Endometriosis is a condition that affects women. It can cause pain in the lower part of the belly and trouble getting pregnant. Endometriosis occurs when tissue normally found in a woman’s uterus, called the endometrium, grows outside of the uterus. This tissue, which does not belong outside the uterus, can then break down, bleed, and cause symptoms.
Symptoms of endometriosis
Some women have no symptoms, but most experience:
- Pain before or during monthly periods
- Pain between monthly periods
- Pain during or after sex
- Pain when urinating or having a bowel movement (often during monthly periods).
Other symptoms can include:
- Difficulty getting pregnant
- Ovarian cysts (sometimes called chocolate cysts or endometriomas) found on ultrasound.
All of these symptoms can also be caused by conditions that are not endometriosis. But if you have any of these symptoms, you may need to be investigated for endometriosis. The only way to know for sure if you have the condition is for a doctor to do a laparoscopy to look for endometrial tissue outside the uterus. Sometimes a specialised ultrasound can be useful, too.
Treatment of endometriosis
There are many treatments for endometriosis. The right treatment for you will depend on your symptoms and whether you want to be able to get pregnant now or in the future.
First-line treatments are medications, such as:
- Pain medication – such as panadol and/or nurofen on the days the pain is present
- Contraceptive pill – this can reduce the number of periods (by skipping periods) and the amount of pain. It is not suitable if you are trying for a pregnancy immediately
- Mirena IUD – this is a device that sits inside the uterus for up to 5 years (it can be removed easily at any time). It has progesterone hormone within it that acts to suppress the growth of endometrial tissue. It is also not suitable if you are trying for a pregnancy immediately.
Some women choose to have surgery as their treatment. The most common surgery is a laparoscopy; this allows the surgeon to see and remove endometriosis tissue. It is usual to follow surgical removal with some attempt at preventing it growing back – either the contraceptive pill, Mirena IUD or pregnancy.
In more extreme cases, or in women who have definitely completed their family, a hysterectomy can help. A hysterectomy is a surgery to remove a woman’s uterus.
Endometriosis can affect your chances of becoming pregnant, although it should be noted that many women with the condition have no trouble at all becoming pregnant. Endometrial tissue can cause hormonal imbalances that change how your ovaries function and can block your fallopian tubes. Surgically resecting mild to moderate endometriosis probably improves your pregnancy chances. If you have endometriosis and have not become pregnant in 6 to 12 months (depending on your age), you should arrange a timely assessment with a fertility specialist to see if fertility treatment such as IVF might improve your chance of pregnancy. Once you have fallen pregnant, endometriosis is not associated with pregnancy complications.