Endometriosis is a complex and challenging condition where endometrial tissue (tissue lining the womb) grows in places other than the womb (usually elsewhere in the pelvis but potentially anywhere in the body), causing a range of problems. Endometriosis affects some 10% of adult women and while it usually presents in women aged 20-40 (reproductive years) it can occur in younger girls and the elderly.
Endometriosis often presents with period-pain, abdominal pain, and pelvic pain. Some 50% of patients are infertile due to endometriosis. Because the initial and early symptoms (pain, period pain, heavy periods) have many possible causes, there is often a delay in reaching the correct diagnosis. The diagnosis of endometriosis is best done via a tissue sample (tissue removed during surgery or a minor procedure) and laboratory analysis, although many patients are diagnosed by “clinical judgement” and this may be quite reasonable given costs and other practicalities (but if you want to be 100% sure, a tissue sample is needed).
Endometriosis s challenging to treat with outcomes somewhat mixed. The main treatments used are:
- Pain relief, usually with anti-inflammatory medicines such as Ibuprofen or Naproxen.
- Hormonal treatments including the contraceptive pill and more specialised hormonal medicines.
- Surgery, usually to remove the endometrial tissue from where it is found.
This condition is a real challenge for many women and indeed, for their doctors too, because while it is quite common it is also quite difficult to treat. The quality-of-life and fertility impacts are very significant. The best outcomes are achieved through early diagnosis and specialist care so please do see your doctor if you have suggestive symptoms.