Understanding endometriosis: Symptoms, causes, and treatment options

Written in association with: Mr Ilyas Arshad
Published: | Updated: 10/12/2024
Edited by: Conor Lynch

Endometriosis is a chronic condition affecting approximately 10% of women of reproductive age worldwide, where tissue similar to the lining of the uterus (endometrium) begins to grow outside the uterine cavity. These endometrial-like tissues may attach to organs such as the ovaries, fallopian tubes, and even the intestines.

 

Every month, these tissues respond to hormonal changes during the menstrual cycle, thickening and breaking down like the normal uterine lining. However, because they are outside the uterus, they cannot exit the body, causing inflammation, pain, and scar tissue (adhesions) over time.

Causes

The exact cause of endometriosis remains unclear, but several theories exist. Retrograde menstruation is one theory, where menstrual blood flows backward into the fallopian tubes and pelvis, causing endometrial cells to implant outside the uterus.

 

Another possibility is immune system disorders, where the body fails to recognise and destroy endometrial-like tissue growing in abnormal areas. There is also a genetic component, as endometriosis is more common in women with a family history of the condition.

 

Symptoms

Symptoms of endometriosis can vary significantly, with some experiencing severe symptoms while others have mild or none at all. Common signs include pelvic pain, often worse during menstruation, painful intercourse, heavy or irregular periods, and digestive issues like bloating and constipation.

 

In severe cases, it can lead to infertility, as scar tissue and adhesions may disrupt the reproductive organs. For those with mild symptoms, diagnosis can be delayed, as the symptoms are sometimes mistaken for other conditions like irritable bowel syndrome or ovarian cysts.

 

There is currently no cure for endometriosis, but several treatment options can help manage the symptoms. Pain relievers, such as nonsteroidal anti-inflammatory drugs (NSAIDs), are often prescribed to alleviate discomfort.

 

Hormone therapy, including birth control pills and hormonal IUDs, can help reduce or eliminate menstruation, which may minimise pain. In more severe cases, surgery may be recommended to remove endometrial tissue. Surgery is an essential part of the treatment process for prolonged cases of endometriosis. For women trying to conceive, fertility treatments, such as in vitro fertilisation (IVF), may also be considered.

 

Early diagnosis and treatment can significantly improve quality of life for those with endometriosis, helping manage pain and preserve fertility.

By Mr Ilyas Arshad
Obstetrics & gynaecology

Mr Ilyas Arshad is a highly respected Consultant Gynaecologist. He is the Clinical Lead for the BSGE Accredited Endometriosis Centre at Liverpool Women’s Hospital and sees private patients at Spire Liverpool Hospital. He also operates on selected patients at HCA Christie, Manchester. He is renowned for his expertise in minimal access surgery including: Endometriosisadenomyosispelvic pain and additionally specialises in, fibroids and menstrual disorders. He is also a proctor in Robotic Surgery for Intuitive Da Vinci systems.

Mr Arshad qualified in medicine from the University of Liverpool in 2000 before pursuing further specialist training in Oxford, London, Surrey, Wales and Nottingham. In 2005, he attained membership of the Royal College of Surgeons of Edinburgh and later went on to achieve membership of the Royal College of Obstetricians and Gynaecologists. He has undergone advanced laparoscopic gynaecological surgical training at the John Radcliffe Hospital in Oxford, which was the busiest British Society of Gynaecological Endoscopy (BSGE) accredited endometriosis centre at that time. In addition, he has attained training in Robotic surgery and will be proctoring other Surgeons keen on becoming Robotic Surgeons.

Mr Arshad received the British Society for Gynaecological Endoscopy’s travelling fellowship award in 2019 and travelled to Bordeaux, France to undergo advanced endometriosis training under world specialist Professor Horace Roman in bowel related endometriosis and nerve sparing surgery. 

Additional to his clinical responsibilities, Mr Arshad holds various teaching responsibilities and has completed a Master’s in medical education. He is an educational supervisor and examiner for final year medical examinations, a clinical supervisor and a supervisor for PhD research students at the University of Liverpool. He is also faculty member of several British Society of Gynaecological Endoscopy (BSGE) courses. In addition, he is a member of the Society’s subcommittee for awards and prizes and chairs the endometriosis specialist interest group for the Merseyside and Cheshire region. 

Throughout his esteemed career, Mr Arshad has published a number of academic papers in peer-reviewed journals. His dedication to his work has also been recognised with various prizes/ awards, including the European Society for Surgical Research prize, Alan Gordan Travelling Fellowship prize and a Service Transformation award from Kent and Canterbury Hospital Trust in recognition for improving care pathways.  

Mr Arshad has also won awards for the excellence of his research and remains actively involved in various ongoing clinical trials. In addition, he is active in publishing academic papers and chapters in medical textbooks, including the 2023 Oxford Handbook for Obstetrics and Gynaecology. Mr Arshad is an accredited member of numerous professional bodies, including the American Association of Gynaecological Laparoscopists and the British and Irish Associations of Robotic Gynaecological Surgeons

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