Endometriosis
What is endometriosis?
Endometriosis is a long-term (chronic) condition where tissue like those in the lining of the womb is found elsewhere in the body. It’s very common, affecting around 1 in 10 women or those assigned female at birth. For some people, it can have a significant impact on their lives.
Symptoms
Symptoms can be different from person to person and month to month. Some people may have severe and debilitating symptoms and others might have no symptoms at all.
Common symptoms of endometriosis include:
- pain in the lower stomach, pelvis, lower back or legs
- painful periods which affect your day to day life – for example, you can’t go to school or work or take part in activities that you enjoy
- pain during ovulation
- heavy or long lasting periods
- pain during and after sex
- pain or bleeding when going to the toilet (pain before or after peeing or pooing)
- bleeding from your back passage (rectum)
- blood in your poo (usually at the same time as your period)
- bloating
- persistent exhaustion and tiredness
- difficulty getting pregnant
These symptoms may be endometriosis, but could also be other health conditions.
What Causes Endometriosis?
The actual cause of endometriosis is unknown. It’s sometimes believed to be genetic. That means if someone in your family has the condition, it’s more likely you may have it too.
What is endometriosis? Learn about symptoms and treatment of endometriosis.
Diagnosing Endometriosis
Getting diagnosed with endometriosis can be difficult and may take some time. The symptoms can vary a lot and can be similar to other common conditions. If you think you have symptoms of endometriosis, speak to your doctor. Share as much information as possible during your first appointment.
It can be helpful to keep a note of your period dates and symptoms using a calendar, a diary or an app.
You should let the doctor know if you have:
- pain during your period, or at any other times of the month, and where you experience this pain
- ever experienced pain or bleeding when you pee or poo, and if this is worse during your period
You should also give the doctor details about the pattern of your periods including:
- the first day of your last period (when it started)
- how many days your period usually lasts
- what was the shortest time between your periods (from the first day of one period to the first day of the next)
- what was the longest time between your periods (from the first day of one period to the first day of the next)
- how you describe your period (light, medium, heavy or very heavy)
- if you are over 25, when you had your last smear test.
- what treatments you have tried before to manage your symptoms
When you see your doctor about your symptoms, they may carry out a pelvic examination. They will look at your vulva, vagina and cervix (the opening between the vagina and the womb) using a speculum (medical instrument). The doctor may then do an internal examination in the vagina to feel for tenderness and masses around the ovaries and womb. Sometimes other tests might be needed, such as a pelvic ultrasound scan. Your doctor will discuss this with you and you can ask any questions you might have.
As this is an intimate examination, the doctor who performs it will have another person (chaperone) present. You can ask for a female doctor to carry it out.
If symptoms continue, your doctor may refer you to a specialist called a gynaecologist for further tests.
Laparoscopy
The only definitive way to diagnose endometriosis is by a laparoscopy – an operation in which a camera (a laparoscope) is inserted into the pelvis through a small cut near the belly button. This is done under a general anaesthetic. The surgeon uses the camera to see the pelvic organs and will look for any signs of endometriosis. Sometimes it’s possible to remove some endometriosis tissue at the same time. This will be sent to the laboratory to confirm whether it is endometriosis. After the laparoscopy, the doctor will be able to tell you if you have endometriosis. It is also possible that no endometriosis is found at laparoscopy.
Symptom Checker
Endometriosis UK have developed a symptom checker designed to check for common endometriosis symptoms: Symptom Checker | Endometriosis UK
NHS Inform have a symptom questionnaire to keep a note of your symptoms which you can print and take to your GP to talk about the symptoms you are experiencing. – Microsoft Word – Menstrual health symptom questionnaire
Other helpful information when visiting your GP:
Treatment and Management
There is no cure for endometriosis. There are different treatments available for endometriosis that can help to control or improve your symptoms.
Heat relief
A hot water bottle or hot bath may help to reduce pain and discomfort.
Pain relief
Paracetamol and non-steroidal anti-inflammatories (NSAIDS) like ibuprofen and naproxen can help reduce pain.
Hormone treatments
Hormone treatments work by stopping or blocking the production of oestrogen in the body which is thought to stimulate the endometriosis. Treatments aim to relieve symptoms and prevent endometriosis growing.
Hormone treatments include:
- contraceptive pill (the pill)
- progesterone-only pill (mini pill)
- contraceptive patch
- contraceptive injection
- intrauterine system (IUS)
- Gonadotropin-releasing hormone (GnRH) analogues
GnRH analogues also reduce the production of oestrogen. This puts your body in temporary menopausal-like state. They are sometimes used if other hormonal treatments haven’t helped to manage symptoms. It’s recommended that hormone replacement therapy (HRT) is started at the same time to reduce side effects of this treatment.
GnRH analogues aren’t a contraceptive so you should use non-hormonal contraception (like a condom or diaphragm) when you have sex to avoid getting pregnant.
If you’re thinking about planning a pregnancy, speak to your doctor about your treatment first so you can decide what’s best for you.
Hormone treatments for endometriosis | Endometriosis UK
Surgery
Surgery can be used to reduce pain by removing areas of endometriosis. Not everyone with endometriosis will benefit from having surgery. Your doctor will be able to discuss this with you.
Support Groups – Ayrshire
Endometriosis UK offer valuable support and information to those affected by Endometriosis. The Ayrshire support group was formed in May 2022. More information can be found here Support Groups | Endometriosis UK
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