Detecting and treating endometriosis
Endometriosis occurs when the tissue that normally lines the inside of the uterus grows outside of the uterus. The tissue often grows in patches, and is normally found in the pelvis and lower abdomen.
Endometriosis is very common—about one in 10 women have the condition. You are more likely to develop endometriosis if there is a close family history, such as a sister or mother who has the condition.
Some women with mild endometriosis can experience quite severe pain, whilst some women who have severe endometriosis never experience any symptoms. The confusing nature of these symptoms can make it hard to diagnose.
- Mild endometriosis—Normally appears as small patches of tissue scattered around inside the pelvis with no scarring.
- Moderate endometriosis—Will normally be present as larger patches, or patches that are more frequent. These patches can attach to the ovaries, fallopian tubes or the utero-sacral ligament.
- Severe endometriosis—Most of the organs in the pelvic cavity will be affected by several large patches and scarring. The uterus, ovaries, fallopian tubes, bowel, bladder, utero-sacral ligaments and pouch of Douglas can be affected.
The exact cause of endometriosis is still unknown. The most popular theory is that during menstruation, the menstrual tissue passes backwards through the fallopian tubes and into the pelvis, where it attaches and grows.
The most common symptom of endometriosis is pain. It is not uncommon to experience pain during menstruation. However the pain of endometriosis is often different and can be severe enough to prevent you being able to complete normal work or social activities. Pain that is interfering with your quality of life should always be investigated by your doctor or gynaecologist.
Other symptoms of endometriosis include:
- Pain on one or both sides of the abdomen—it can be a deep pain inside pelvis, in the lower back or in the rectum.
- Pain during intercourse.
- Prolonged discomfort after intercourse.
- Pain when passing urine (if the endometriosis is affecting the bladder).
- Fatigue—some women feel particularly tired during menstruation or at other times throughout their cycle.
- Infertility—endometriosis can impact your ability to become pregnant.
Adelaide Obstetrics gynaecologists can confirm a diagnosis based on either ultrasound imaging or laparoscopy (keyhole surgery). Laparoscopy is the most accurate way to diagnose endometriosis. Our doctors are able to carry out treatment during the same procedure.
Risks of endometriosis to fertility
Even mild endometriosis can be a major cause of infertility. About 40% of women who have endometriosis can have difficulty falling pregnant. Current research suggests that women with endometriosis have eggs and embryos that may be less viable.
The tissue or patches of endometriosis appear to impact fertility as they may release substances that:
- Affect normal embryo development.
- Decrease sperm movement.
- Decrease the ability for the fallopian tube to capture the egg after ovulation.
- Impact the development of the placenta.
Endometriosis can also cause adhesions to form around your fallopian tube and ovary, which can cause the fallopian tubes to become narrow, blocked or damaged, making conception difficult.
It is certainly possible to become pregnant if you have endometriosis. However, some women may need some medical assistance, which Adelaide Obstetrics & Fertility’s doctors can provide.
Treatment for endometriosis
Endometriosis treatment can help to stop the disease progressing, alleviate symptoms, and improve fertility.
Studies have shown that of the women who do not have treatment for endometriosis:
- In 50% the endometriosis will get worse.
- In 25% the endometriosis will not change.
- In 25% it will shrink or disappear.
Depending on the severity of symptoms, there are a number of treatments available, including surgical treatment, hormonal therapies, and a combination of both.
The options of both treatments can be discussed fully with you by one of our doctors, who can help you to make the best choice depending on your individual needs and circumstances.
If you think you may have some of the symptoms of endometriosis, please book an appointment with a gynaecologist at Adelaide Obstetrics & Fertility by calling us on 08 8272 7755.