Endometriosis

Endometriosis is a common condition affecting women during the reproductive years. This condition occurs when the endometrial tissue (usually present on the inside of the uterus) is present outside the uterine cavity. This misplaced tissue could cause pain, heavy and prolonged menstrual bleeding, infertility and bleeding when passing stools or urine. We can help you manage this condition.

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The Symptoms

Endometriosis is classified into four stages (I-minimal, II-mild, III-moderate, and IV-severe) depending on location, extent, and depth of endometriosis implants. The presence and severity of adhesions as well as the presence and size of ovarian endometriomas.

Painful periods (dysmenorrhea)

Pain and cramping may begin a few days before you start your period and extend a few days into your period. Lower back pain and abdominal pain is also common.

Pain with bowel movements or urination

Pain when urinating or bowel movements is most likely experienced while you are having your period.

Excessive bleeding

You may occasionally experience heavy menstrual periods or bleeding between periods.

Pain with intercourse

Often times you may experience pain during or after sex.

Infertility

In many cases, women experiencing infertility are then diagnosed with endometriosis while seeking fertility treatment.

Other signs and symptoms

Diarrhoea, fatigue, constipation, bloating and nausea while on your period is also experienced by women with endometriosis.

Many young women feel overwhelmed by endometriosis. The truth is that neither cause nor cure of the disease is known. However, accepting and learning to manage the chronic pain and dealing with infertility could be beneficial towards coping skills regarding the condition.

How is Endometriosis diagnosed?

There are several signs that you might have Endometriosis, however, you need to visit the doctor in order to diagnose the problem and eliminate other possible issues.

Symptom analysis

In order to determine if you do have endometriosis, the doctor will ask you about the symptoms you are experiencing as well as your history regarding those symptoms.

Vaginal ultrasound

After initial questioning, the doctor will then perform a vaginal ultrasound to see if any ovarian endometriomas are present.

Laparoscopy

Laparoscopy can be performed as a diagnostic to determine whether any endometrioses or abnormalities of the Fallopian tubes or ovaries exists.

Treatment Options & Techniques

In treating endometriosis the goals are providing pain relief, restricting progression of the process, and restoring or preserving fertility where needed.

Pain management

Pain killers may be effective when combined with ovarian suppression through hormone therapy and exercise.

Hormonal therapy

Hormonal therapy could vary between Gonadotropin releasing hormone (GnRH) and progesterone treatment. GnRH analogue usually comes in subcutaneous injections (monthly or 3 monthly).

This medication allows shrinkage of the ectopic endometrial tissue by ceasing the production of estrogen. GnRH is very effective in relieving pain associated with endometriosis but long term use is limited by the risk of osteoporosis.

Progesterone treatment is usually administered through tablets or injections. The treatment is effective in relieving painful symptoms but its side effects may be troublesome and include weight gain, abnormal bleeding and acne.

Surgery

Laparoscopy is usually the most common surgery due to the advantages of diagnosis and treatment at the same time. Usually the endometriosis is destroyed using a laser or cautery and normal anatomy restored. In certain cases a combined approach of surgery and medication could be beneficial to the patient.

Infertility

If a pregnancy is not achieved following a reasonable waiting period after a laparoscopy, ART (artificial reproductive technology) could be recommended. IVF is usually indicated if the Fallopian tubes were blocked or damaged due to the endometriosis.

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