Endometriosis
Endometriosis is a chronic condition that impacts the entire body and significantly affects both physical and mental health.
It can cause a range of symptoms, including severe menstrual pain, gastrointestinal changes, fatigue, and cognitive difficulties like brain fog. It can also impact fertility in some individuals.
What is Endometriosis?
Endometriosis affects an estimated 190 million women and individuals assigned female at birth (AFAB) globally, representing about 5-10% of those in their reproductive years.
The development of endometriosis involves tissue similar to the womb lining forming outside the uterus, which bleeds similarly but without an exit route, causing pelvic scarring and often severe pain. These tissue clumps can attach to other organs, growing and potentially causing more issues over time. It is classified into four stages by the American Society for Reproductive Medicine, ranging from minimal to severe, based on the extent and depth of the endometrial tissue.
Due to the complexity of its symptoms and the need for surgical diagnosis, it often takes nearly nine years to diagnose in places like England and Scotland, as reported by Endometriosis UK in 2024.
What causes Endometriosis?
Several theories attempt to explain the onset of endometriosis:
This theory suggests menstrual blood flows backward into the pelvic cavity instead of leaving the body, but it doesn’t fully explain why endometriosis sometimes appears in areas like the lungs or brain, or in men and non-menstruating individuals.
This theory posits that certain triggers cause cells to transform into endometrial-like cells, but it doesn’t account for all manifestations of the disease.
Another theory proposes that oestrogen promotes the growth of endometriosis cells, which are less responsive to progesterone, with certain toxins potentially exacerbating this growth.
This perspective links DNA damage and inflammation to the proliferation of endometrial cells, compounded by a failure of these cells to undergo normal cell death (apoptosis).
Observations of higher autoimmune disorder rates in those with endometriosis suggest a malfunctioning immune system might contribute to the condition.
While no single gene has been linked to endometriosis, familial patterns suggest a genetic component.
This theory suggests that stem cells might turn into endometrial cells if the receive incorrect signals, explaining why endometriosis can appear throughout the body.
What are common symptoms of Endometriosis?
Menstrual symptoms are not limited to pain; periods can also be heavy and include spotting. Other common issues include bloating, headaches, fatigue, painful bowel movements, painful urination, and pain during sex. The condition can affect mental health, leading to depression and anxiety due to ongoing pain. It can also impact daily life significantly, affecting work and personal finances due to frequent medical expenses and missed work.
What long does diagnosis take, and what follows?
It can take an average of 8 years to receive a diagnosis of endometriosis, underscoring the importance of seeking medical attention early to manage symptoms effectively.
Endometriosis is typically confirmed via laparoscopy, a surgical procedure involving a camera. While ultrasounds can aid in diagnosis, they often miss less obvious cases, making surgical confirmation necessary. MRI scans are also used to locate and assess the spread of endometrial tissue.
Once diagnosed, prompt treatment is crucial to prevent long-term health issues, such as infertility, financial strain, and psychological impacts.
What treatment options are available?
Our team can discuss your symptoms and take a detailed diary of symptoms helping to determine the severity and potential treatment paths, including possible surgical exploration and management strategies, particularly in terms of contraception.
It’s useful to prepare for doctor’s visits by discussing your experiences and forming questions to ensure you receive comprehensive care and guidance for future management.
Simple measures like using a hot water bottle can greatly alleviate symptoms.
Engaging in regular exercise and adopting an anti-inflammatory diet – low in sugar and salt, high in fibre, and rich in vegetables, fruits, and healthy fats like olive oil and oily fish – are effective strategies.
Over-the-counter pain relievers such as paracetamol, codeine, and anti-inflammatories like ibuprofen or naproxen are common. However, they carry potential side effects, and excessive use can be harmful.
If these medications become ineffective, consult your doctor for alternative treatments.
Contraceptive methods can also help manage symptoms of endometriosis and may slow its progression. Options include progestogen-only treatments like the hormonal coil (IUS), injections, and some pills, as well as combined hormonal methods like the pill, patch, and vaginal ring. It’s important to discuss with a specialist to find the most suitable option.
In severe cases, GnRH analogues may be used to halt hormone production from the ovaries, effectively inducing a temporary menopause. This can lead to menopausal symptoms and, if used for extended periods, may reduce bone density.
Surgery might involve removing endometriosis lesions via keyhole surgery, or in more severe cases, excising larger clumps of cells. In extreme scenarios, removing the ovaries and womb might be necessary, followed by long-term hormone replacement therapy to mitigate menopausal effects.
While not supported by extensive research, some find CBD tampons helpful for menstrual cramps due to their anti-inflammatory properties.
This device emits electrical impulses that can disrupt pain signals to the brain, providing a tingling sensation that may relieve pain.
Techniques like acupuncture, massage, osteopathy, and mindfulness might not have strong scientific backing but can be beneficial in managing stress and pain associated with endometriosis.
Support networks, including Endometriosis UK, provide community and resources for those affected by this challenging condition.
Book a Consultation
Virtual Comprehensive Consultation with Doctor
45 minute Consultation-
Discuss all aspects of menstrual, vaginal, sexual and contraceptive health
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Suitable for those with other medical conditions that need further advice.
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Summary letter to you and your GP for ongoing care if needed.
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A private prescription is included in this appointment if needed (cost of contraception is paid separately directly to pharmacy)
What additional support is available?
Support networks, including Endometriosis UK, provide community and resources for those affected by this challenging condition.
