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Endometriosis is a very common condition found in women where cells typically found inside the uterus (womb) are located outside of the uterus and surrounding pelvic area including; pelvis, ovaries, fallopian tubes and occasionally the bladder and bowel. Every month these cells react in the same way to those inside the uterus building up then breaking down to bleed which inside the uterus is known as menstruation (period). Although, unlike periods, endometriosis has no way to escape; therefore leading to inflammation, pain and the formation of scar tissue.
Endometriosis can affect any females who have started their periods. One in ten women of child bearing age have some degree of endometriosis with symptoms presenting themselves between the ages of 25-40 years old. It is estimated that two million women in the UK have this condition.
The cause for this condition remains unknown. Retrograde menstruation is a possible explanation and this is where some of the blood shed from the womb during your period travels down the fallopian tube or back tracks. Though some professionals feel this condition could be hereditary (runs in the family).
Some women can experience all of the symptoms below, some of them or none at all.
Endometriosis can be difficult to diagnose immediately as the symptoms experienced are similar to those of other conditions, an example being irritable bowel syndrome.
A formal diagnosis of endometriosis is made through performing a diagnostic laparoscopy (keyhole surgery). This usually is a day case procedure, performed under a general anaesthetic (putting you to sleep) where a small camera is inserted into your belly button to look inside the abdomen and pelvis.
The diagnosis of this can then be made by the doctor sometimes just by visualising the endometriosis. Often a small piece of endometriosis known as a biopsy is sent for testing with results relayed to you when they are back. If fertility has been a concern then the doctor may also flush your tubes to make sure they are clear and patent checking for any blockages/signs of endometriosis.
Untreated endometriosis becomes worse in approximately four out of ten women; however in about three out of ten women it will improve. For the remainder the condition and symptoms remain the same. Women with severe untreated endometriosis are at risk of complications such as; obstruction or blockage of the ureter (the tube between the kidney and bladder).
Treatment is not required if no pain and fertility not an issue. Mild endometriosis evident during a diagnostic laparoscopy may be treated at the same time.
In more severe cases there are many options available and these are divided into medical management and surgical management. The option that is best for you will be discussed with your doctor and will depend on personal individual factors including: age, pregnancy status and thoughts on future pregnancies, how you feel about undergoing surgery, how effective previous treatment has been and what symptoms you want to try and manage.
These will be discussed thoroughly between you and your doctor prior to commencing treatment although some risks associated with choosing medical management are:
The risks depend on the operation performed but they may include:
In order for you to make an informed choice about your operation please ask one of the doctors or nurses if you have any questions about the operation before signing the consent form.
Many women who have endometriosis are able to have children without any problems although some women will find conceiving more difficult. Severe endometriosis may mean adhesions present around the ovaries and this can prevent the egg from moving down the fallopian tube to conceive.
With the difficulties of getting pregnant endometriosis have treatments which may help (see listed below).
You can still get pregnant if you have severe endometriosis, it could just take longer.
Complementary therapies have not been scientifically proven but many women feel that therapies such as acupuncture or reflexology help to manage symptoms.
Pain control is better if you are able to stay ahead of it by taking medication regularly. Anti inflammatory drugs (Ibuprofen, Nurofen) provide good pain control and can be taken with paracetamol and/or codeine.
Exercise is a good relief for pain symptoms and this can be whatever exercising you are most comfortable with doing. Irritable bowel syndrome and endometriosis co exists and can be managed by following a healthy diet with plenty of fruit and vegetables. Peppermint water may also help too.
If you have any problems or are worried, please do not hesitate to contact us on the gynaecology ward:
Royal Sussex County Hospital
Telephone 01273 523191
Princess Royal Hospital
Horsted Keynes Ward
Telephone 01444 441881 extension 65686
This information sheet has been produced by the Gynaecology Ward Sister Hannah Tompsett and Samantha Backley.
This information is intended for patients receiving care in Brighton & Hove or Haywards Heath.
The information in this leaflet is for guidance purposes only and is in no way intended to replace professional clinical advice by a qualified practitioner.
Publication Date: October 2021
Review Date: July 2024