Endometriosis

What is Endometriosis?

Endometriosis is a condition that affects women. It can cause pain in the lower part of the belly and trouble getting pregnant.

Endometriosis occurs when tissue normally found in a woman’s uterus, called the endometrium, grows outside of the uterus. This tissue, which does not belong outside the uterus, can then break down, bleed, and cause symptoms.

Some women with endometriosis have no symptoms. But most have pain in the lower part of the belly that can occur:

  • Before or during monthly periods
  • Between monthly periods
  • During or after sex
  • When urinating or having a bowel movement (often during monthly periods)

Other symptoms of endometriosis can include:

  • Difficulty getting pregnant
  • Ovarian cysts (sometimes called chocolate cysts or endometriomas) found on ultrasound

All of these symptoms can also be caused by conditions that are not endometriosis. But if you have any of these symptoms, you may need to be investigated for endometriosis. The only way to know for sure if you have endometriosis is for a doctor to do a laparoscopy and look for endometriosis tissue outside the uterus. Sometimes a specialised ultrasound can be useful, too.

 

Treatment of Endometriosis

Endometriosis has many treatments. The right treatment for you will depend on your symptoms and whether you want to be able to get pregnant now or in the future.

First-line treatments are medications, such as:

  • Pain medication – such as panadol and/or nurofen on the days the pain is present
  • Contraceptive pill – this can reduce the number of periods (by skipping periods) and the amount of pain. It is not suitable if you are trying for a pregnancy immediately
  • Mirena IUD – this is a device that sits inside the uterus for up to 5 years (it can be removed easily at any time). It has progesterone hormone within it that acts to suppress the growth of endometriosis. It is also not suitable if you are trying for a pregnancy immediately.

Some women choose to have surgery to treat endometriosis. The most common surgery is a laparoscopy; this allows the surgeon to see and remove endometriosis tissue. It is usual to follow surgical removal with some attempt at preventing it growing back: either the contraceptive pill, Mirena IUD, or pregnancy.

In more extreme cases, or in women who have definitely completed their family, a hysterectomy can help. A hysterectomy is surgery to remove a woman’s uterus.

 

Pregnancy Considerations

Endometriosis can affect your chances of becoming pregnant, although it should be noted that some women with known endometriosis have no trouble at all becoming pregnant. Endometriosis can cause hormonal imbalances that change how your ovaries function, and can block your fallopian tubes. Surgically resecting mild to moderate endometriosis probably improves your pregnancy chances. Women with endometriosis who have not become pregnant in 6 to 12 months (depending on their age) should seriously consider IVF.