Discover How to Spot and Treat Endometriosis

With all the advances in medical science, it's amazing there are still some diseases ladies know so little about. Endometriosis is one such condition - there is currently no cure, but by teaching women to spot the symptoms and get diagnosed, ladies can help relieve the pain and get you back to living your life.

Endometriosis (pronounced end-oh-me-tree-oh-sis) is when cells normally found inside the womb start growing in other areas of the body. Most are found in the pelvis, underneath the ovaries and around the fallopian tubes and ligaments, but they can also grow in the bladder and bowel. Rarely, endometriosis can affect the lungs. The cells look like little pepper spots and range from pink to black in colour, depending on the severity of the condition.
Every month, hormones make your womb lining thicken in preparation for pregnancy - but if this doesn't happen the lining breaks down and is released as a period. Endometriosis cells also swell, but they are growing elsewhere in the body. When they break down and bleed, the blood has nowhere to go, which causes intense pain, inflammation and can lead to adhesions. These can be like cobwebs, or as tough as superglue. In severe cases, adhesions can stick the womb, ovaries and bowel together.

If your mother or sister had endometriosis, you're seven times more likely to develop it. You're also more likely to have a severe form of the condition - but endometriosis doesn't always run in families. Another cause is retrograde menstruation. This is when some menstrual blood flows back up the fallopian tubes and into our abdomen. Some cells i this blood are capable of attaching themselves and start growing. Ladies think every woman having a period has some degree of retrograde menstruation, but not all of them will develop endometriosis. It could be some women, such as those with heavy, periods, are overwhelmed by the amount of blood flowing back, so the 'mop-up' team in the body cannot do its job properly.

Another possible cause is when cells change from one form to another, or metaplasia. This explains how endometriosis can appear in the lungs - somewhere unaffected by retrograde menstruation. Although the cells are changing, endometriosis is not cancer. It's thought some adult cells maintain the ability ladies had as embryos to develop into new, different cells. Our environment may also be to blame. There are some toxins in the environment, called dioxins, that have been found to trigger endometriosis in laboratory experiments, but this has never been proven in people. Some women say taking the combined pill triggered their endometriosis. What is more likely is the Pill was controlling their symptoms, but when they stopped taking it their endometriosis returned. Endometriosis is not an infection or contagious, so you cannot catch it.

Spotting endometriosis

The symptoms of endometriosis vary between women, but the most common symptoms are extremely painful periods, pain in your pelvis or lower abdomen, pain during or after sex, trouble opening your bowels and sharp stabbing pain or bleeding when you do, pain or problems having a pee, and feeling tired. The pain is worst in the weeks or days before your period and you may notice a monthly pattern. Endometriosis can also cause cysts in the ovaries, ranging from the size of a pea to a rugby ball! These cause intense pain on the side of the affected ovary which gets worse leading up to and during your period. Most women can manage to get themselves to work if they have heavy or painful periods, but if you are missing work regularly or plan your life around your periods - like when to book a holiday – then you could well have endometriosis. Many symptoms can be confused with something else, such as irritable bowel syndrome, so it's important to keep going back to your GP if you think you're affected.

The right diagnosis

The European Network on Endometriosis says it takes around eight years to get a proper diagnosis, but in that time the condition can affect your career, relationship and fertility. Women with endometriosis can get pregnant, but adhesions may prevent an egg reaching the fallopian tubes, or a chemical released by the endometriosis can affect sperm. Endometriosis can only be properly diagnosed with a laparoscopy – a thin telescope inserted through a tiny cut in the abdomen, allowing, a surgeon to look at your organs. If you agree, the surgeon can also remove any endometriosis they find with a laser, heat or electric current at the same time. The type of treatment you need will depend on your symptoms and age - if you are nearing the menopause, for example, if you've already had or are planning a family, and if you've had success with previous treatments.

You may be offered hormonal treatments such as the Pill, or drugs that mimic pregnancy or menopause to keep symptoms at bay. The Pill stops the ovaries releasing an egg, stopping the menstrual cycle, while progestogen drugs fool your body in to thinking it's pregnant, stopping your periods. However, progestogens can make you retain fluid and feel low. Anti-progestogens and gonadotrophin-releasing hormones cause an artificial menopause by 'switching off ' your ovaries. Adding HRT can reduce menopausal symptoms. With hormonal treatments, your endometriosis may return when you stop taking them.

If you want to get pregnant, or if hormonal treatments are not suitable or successful, you may have laparoscopic surgery to cut out any endometriosis or adhesions - which may also improve your fertility - or a laparoscopic, which involves a bigger incision in the abdomen to remove larger areas of endometriosis. A drastic option is a hysterectomy to remove the womb and ovaries – this would only be suggested if all other treatments had failed. But surgery may not remove all the rogue cells, so you could still suffer from endometriosis.

Most women find surgery works for around five years - but if symptoms return within six months, talk to your GP Without knowing what causes it, our treatments are only abating, rather than curing, endometriosis. There have been remarkable results with the Mirena coil, a progestogen- releasing intrauterine device. Research shows it can reduce endometriosis symptoms, but some have found that it can completely treat endometriosis and make a big difference to symptoms. Research is still continuing, as are many studies into what actually causes endometriosis. Ladies need to know how it starts so ladies can discover how to get it to stop. Until then, keep fighting for the right diagnosis to manage your endometriosis.