What is Endometriosis?
Endometriosis is a condition where tissue similar to the lining inside the uterus (the endometrium) starts to grow outside the uterus. This can cause pain, infertility, and other symptoms, commonly affecting the ovaries, fallopian tubes, and the tissue lining the pelvis.
It is estimated that 1 in 10 women and those assigned female at birth are currently living with endometriosis.
Endometriosis can affect someone from puberty to menopause, although the impact may be felt for life.
Symptoms of Endometriosis
- Pelvic pain, often associated with menstrual periods
- Pain during intercourse
- Pain with bowel movements or urination
- Heavy menstrual bleeding or bleeding between periods
- Infertility
- Fatigue, diarrhoea, constipation, bloating, and nausea during menstrual periods
Diagnosis and Treatment
Diagnosing endometriosis can be challenging and often involves:
- Detailed patient history and symptom discussion
- Physical and pelvic examinations
- Imaging tests such as transvaginal ultrasound or MRI
- Laparoscopy, a minimally invasive surgical procedure to view and potentially treat endometriosis (RCOG) (Endometriosis UK).
Treatment depends on the severity of symptoms, the extent of the disease, and whether the woman wishes to become pregnant. Options include:
- Pain relief with NSAIDs like ibuprofen or paracetamol
- Hormonal treatments to reduce or stop menstruation (e.g., birth control pills, hormone-releasing intrauterine devices, GnRH analogues)
- Surgical interventions to remove endometriosis tissue or, in severe cases, hysterectomy (RCOG) (Endometriosis UK).
Endometriosis and Menopause
Menopause often leads to a reduction in endometriosis symptoms due to decreased oestrogen levels. However, some women may continue to experience symptoms post-menopause, particularly if they use Hormone Replacement Therapy (HRT). HRT can potentially reactivate endometriosis symptoms because it reintroduces oestrogen into the body (RCOG).
Women with a history of endometriosis should discuss the risks and benefits of HRT with their healthcare provider. Management may involve continued pain relief strategies, careful monitoring, and possible adjustments to hormone therapy (RCOG) (Endometriosis UK).
