Endometriosis is a chronic condition affecting women of childbearing age where the cells and tissue (endometrium) that line the inside of the womb (uterus) grows outside the womb and into the pelvis.
We've sat down with one of our top consultant obstetricians and gynaecologists Mr Nitish Narvekar and asked him to explain why it occurs, why it causes so many problems and if it can be treated.
Why do women get endometriosis and where does it occur?
The most common reason for endometriosis is the regurgitation of the womb lining through the fallopian tubes into the pelvis during menstruation. Therefore it is predominantly found in or around pelvic organs such as ovaries, fallopian tubes, and large bowel.
It can spread from the pelvis to other organs inside the tummy (abdomen) or by bloodstream/lymphatic systems to distant organs such as the lungs, brain, and eyes. Endometriosis can run in families, or ethnic groups, or when the immune system is unable to clear the womb lining or cells.
How can I relieve my symptoms when it flares up?
The most common symptom is pain, usually felt during periods or during/after sex; pain or other symptoms related to peeing or opening bowels can also be due to endometriosis. There is no definitive cure for endometriosis, but, pain can be managed by taking painkillers such as ibuprofen and paracetamol.
Endometriosis may also cause heavy periods and infertility and it is best to see a specialist if you suffer from these conditions as a pelvic ultrasound scan done by a trained expert gynaecologist may diagnose even early endometriosis.
Why does endometriosis cause so many problems?
As endometriosis is caused by the deposits of the womb lining in and around the pelvic organs. Whenever women with the condition have a period, the womb lining in the endometriosis also bleeds but, unlike period blood, which comes out per vagina, the blood within the endometriosis has nowhere to go. This results in chronic inflammation and damage including scarring to the surrounding tissues and organs.
How can it be treated and can it return?
Whilst painkillers are good for managing pain symptoms, they do not suppress endometriosis and instead allow it to grow and spread in the background therefore it is best to see a specialist at the earliest opportunity. Suppressive treatments, which include the oral contraceptive pill and insertion of ‘Mirena’ hormone coil into the uterus, are highly effective for minimal or mild endometriosis.
For advanced endometriosis, large ovarian cysts (endometrioma) or infertility it is best to consider surgery. The aim of surgery is to completely burn the endometriosis followed by the use of the pill/Mirena to prevent an early recurrence.
Women with infertility should try for children soon after as pregnancy and breastfeeding are natural suppressive treatments for endometriosis.
Overall, endometriosis is a chronic condition and is best managed with symptomatic relief and judicious use of surgery and preventative hormone therapies.
Book an appointment with Mr Narvekar now if you would like an expert opinion on any of your gynaecological problems.