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Endometriosis is a condition defined by the growth of tissue similar to that of the lining of the womb (endometrium) outside of the womb itself. This tissue is typically found in or around pelvic structures such as the bladder, ovaries, colon and rectum.
It is estimated that around 10% of women between the age of 25-40 are affected by endometriosis, however the true prevalence is not known as some women may be asymptomatic. On average it takes 7.5 years from onset of symptoms to get a diagnosis of endometriosis.
Endometriosis can present differently in every woman, and as previously mentioned some women are completely asymptomatic. Symptoms are rare following the menopause as the female hormone, oestrogen, is required for endometriosis.
Some symptoms may include:
Painful periods. The pain typically begins a few days before the period and usually lasts the whole of the period. It is different to normal period pain which is usually not as severe and doesn’t last as long.
The cause of endometriosis is not known. However, the most common theory is that the lining of the womb (endometrium) escapes into the pelvis from the womb via the fallopian tubes during menstruation.
There appears to be a genetic predisposition to endometriosis, however no specific gene has been identified to cause endometriosis.
On average it takes 7.5 years from onset of symptoms to get a diagnosis of endometriosis. Many women are satisfactorily treated either hormonal or non-hormonal treatment in primary care without a formal diagnosis of endometriosis.
The only way to definitively diagnose endometriosis is via a laparoscopy, a keyhole operation made under a general anaesthetic to visualize endometrial deposits inside the pelvis and abdomen. In some cases, an ultrasound may be used to aid a diagnosis.
Endometriosis Treatment
Management of endometriosis is largely dependent on the underlying symptoms for which a patient is seeking treatment. For endometriosis-related pain treatment either incorporates simple pain killers (e.g. paracetamol, ibuprofen, mefenamic acid), hormonal treatments (combined or progesterone only contraceptives) or a combination of both.
Depending on the symptoms, preferences, and priorities of each individual patient laparoscopic excision or ablation of endometriosis, or hysterectomy may be appropriate.
Medicinal cannabis can be considered for endometriosis-related pain when first line therapies have not achieved adequate benefit.
