Endometriosis and Pelvic Pain

Endometriosis affects approximately 10 percent of women in their reproductive years. It occurs when endometrial cells, similar to the lining of the uterus, form outside of the uterus such as in the Fallopian tubes, ovaries and pelvic wall. The cells alter the environment of the pelvis and reproductive tract and cause pain and discomfort. The pain is often felt during and in the lead up to menstruation. The pain is often described as a sharp, shooting like pain, with bloating and gas, and may cause fatigue. Without treatment, endometriosis can interfere with every day activities and can seriously affect fertility.

Symptoms of Endometriosis:

Symptoms and severity may differ from woman to woman, and there is a likely genetic component with some women in the same family affected. It is worth getting a referral to a gynaecologist if you are suffering from symptoms such as:

• Painful periods from an early age (dysmenorrhoea)
• Pelvic pain, bloating, gas, constipation.
• Heavy menstrual bleeding, with or without clots.
• Irregular periods – bleeding before period is due or prolonged bleeding.
• Pain with and after intercourse – (dyspareunia)
• Struggling to conceive for longer than twelve months.

Women may also have trouble falling pregnant, and if a couple has been unable to conceive after trying for 12 months then endometriosis can be present in up to 30% of cases. The reasons why endometriosis causes fertility problems are likely to be due to changes in the womb lining tissue, egg development or changes in tubal function. In severe cases, the tubes may even become blocked

Treatment for Endometriosis:

Hormonal therapy such as the contraceptive pill (COCP) or a hormone releasing IUD can assist with cycle-control by suppressing or ceasing periods which is effective to treat pain. As these hormones usually also act as contraception, they are only suitable for women not currently wanting to fall pregnant.

Laparoscopy:

The diagnosis of endometriosis can be difficult as most of the tissue deposits are too small to show up on examination or imaging such as ultrasound. Laparoscopy (keyhole surgery) is required to find out whether a woman has endometriosis. It is usually also treated or removed at the same laparoscopy. Besides surgical treatment, hormone medications that suppress or stop the periods can be effective to treat pain.

If you are experiencing any symptoms of endometriosis, it is important that you seek professional help from your GP as a starting point, then consult a gynaecologist. To schedule an appointment with Dr Elgey, you can call our rooms on 07 5667 7711