Endometriosis

Endometriosis extends beyond just severe menstrual pain; it’s a chronic condition that impacts the entire body and significantly affects both physical and mental health. Experiencing debilitating menstrual pain that requires taking several days off is not normal.

How 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. 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?

  • Non-hormonal and Lifestyle Approaches: 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.
  • Medication: 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.
  • Hormonal 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.
  • Chemical Menopause Treatments: 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.
  • Surgical Interventions: 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.
 

Alternative Treatments:

  • CBD Tampons: While not supported by extensive research, some find CBD tampons helpful for menstrual cramps due to their anti-inflammatory properties.
  • TENS Machine: This device emits electrical impulses that can disrupt pain signals to the brain, providing a tingling sensation that may relieve pain.
  • Complementary Therapies: 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.
 

Our team is here to discuss your symptoms and explore the most effective treatment options, 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.

Endometriosis

Endometriosis is a systemic condition that 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? How prevalent is it?

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. 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 it?

Several theories attempt to explain the onset of endometriosis:

  • Retrograde Menstruation: 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.
  • Metaplasia: 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.
  • Hormones and Environmental Toxins: Another theory proposes that oestrogen promotes the growth of endometriosis cells, which are less responsive to progesterone, with certain toxins potentially exacerbating this growth.
  • Oxidative Stress and Inflammation: 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).
  • Immune Dysfunction: Observations of higher autoimmune disorder rates in those with endometriosis suggest a malfunctioning immune system might contribute to the condition.
  • Genetics: While no single gene has been linked to endometriosis, familial patterns suggest a genetic component.
  • Stem Cells: This theory suggests that stem cells might turn into endometrial cells if they receive incorrect signals, explaining why endometriosis can appear throughout the body.
 

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.

Stages of Endometriosis:

Endometriosis 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.

Diagnosing Endometriosis:

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.

Potential Health Risks:

Endometriosis can complicate fertility, especially in more severe cases, although the relationship between disease severity and fertility challenges can vary.

Discussing Endometriosis with Healthcare Professionals:

We can take a detailed diary of symptoms helping to determine the severity and potential treatment paths, including possible surgical exploration and management strategies.

Pre-Diagnostic Steps:

Our team can offer guidance, advocacy and support on treatment options and help to navigate healthcare options with you. 

Post-Diagnosis Management:

Managing endometriosis involves addressing symptoms through methods like hormonal contraception to alleviate pain and possibly slow disease progression. For those trying to conceive, a fertility specialist might be recommended.

Support networks, including Endometriosis UK, provide community and resources for those affected by this challenging condition. See the Useful link page. 

Virtual Comprehensive Consultation with Doctor

45 minute Consultation
£ 199
  • Discuss all aspects of menstrual, vaginal, sexual and contraceptive health
  • Suitable for those with other medical conditions that need further advice.
  • Summary letter to you and your GP for ongoing care if needed.
  • A private prescription is included in this appointment if needed (cost of contraception is paid separately directly to pharmacy)