March is Endometriosis Awareness Month

The endometrium is the lining of the womb. That’s the lining that is shed as a period every month if you are not pregnant. In some women, cells from the lining can seed somewhere outside of the womb causing the endometrium lining to build up where it is not supposed to be. Places like the ovaries, the fallopian tubes or elsewhere in the pelvis or gut. We are not quite sure what causes this. Just like the normal endometrium/lining inside your womb builds up every month in preparation for a pregnancy were one to occur, the lining can build up in the bowel/ovary/ bladder wherever else it is, as it’s under your hormonal control too. Then, these areas outside of the womb, will shed or bleed just like your womb does when you are having a period. I have even seen someone with a bleeding belly button! This can obviously cause abnormally intense pain in the lower abdominal area, back, down the back of the legs and in other areas too. Sometimes the bleeding can be very heavy or even occur between periods.

The constant building up and lining of the endometrial tissue in abnormal places like the ovaries or fallopian tubes can cause scaring and blockages which may impair fertility also.

Funnily enough, even a small patch of endometriosis in the wrong place can cause severe symptoms and a very large patch can sometimes cause no symptoms and go un-noticed until someone finds they can’t get pregnant and has investigations for this. Surprisingly you can also have severe endometriosis and have no trouble at all!

Endometriosis can sometimes just get better on its own (3/10 women). Being pregnant helps too as the lining is not being shed while you are pregnant. Symptoms also tend to improve around  the peri menopause.

So how is it diagnosed?

The gold standard is via laparoscopy. A laparoscopy is key hole surgery where a camera is inserted via the front of the tummy in to the pelvic cavity to take a look around. This is done under general anaesthetic. For this reason, we often try to treat the symptoms before doing this invasive procedure. Not everyone has to have a laparoscopy. Laparoscopies tend to be done in women in whom conservative treatment (see below) has not worked or if they are being investigated because they cannot conceive.

So what treatments options are there?

1. Simple painkillers like Panadol, Ibuprofen if symptoms are mild
   2.The combined contraceptive pill can shrink endometrial pockets and even prevent further endometriosis.
   3.The Mirena coil is a contraceptive which thins the lining of the womb and also thins the pockets of endometrium elsewhere in the pelvis. This is why it helps the pain.The Mirena has helped the lives of many women who otherwise may have needed surgery. https://patient.info/sexual-health/long-acting-reversible-contraceptives-larc/intrauterine-system
2. Laser treatment of the pockets of endometrium when they are found at laparoscopy.
3. Hormone injections if other methods have failed
   6.Hysterectomy in extreme cases.
   For help please call 221-3983 or book a Women’s Health appointment via our online booking: https://amesmedicalservices.com