Endometriosis is a common gynaecological problem affecting women of reproductive age. It occurs when the tissue that usually lines the uterus (endometrium) start growing on surfaces of other organs in the pelvis. Endometrium may grow on ovaries, fallopian tubes, the outer surface of the uterus, pelvic cavity lining (peritoneum), bladder or rectum. Rare locations can be a Caesarean Section scar, vagina, cervix or diaphragm. Patients may experience pelvic pain during menstruation or at other times, heavy menstrual bleeding, painful bowel movements or urination and infertility.
Causes of Endometriosis
The exact cause for the endometriosis is not known, but it is thought to be inherited through genes that run in families. Exposure to environmental toxins and immune factors may also play a role.
Diagnosis of Endometriosis
Your gynaecologist will ask you about general health, your symptoms and perform a pelvic examination to feel for the presence of large cysts or scars. An ultrasound scan may also be performed to look for ovarian cysts, though most endometriosis can not be seen on ultrasound.
Treatment
There are several treatment options available to minimise the pain as well as control heavy bleeding.
Pain Medication
Over the counter pain relievers may be helpful for mild pain, such as nonsteroidal anti-inflammatory medications or paracetamol. Opioid pain medication is best avoided if possible.
Hormone Treatment
Hormone treatment is recommended to suppress the activity of endometriosis. There are many forms of hormonal treatments including the oral contraceptive pill, progesterone pills, Depo Provera injections, Implanon implant, Mirena intrauterine device or GnRH agonist implants.
Surgery
Surgery is an option for women having severe pain, ovarian cysts or fertility problems.
Laparoscopy: During this surgery, growths and scar tissue are removed. This is a minimally invasive technique and does not harm the healthy tissues around the growth.
Hysterectomy: It is a surgery that involves removal of the uterus. This procedure is done when there is severe damage to the uterus and only if the patient is not willing to become pregnant.
