Endometriosis

Surgery may be needed

Endometriosis is a painful, chronic disease that is estimated to affect up to 25% of all women.

However, some experts believe the true figure is probably much higher.

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What is Endometriosis?

Endometriosis occurs when the tissue which lines the uterus - the endometrium - is found elsewhere in the body.

This can be in the abdomen, on the ovaries, fallopian tubes, bladder, bowel, vagina, cervix or vulva.

Less commonly endometrial growths may also be found in the lung, arm or thigh.

In the uterus, endometrial tissue builds up during the menstrual cycle, and then breaks down and sheds off during a period.

This keeps the lining of the uterus healthy and ready to nourish a developing foetus.

However, the when the tissue acts in the same way outside the uterus it can cause problems.

Menstrual blood can be easily shed from the uterus, not from elsewhere in the body.

This can result in internal bleeding and inflammation.

Who gets it?

Endometriosis can occur at any time from the onset of menstrual periods until the menopause.

It is extremely rare for it to be first diagnosed after the menopause, but not unknown.

For the majority of women the condition ceases at the menopause.

What are the symptoms?

• Pain before and during periods
• Pain with sex
• Infertility
• Fatigue
• Painful urination during periods
• Painful bowel movements during periods
• Diarrhoea, constipation, nausea

Many women with endometriosis may also suffer from allergies and sensitivity to certain chemicals.

How is it diagnosed?

The only way to confirm endometriosis is to carry out a laparoscopy.

This is a way to examine the female genitals using a laparoscope - a surgical instrument with a fibre optic system which brings light into the abdomen.

Using this instrument doctors are able to pinpoint the location, size and extent of the growths.

What Causes Endometriosis?

The cause is unknown.

One theory is that during menstruation some of the menstrual tissue backs up through the fallopian tubes and implants in the abdomen.

A second theory is that endometrial tissue is spread to other parts of the body through the lymph system or through the blood system.

A third theory suggests that the condition is caused by remnants of tissue remaining from the earliest stages of development before birth.

It is also possible that some women are genetically predisposed to develop the condition.

The toxic pollutant dioxin has also been linked to an increased risk of endometriosis.

How is it treated?

There is no cure for the condition. However, there are range of treatment options, depending on the woman's age and whether she wants to have children.

Hormone therapy can be used to stop ovulation, and shrink the endometrial growths. However, there are side effects.

Sometimes it is possible to use surgery to remove growths. This is either done by laparoscopy or by a larger open operation - a laparotomy.

For women with severe endometriosis radical surgery may be the last resort.

Hysterectomy can be done with or without removing the ovaries.

But if the ovaries are left in place then the chance of recurrence is increased with some women needing a further operation to remove the ovaries at a later date.