Endometriosis

Are you suffering from period pain or other menstrual problems ?

Have you been investigated for possible causes ?

Endometriosis is one of the causes of painful periods.

What is endometriosis ?

Firstly let's look at the meaning of endometrium.

Endometrium is the lining of the womb that is shed each month, although that's  not the only place. Endometriosis is a condition when this layer of tissue appears outside of the womb.  It reacts the same way as the womb does during the menstrual cycle. Even though it's a benign condition, it is of great importance because it can be hard to detect and generally takes 4-10 years for the diagnosis.

How common is Endometriosis?

In 2016–17, there were around 34,200 endometriosis related hospitalisations in Australia.

Around 1 in 9 (11%) women born in 1973–78 were estimated to have been diagnosed with endometriosis by age 40–44.

There is an increasing trend in people with this condition. The number of people diagnosed with endometriosis between the ages of 25-29 has increased from 4% to 6.6% between two different studies. That’s 1.7 times increase.

However, given endometriosis is not easily diagnosed, the estimated numbers are expected to be less than actual.  Confirmed diagnosis requires a keyhole surgery/ laparoscopy.

Who is at risk of getting endometriosis ?

Key risk factors are

• Obstruction of menstrual outflow

• Exposure to certain chemicals as an unborn baby

• Prolonged exposure to hormone, estrogen due to factor such as early menarche, late menopause, or overweight

• Short menstrual cycles

• Low birth weight

Endometriosis has, in the past, been said to be more common among women who are:

• Women with no pregnancies or bear children late in life

• High achievers with a type A personality

• Caucasians

• Between the ages of 30 - 40 years; although it may occur in younger age groups, including some teenagers

• High social class

• Underweight

Causes of endometriosis

The exact cause of endometriosis is unknown.

Most commonly accepted theory is the backflow of endometrial tissue through the tubes. This is seen in 80% of women but not all of them suffer from endometriosis.

Another theory suggests that changes in cells due to the estrogen hormone during the teenage years could be responsible.

Other potential causes are endometrial tissue getting displaced through pelvic veins or lymphatic system and, presence of endometrial tissue at the site of injury such as “c section”  or episiotomy

Symptoms

• Painful periods

• Painful sexual intercourse

• Chronic pelvic pain

• Pain during ovulation

• Difficulty in conceiving

• Heavy periods, spotting or bleeding between periods

• Chronic tiredness

• Abnormal bleeding when passing urine or bowel movement

How can it be diagnosed ?

Currently practiced methods are:

• Ultrasound of pelvis

• Laparoscopy

How is endometriosis treated ?

The treatment depends on the expected outcome.

Your GP would be able to provide guidance based on your individual circumstances