According to research, endometriosis affects 1 in 10 women during their reproductive years. Symptoms can start as early as your first period and continue even after menopause has been established. But what exactly is this condition and how can you better manage its symptoms and complications?
“Endometriosis is an often painful disorder in which tissue that normally lines the inside of your uterus – the endometrium – grows outside your uterus. Endometriosis most commonly involves your ovaries, fallopian tubes and the tissue lining your pelvis. However, it’s very rare that your endometrial tissue may sprout beyond pelvic organs. While there are many theories and research on this condition, its exact causes are still unknown. If you have a mother or sister who has endometriosis, you may be at risk of having it as well,” says Dr Nokukhanya Khanyile, Medical Doctor and Kotex® health expert.
Kotex sat down with Dr Khanyile to find out more about this disorder and what the common signs, symptoms, diagnosis and treatment of endometriosis include:
Painful periods (dysmenorrhea): pelvic pain and cramping may begin before and extend several days into a menstrual period. You may also have lower back and abdominal pain
Pain with intercourse: pain during or after sex is common with endometriosis
Pain with bowel movements or urination: you’re most likely to experience these symptoms during a menstrual period
Excessive bleeding: you may experience occasional heavy menstrual periods or bleeding between periods (inter-menstrual bleeding)
Infertility: sometimes, endometriosis is first diagnosed in those seeking treatment for infertility
Other signs and symptoms: you may experience fatigue, diarrhea, constipation, bloating or nausea, especially during menstrual periods
The only way to confirm a diagnosis of endometriosis is for a doctor to do surgery and visualize the tissue outside of the uterus. Investigations such as a pelvic ultrasound or scan are used to rule out other causes of pelvic pain like cysts, fibroids, etc. and while a chocolate cyst (cysts that typically form deep within ovaries) may be seen on ultrasound, it can only be confirmed with surgery. The idea of surgery may cause stress and frustration for people because it may seem like the doctor is doing unnecessary investigations, but it is a necessary step to confirm the diagnosis.
After surgery, the doctor will be able to establish if the endometriosis is mild, moderate or severe. However, people with mild endometriosis can have severe symptoms and vice versa.
Endometriosis can be a challenging condition to manage. An early diagnosis, a multidisciplinary medical team and an understanding of your diagnosis may result in better management of your symptoms.
Depending on which symptoms cause you the most concern, there are different ways to treat endometriosis. It is important to know that endometriosis is not curable but it’s symptoms can be managed through a few steps. These include:
Pain medication: over the counter or prescription of non-steroidal anti-inflammatory drugs such as Ibuprofen or Naproxen may reduce the severity of pain experienced. Some suggest that using the tablets a day or two before the onset of your period may help to improve your symptoms
Hormonal therapy: by reducing the heaviness and sometimes even frequency of your period, the oral contraceptive pill, 3 monthly injectable and implant that is placed under the skin or into the uterus may assist with the pain associated with periods. Before making any changes to your current birth control regimen, be sure to consult your doctor
Gonadotropin releasing hormone therapy: if you are not trying to fall pregnant, these agents have been shown to significantly reduce pain by including a temporary menopause where no estrogen is made by the ovaries and the endometriosis can shrink
Surgery: using either open – where they make a cut on the skin through the muscle – or laparoscopic – where tubes with cameras are placed through small incisions in the skin, a doctor can visualize and remove the endometriosis, cut away any adhesions that have formed or remove an endometrioma. In severe cases, they may need to perform a hysterectomy, where they remove the uterus or an oophorectomy, where they remove the ovary. This is important to know because in an emergency setting, one of these surgeries may need to be carried out which will cause irreversible infertility. Your consent must be obtained before such an operation
“Endometriosis is a potentially problematic condition that cannot be cured but can definitely be treated. It is therefore important to be aware of the symptoms and see your doctor When speaking to your doctor, it is important to discuss your plans to have children as this will affect the management of the endometriosis,” concludes Dr Khanyile.