What happens when you have endometriosis?

Written by: Mr Nitish Narvekar
Published:
Edited by: Laura Burgess

What is endometriosis?

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.
 

Why do women get endometriosis and where in the body 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, and 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 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, or, large ovarian cysts (endometrioma), or, infertility, it is best to consider surgery. The aim of surgery is to completely excise/burn the endometriosis followed by use of the pill/Mirena to prevent early recurrence.

Women with infertility should try for children soon after – 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.

By Mr Nitish Narvekar
Obstetrics & gynaecology

Mr Nitesh Narvekar is a consultant gynaecologist and obstetrician, and an accredited specialist in reproductive medicine and minimal access surgery in London. He specialises in the investigation and treatment of infertility, fertility preservation for cancer and personal choice, fibroids, endometriosis and uterine anomalies such as polycystic ovaries, abnormal vaginal bleeding and pelvic pain. Mr Narvekar has performed over 500 complex operations for management of various reproductive and general gynaecological conditions.

He graduated from GOA University, India in 1990 and then trained as an obstetrician and gynaecologist. Mr Narvekar was admitted as a member of the Royal College of Obstetrician and Gynaecologist in 1999. He undertook a research fellowship in Reproductive Medicine at the University of Edinburgh followed by a sub-specialty fellowship in Reproductive Medicine and Minimal Access Surgery at University College London Hospitals. He was accredited as a dual specialist in 2008. Mr Navekar is widely published in the field of reproductive medicine and minimal access surgery and is actively involved in the training and examination of students and specialists. 

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