide to treat your endometriosis to reduce the need for additional surgery.
How is endometriosis treated?
In each case, a doctor should walk you through your options and make you aware of the risks and/or side effects associated with each treatment.
Pain medication
Doctors may prescribe anti-inflammatory medication as a first port of call to see if symptoms ease. Ibuprofen and paracetamol can be taken together to boost the effects of pain relief.
Hormone treatment
Hormone-based treatments such as the combined oral contraceptive pill target endometriosis by limiting the production of oestrogen in your body. Endometriosis needs oestrogen to grow, hence why reducing the hormone's presence can help.
Surgery
Tissue can be removed or destroyed through surgery, depending on the location and volume of endometriosis. There are two main types of surgeries:
Laparoscopy
Tiny incisions are made in your tummy area and a device with a camera (called a laparoscope) is inserted to help the surgeon perform the operation. Fine instruments are also inserted to remove or destroy the endometriosis tissue. A laparoscopy can go a long way in relieving your symptoms and can help improve fertility. Symptoms can still return though.
Hysterectomy
This procedure removes the uterus and consequently the option of giving birth. In most cases, a small incision is made and the surgery is done with the help of a camera. Though it’s unlikely, endometriosis symptoms can still return after the surgery.
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