Image by: Wikimedia Commons

 

 

Do I have endometriosis?  Endometriosis is a painful condition where the tissue that normally lines the uterus (endometrium), grows outside the uterus. This may be on the ovaries, pelvic sidewalls, fallopian tubes although it is rarely found spreading beyond the pelvic organs. Occasionally it may affect the bladder.

The tissue acts as if it is still in the uterus, so it follows the hormonal menstrual cycle – it thickens, breaks down and bleeds. The bleed can’t exit the body so it remains in the pelvis. It irritates the surrounding tissues, leading to scar tissue and adhesions. Adhesions are bands of fibrous tissue, that stick organs together or to the pelvic side wall.

 

The bleeding in the pelvic cavity can cause severe pain, especially during the menstrual period, painful sex (dyspareunia), painful bowel/bladder movements. If the ovary is affected, an endometriotic cyst (chocolate cyst) may form. It is seen in women with infertility but it is not a direct cause of infertility in itself.

There are four stages of Endometriosis, starting at I (mild) through to IV (severe). The severity of the endometriosis is not proportionate to the level of symptoms however, and the staging of the condition depends on where in the pelvis it is located and how widespread.

Symptoms:

  • Pelvic pain that starts just before menstruation and reduces afterwards.
  • Cramping abdominal pain.
  • Dyspareunia – painful sexual intercourse.
  • Pain during bowel movements or during urination leading to diarrhoea, urinary frequency or urgency.
  • Infertility ( Endometriosis is not a cause for infertility but the after effects of endometriosis can)

Diagnosis:

Mr Penman has the expertise to diagnose endometriosis from the patient history, examination in clinic and usually a pelvic scan and laparoscopy may well be required. The laparoscopy is a minimally invasive surgical procedure performed under a general anaesthetic. This enables Mr Penman to see the stage of the condition and consider what the best form of treatment would be.  This procedure is performed as a day case so no overnight stay is required for diagnosis.

Treatment:

Pain relief can make a tremendous difference to coping with endometriosis. Medication can also be prescribed to cease the menstrual cycle for a period of several months to allow the endometriotic areas to heal.  There are other non surgery options to try for relief from the pain of endometriosis, depending on whether you are wanting to be pregnant or not.  Surgery as mentioned before is also an option but if the endometriosis is widespread and severe, surgery may not be viable. Mr Penman is an expert in the field of endometriosis and will discuss your results with you, offering you the best options to treat your level of the condition.

If you think you might have endometriosis, make an appointment to see Mr Penman by either clicking the blue gynaecology appointment button to the right of this article or ring the hospital where you would like to consult with Mr Penman and make your appointment.