Endometriosis
Endometriosis is a chronic and often painful condition where tissue similar to the lining of the uterus, known as the endometrium, grows outside the uterus. This tissue can be found on the ovaries, fallopian tubes, the outer surface of the uterus, and other organs within the pelvis.
Although less common, endometrial-like tissue can also appear beyond the pelvic region.
The exact cause of endometriosis remains uncertain, but several theories aim to explain its development:
Retrograde Menstruation
One widely accepted theory is retrograde menstruation, where menstrual blood flows backwards through the fallopian tubes into the pelvic cavity instead of leaving the body. This allows endometrial cells to implant and grow outside the uterus.
Embryonic Cell Transformation
Another theory suggests that embryonic cells, which can transform into endometrial-like cells, might mistakenly develop into endometriotic growths due to hormonal changes during puberty.
Immune System Disorders
Problems with the immune system may also contribute to the development of endometriosis by failing to recognise and destroy endometrial-like tissue growing outside the uterus.
Surgical Scars
Endometrial cells may attach to surgical incision sites after surgeries such as hysterectomies or caesarean sections, leading to endometriosis.
Several factors may increase the risk of developing endometriosis. These include:
- Age: Endometriosis typically affects women during their reproductive years, particularly those in their 30s and 40s.
- Family History: Women with a close relative, such as a mother, sister, or aunt, with endometriosis are at higher risk.
- Menstrual Factors: Conditions such as early menstruation, heavy periods, or cycles shorter than 27 days may increase risk.
- Nulliparity: Women who have never given birth are more likely to develop endometriosis.
- Medical Conditions: Disorders that prevent the normal passage of menstrual flow out of the body, such as uterine abnormalities, can be risk factors.
Diagnosing endometriosis can be challenging due to the variability of symptoms. The following methods are commonly used:
Pelvic Examination
During a pelvic exam, a doctor might feel for abnormalities, such as cysts on reproductive organs or scars behind the uterus. However, it’s often not possible to feel small areas of endometriosis unless they have caused a cyst to form.
Imaging Tests
Ultrasound and magnetic resonance imaging (MRI) can help identify endometriotic cysts. While these tests don’t definitively diagnose endometriosis, they can provide supporting evidence.
Laparoscopy
Laparoscopy is a surgical procedure where a camera is inserted into the pelvic cavity through a small incision. This allows the doctor to directly see and potentially remove endometrial tissue. It’s considered the gold standard for diagnosing endometriosis.
While there is no cure for endometriosis, several treatments can help manage the symptoms. These include:
Medications
- Pain Relievers: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can help reduce pain and inflammation.
- Hormone Therapy: Hormonal treatments can help reduce or eliminate pain by lowering or stopping menstruation. Options include hormonal contraceptives (pills, patches, rings), GnRH agonists and antagonists, progestin therapy, and aromatase inhibitors.
Surgical Treatments
- Conservative Surgery: For women who wish to become pregnant, surgery to remove endometrial growths while preserving the uterus and ovaries is an option.
- Hysterectomy: In severe cases, removing the uterus (hysterectomy) and possibly the ovaries may be considered. This is typically a last resort.
Note: Should surgery be required, our specialists offer surgery at Gosford Private Hospital where you can enjoy rapid access and premium quality facilities. Our specialists can also consent you to the Gosford Hospital Public Surgery Wait List, where the majority of our specialists perform surgery but less frequently.
Endometriosis can significantly impact a woman's quality of life, but with proper management, many can lead fulfilling lives.
Strategies such as maintaining a healthy diet, regular exercise, stress management techniques, and support groups can be beneficial.
In Australia, an estimated 10% of women suffer from endometriosis, which equates to approximately 800,000 women.
The Australian Government has recognised endometriosis as a significant health issue and has invested in research, improved care pathways, and awareness campaigns to support those affected by this condition. Access to specialised endometriosis care and support services is available across the nation through initiatives like the National Action Plan for Endometriosis.
Several organisations and resources are available to support those living with endometriosis in Australia, including:
- Endometriosis Australia (www.endometriosisaustralia.org)
- Jean Hailes for Women’s Health (www.jeanhailes.org.au)
- Australian Government Department of Health (www.health.gov.au)
By understanding endometriosis, recognising its symptoms, and accessing appropriate treatment and support, women can manage their condition effectively and improve their quality of life. If you suspect you have endometriosis or are experiencing symptoms, it is essential to consult with a healthcare professional for proper diagnosis and treatment options.
Get in touch
If you wish to make a booking with one of our specialists or allied health team, please get in touch with our friendly support staff.
We understand the need for women-led care and have an easy referral system to other health care professionals who provide a range of services specialised to your individual needs.