Chances are as a menstruating person, you’ve probably heard the word ‘endometriosis’ bandied around. Particularly if you have painful periods. You may have even had it suggested to you along the way that you have endometriosis.
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Endometriosis is by no means a basic condition but an extremely common condition which affects women in a lot of ways. It is estimated that 1 in 10 womben have endometriosis. I suspect there are many more out there who have not sought help, who may not have been adequately investigated or who may not even realize they are suffering from this condition.
What is Endometriosis?
It is a medical condition where the lining that normally grows inside the uterus (the endometrium) starts to grow in other places outside of the uterus. As you can imagine, when something starts to turn up in places it shouldn’t be, it can cause some problems.
Common places that the endometrium grows in endometriosis
> Outside surface of the uterus > Ovaries > Fallopian tubes > Sometimes it forms ovarian cysts (a cyst is a little sac full of fluid — in this case blood and endometrial tissue) > Inside the pelvis on the muscles and walls > Less common places affected by endometriosis are the bladder, bowel, surgical scars, cervix, vulva and vagina
What are the symptoms?
> Very painful periods > Sometimes heavy periods > Pain leading up to periods > Painful ovulation (between your cycle) > Chronic pelvic pain > Pain during sexual intercourse > Pain when opening your bowels > Pain when peeing > Bloating > Difficulty falling pregnant
What's with the extreme pain?
Endometriosis goes FAR beyond painful periods.It is a condition that affects each woman as a whole — physically, emotionally and mentally. So understandably there are other symptoms that can come along with endometriosis.
That's a whole lot of pain.
Remember normally the endometrium grows inside the uterus every month under the influence of hormones. Then during a women’s period, she will shed that endometrium as her period, clear it out through the vagina and then start the monthly processes of growing the endometrium again.
The deposits of the endometrium that aren’t inside the uterus ( happens with the Endometriosis condition) will undergo the same process normally but they are NOT shed out through the vagina: they stay trapped where they are! The endometrial growth outside of the uterus can, in time, cause organs to stick together inside the pelvis and can also cause significant scarring, which further increases pain.
Who gets Endometriosis and Why?
Unfortunately, endometriosis is a very common condition. It affects around 10% of womben, though I think this figure underestimates the true number of people suffering from endometriosis. Not only can confirming the diagnosis be challenging, but a lot of women who have endometriosis may not have sought help, may have not been adequately investigated or may not even realize they are suffering from this condition. Some people only find out they have endometriosis when they start trying to get pregnant and have difficulties conceiving.
There is no definitive answer to the cause (yet)! There are a few theories on what may cause it but the real cause is unknown. One possible theory, known as ‘retrograde menstruation’ purports that perhaps a small amount of the endometrial lining instead of expelling out through the cervix and vagina could be forced upwards into the fallopian tubes and then out into the pelvic cavity. Without getting too sciencey on you, in a nutshell, there hasn’t been any clear cut cause of endometriosis identified.
If you are really identifying with the list of signs and symptoms in this post, then there is a possibility that you may have endometriosis. What you need to do is book an appointment to see your doctor or a doctor at a sexual health or family planning clinic.
The Diagnosis and Expectations
Doctors vary in the way they practice but you can go along expecting to have a good chat to the doctor about your symptoms.
Few things worth noting down before your appointment that the doctor will want to know are:
> Date of your last period > How long you’ve had pain for > What makes pain better or worse > When the pain starts (before or during bleeding) > When your periods started (at what age) and how long after this the painful periods started whether anyone in your family suffers from painful periods If you are on any type of contraception. If yes, its name and how long for, and whether it helps your pain > Whether you get pain with peeing or pooing during your period > Whether you get pain during sexual intercourse > Whether you get pain in your pelvis at times outside of your period
After the chat, you may need to have swabs done to check for infections (you can do these yourself in the bathroom) or if you are due for a cervical smear, now would be a good time for this! Some doctors may want to examine you, but they will talk you through that at the time and you can decide together if that would be okay.
One thing I really want to stress to you is that you will NOT get a confirmed diagnosis from seeing the doctor at your first appointment, they may strongly suspect you have endometriosis but they will often refer you onwards to another specialist to confirm this.
If after your chat you and your GP think you may have endometriosis, your GP can refer you on to a specialist gynaecologist for a review. You may have a scan, but the gold standard way to diagnose endometriosis is by having keyhole surgery. The gynaecologist will make small incisions in your abdomen (don’t worry you’ll be under a general anesthetic so you won’t feel a thing) and put a camera inside to see if they can see patches of endometriosis inside the pelvis or on the organs. They will then scrape some of these off to send away to the lab so they can confirm that is what it is by looking at it closely under a microscope.
Learn more about Endometriosis
There is so much information out there about endometriosis and I strongly encourage my patients to read as much as they can. A few websites that I recommend to get you started are below:
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