Endometriosis can make life hard. But getting help and finding ways to manage its symptoms is certainly possible.
Menopause often helps women suffering from endometriosis to find relief as endometrial tissue no longer can thrive when their ovaries stop producing hormones that stimulate its growth.
Symptoms
Endometriosis affects women by giving them painful periods, pelvic and back pain, difficulty getting pregnant and an increased risk for depression and anxiety.
Gynecological patients make up approximately one in 10 cases, yet it often goes undetected for years due to symptoms often being misinterpreted as menstrual cramps. Diagnosing it is difficult; many who exhibit symptoms don’t receive one until seeking infertility treatment.
Doctors generally classify endometriosis in stages 1 through 4, depending on its spread, depth and locations on your body. Stage 1 typically contains only minimal implant, lesions or scar tissue deposits while Stage 2 typically features more implants deep within tissue that lines uterine or pelvic organs.
Most women living with endometriosis experience mild to moderate symptoms. The most frequent are pain just before and during their period, as well as discomfort during sex, bowel movements or urinating. Pain may also arise at other times.
Medication such as painkillers and hormone medications that prevent eggs being released from the ovaries (which suppress ovulation) may temporarily ease period pain, but these drugs don’t treat the cause and symptoms usually return upon stopping treatment. Acupuncture or massage may provide some temporary relief; however, their effectiveness has yet to be scientifically established, potentially interfering with prescribed medication regimens.
Diagnosis
Endometriosis occurs when tissue normally found inside of the uterus begins to protrude outside its normal place, such as attaching itself to ovaries, fallopian tubes, exterior of uterus, bowel or other internal parts of the body. As hormones shift during menstrual cycles this tissue responds by growing and bleeding rapidly, eventually producing scar tissue and other symptoms that disrupt menstruation cycles and cause bleeding episodes.
Doctors typically identify endometriosis by performing an exam of your pelvic area with either a laparoscope or ultrasound machine, as well as using imaging tests such as pelvic CT scanning or MRI to examine what’s happening inside. The images from these tests help doctors pinpoint areas of inflammation, cysts and other signs associated with endometriosis.
If your symptoms are mild, your doctor may suggest medications to suppress your ovaries’ natural estrogen production and control periods and reduce pain. Combinations of estrogen and progestin may be particularly effective; these can come in the form of pills (oral or implant), vaginal rings or patches worn against the skin that should be changed regularly. Doctors can also lower estrogen levels via injections known as leuprolide acetate injection, more commonly known by its brand name Lupron(r).
Women suffering from advanced endometriosis who don’t find relief through hormonal treatment or those seeking pregnancy require surgery. Laparoscopic surgery requires making small cuts in your abdomen before inserting a tube-like tool equipped with cameras and tools for destroying endometrial cells; recovery time from laparoscopic procedures tends to be quicker while less scars remain than traditional open surgery procedures.
Treatment
Endometriosis can be treated using pain-relieving medicines (e.g. paracetamol), hormone therapy and surgery. Your choice of treatment will depend on its severity, extent and any plans to become pregnant in the near future. For optimal care it is advisable to work with a team of health professionals trained specifically in endometriosis management such as gynaecologists, surgeons with advanced laparoscopy skills and pelvic floor physiotherapists who are all equipped with appropriate expertise in diagnosing endometriosis management.
Women living with endometriosis may be at an increased risk of epithelial ovarian cancer, specifically clear cell and endometroid carcinomas; however, these cases are uncommon and there is no preventive screening option available to them.
Your doctor will begin diagnosing endometriosis through a pelvic exam and imaging tests such as ultrasound or CT scan. They may also perform laparoscopy, where a thin tube with a camera at its end (called a laparoscope) is inserted into your abdomen in order to view scar tissue; they can take samples for examination under microscope in order to confirm a diagnosis.
Hormonal treatments may provide relief from period pain and reduce the chances of endometriosis recurrence after treatment, including pills, nasal sprays or shots of hormone-releasing hormone analogues like progestogens or gonadotrophin-releasing hormone analogues such as the contraceptive pill and progestogens or gonadotrophin-releasing hormone analogues such as aromatase inhibitors which stop your body producing the chemical that boosts estrogen levels – these medicines aren’t commonly prescribed here but sometimes used so you would need to use contraception in order to avoid pregnancy while taking these treatments in order to avoid pregnancy occurring.
Prevention
Endometriosis occurs when tissue similar to that found lining your uterus begins growing elsewhere in your body, typically your fallopian tubes, outside your pelvic organs (on their surface) or your bowel. It may cause menstrual cramping and abnormal vaginal bleeding as well as difficulty getting pregnant – leading to pain around menstruation time, abnormal vaginal bleeding and difficulty becoming pregnant; additionally it may create long-term painful adhesions (long-term scar tissue formation).
There is no known way to prevent endometriosis, but speaking with your doctor about symptoms and treatments that could work for you is a great start. Furthermore, learn more about managing symptoms as well as joining support groups can also be invaluable resources.
Some individuals may find relief using over-the-counter pain relievers like ibuprofen (Advil, Motrin IB) and paracetamol. Your healthcare team may also recommend hormone treatment which can ease symptoms by decreasing oestrogen levels – however this is only temporary relief; symptoms will return once you stop taking these drugs.
People suffering from severe or persistent endometriosis may require surgery. Surgeons will make a small incision in your abdomen and insert a thin tube-like tool called a laparoscope with cameras and lights for viewing the procedure. They then use tools to either remove endometrial tissue using tools or destroy it using heat (ablation), depending on the extent of endometriosis present and your plans to have children in the future. They might even suggest having your uterus completely removed via hysterectomy depending on its extent and your plans for trying for children in future.
