Hi Readers!

This weeks article is about endometriosis. Please note that this article is for anyone who has a uterus. This affects women who identify as women as well as trans* men.

This condition can affect individuals with a uterus of any age. 

Endometriosis is a condition where tissue similar to the lining of the womb starts to grow in other places, such as the ovaries and fallopian tubes.

It is a long-term condition that can have a significant impact on your life. This article will touch on the signs and symptoms, cause and treatments of endometriosis. 

How do I know if I have endometriosis?

Some women are severely affected, while others may not have any symptoms. The main symptoms of endometriosis are: 

  • Pain in your lower abdomen or back, usually worse during menstruations
  • Period pain that stops you doing your daily activities
  • Pain during or after sex
  • Pain when urinating or defecating during your period
  • Feeling sick, constipated, having diarrhoea or blood in your urine during your period (it is understandable if you cannot identify this correctly)
  • Difficulty getting pregnant
  • Heavy menstruations, using lots of tampons or hygienic pads, possibly even bleeding through your clothes.                   

For some, endometriosis can have a big impact on their life and may sometimes lead to feelings of depression. 

When should you visit your GP?

It is important to go see your GP or a healthcare professional if the symptoms are having a big impact on your life. Be prepared when you see your GP; it always seems more difficult to remember everything you are going through when you are sitting in front of them. To help with this, Endometriosis UK created a diary for you to fill out.

It can be difficult to diagnose endometriosis because the symptoms can vary and be similar to other conditions. The GP will examine your lower abdomen and vagina. If your GP thinks you have endometriosis, they may prescribe some treatment. If these do not work, they will refer you to a gynaecologist, who will perform ultrasound scans and further investigate. 

What are the treatments for endometriosis?

Unfortunately, there is no cure for endometriosis, but there are treatments that help ease the symptoms and manage the pain such as:

  • Painkillers (Ibuprofen and paracetamol – for my Canadian & American readers this is Tylenol, Motrin and Advil) 
  • Hormone medicines and contraceptives
  • Surgery to remove the patches of endometriosis tissue
  • Removal of part or all of the organs affected by endometriosis (hysterectomy)

Your doctor will discuss the options with you. Sometimes they may suggest not starting treatment immediately to see if your symptoms improve on their own.

What are the complications of endometriosis?

One of the main complications of this condition is difficulty getting pregnant or infertility.

There is a possibility of surgery to remove endometriosis tissue. This can improve the chances of getting pregnant. However, there are no guarantees that you will be able to get pregnant after treatment. Please be sure to speak to your surgeon about possible risks of this surgery. 

Living with endometriosis

Endometriosis affects women physically and emotionally. 

Endometriosis UK has a support group, a helpline (0808 808 2227) and an online community. 

Causes of endometriosis

Unfortunately, the cause of this condition is not known but there are several theories:

  • Genetics: this condition tends to run in the family and affects women of certain ethnic groups more than others
  • Retrograde menstruation: this is when the lining of the womb flows up through the fallopian tubes and embeds itself on the organs of the pelvis rather than leaving the body.
  • Problem with the immune system: the body’s natural defence against illness and infection
  • Endometrium cells spreading through the body in the blood or lymphatic system (a series of tubes and glands that form part of the immune system)

These theories do not fully explain endometriosis. It can be very frustrating for anyone not to have an answer to the question why this is happening? Where is this coming from?

The treatments that are offered for endometriosis, aim to ease the symptoms so they do not affect your day-to-day life. The treatments can be given to relive pain, slow the growth of endometriosis tissue, improve fertility or stop the condition returning. Before deciding which treatment is best for you, your gynaecologist will walk you trough the risks and benefits of each. There are things to consider when choosing your treatment; your age, are you trying to get pregnant, your feelings towards surgery and if you have tried any treatments before. 

If your symptoms are mild, you have no fertility issues or you are nearing menopause, it may not be necessary to have treatment. 

Sometimes endometriosis gets better on its own. Sometimes it can also get worse if it is not treated. This is why it is important to keep an eye on your symptoms and decide whether or not you want treatment if your symptoms do not improve and being to affect your daily activities. 

Fertility problems

Once again, it is not fully understood why it causes fertility problems but it is often suggested that it is due to the damage done to the fallopian tubes. Not all women with endometriosis will have problems getting pregnant, some will be able to get pregnant without treatment. 

Surgery sometimes helps as it removes the visible patches of endometriosis tissues but there is no guarantee that you will get pregnant. Some women and couples will decide to go down the in vitro fertilisation (IVF) route but if the women has moderate to severe endometriosis, they will have a lower chance of getting pregnant through this method. ( I have written an article about IVF treatment affects on your sexuality if you are interested.)

Adhesions and ovarian cysts

Some individuals with endometriosis will develop adhesions (sticky areas of endometriosis tissues that join organs together) or ovarian cysts (fluid filled growth in the ovaries that can sometimes become very large and painful). These can happen when the endometriosis tissue is in or near the ovaries. These can be treated with surgery, although there is a possibility these come back if the endometriosis returns. 

Bladder and bowel problems

If the endometriosis affects the bladder or the bowel, it can be difficult to treat and may require major surgery. You may be referred to a specialist. If it affects the bladder and you need surgery, this may involve cutting away part of the bladder. There is also a possibility of placing a catheter.

Please speak to your GP if you have symptoms or a family history. 

If you would like to arrange a counselling session around the effects it is having on your sexuality or self-esteem, please contact me to book an appointment.

Be kind to one another!

Julia, Sexologist

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