Endometriosis, or ‘endo’ is a chronic condition where tissue similar to the inner lining of the womb or ‘uterus’, also grows outside of the uterus. At least 1 in 10 women have endo. This number is probably higher because of how we, as a society, view periods and period pain: we often don’t talk about it, or are maybe told ‘you don’t look sick’. In addition, the surgical diagnosis of endo can often take years.
Why does someone have endo?
We don’t know. We think it’s a combination of theories ranging from genetics, to ‘retrograde’ periods (period bleeding into the abdomen).
What are the effects of endo?
Severe pain. During a period, when the inner lining of the uterus ‘sheds’, this also happens to the other abnormal endo tissue. As a result, the pain that someone with endo experiences can be much worse than the ‘typical’ period (whatever that is). After the period ends, there is often lingering or ‘chronic’ pain from inflammation around the endo tissue. This causes scarring or ‘adhesions’, and can change how the nerves feel pain. All of these abnormal changes also cause tension in the pelvic floor muscles and can cause pain with intercourse.
Did you know endometriosis or ‘endo’ doesn’t just cause pelvic pain symptoms?
Endo is a multi-system condition. As doctors, we often ask about symptoms like period pain, but there is a lot more to the condition. The symptoms of endo overlap with other conditions like Irritable Bowel Syndrome (IBS). Many women with endo describe more dominant symptoms like bloating. This is why diagnosis can be delayed.
The symptoms that women with endo suffer are not always linked to ‘how much’ endo or ‘where’ the endo grows. This is a common misconception.
Every woman with endo has their own set of symptoms – they can vary from woman to woman.
The spectrum of symptoms that women with endo experience include:
– Irritative GI symptoms like bloating, nausea & vomiting, and diarrhoea with alternating constipation
– Flank, back and leg/thigh pain
– Bladder symptoms like pain with urge to urinate or when holding back, and urinating frequently.
If you have the above symptoms and feel that they are affecting your lifestyle, it’s important to see a Gynaecologist as part of the assessment.
Did you know that endometriosis or ‘endo’ can be linked with infertility?
Not all women with endo have infertility; in fact, it probably affects about half.
How does it cause infertility? It can be from the scar tissue affecting the anatomy of the fallopian tubes that carry the egg/sperm, or from inflammation causing a release of chemicals.
If you have been trying to fall pregnant for more than 6 months, and have confirmed endo, or even the symptoms of endo (see post Part 2), it is important to see a Gynaecologist as soon as possible. Prompt ‘key-hole’ surgery to remove or reduce the amount of endo has positive effects on fertility. Seek help sooner than later.
What are the management options?
Surgery is needed for diagnosis, grading the endometriosis and treatment. Surgery provides improvements in your symptoms, and can improve fertility rates. Managing endo, especially during COVID, also needs a well planned non-surgical and holistic approach.
Endo being a chronic condition means that there is no ‘quick fix’. Surgery is useful for severe symptoms that don’t improve with first-line treatment or when infertility is an issue.
Anti-inflammatories (e.g. ibuprofen) and hormone options help. They do have some mild side effects, but they are effective in reducing pain and bleeding. There are different types of hormone options ranging from contraceptive pills, injectables, skin patches and intra-uterine devices (IUDs). It’s trial and error to find the right one that works for you.
It’s also really important to see other Specialists. A pelvic physiotherapist will manage abnormal pelvic floor muscle activation. Dietitians offer tailored advice on foods that reduce inflammation and gut symptoms. Let’s not forget the mental health impact of endo; seeing a mental health specialist can help women navigate their endo journey. Having a Gynaecologist as a coach who understands endo and can help co-ordinate this care is invaluable.
Dr Kiran is highly trained and passionate Gynaecologist with a holistic view of endometriosis. He offers high-level laparoscopic key-hole surgery for women. His is committed to helping you confidently manage this condition. He will spend time with you to understand how the disease has affected different parts of your health and life. He has a team of various Specialists, such as Physiotherapists, Dietitians and Pain Specialists, who he works closely with to provide you with a comprehensive care plan.
Dr Kiran is based in South East Melbourne. He consults in the Casey and Frankston areas, with his main rooms in Berwick. Surgery can be offered privately at St John of God Berwick, Cabrini Hospital in Malvern or Frankston Private Hospital.
Contact our rooms to arrange an extended 1 hour Initial Appointment.