Symptoms

The symptoms of endometriosis vary and some women may have no symptoms at all.

Most common symptoms include:

• painful or heavy periods
• pain during sex
• pain in the lower back, pelvis or abdomen
• bleeding between periods
• fertility problems

The experience of pain varies between women. Most women with endometriosis get pain in the area between their hips and the tops of their legs. Some women have this all the time, while others only have pain during their periods, when they have sex or when they go to the toilet.

How severe the symptoms are depends largely on where in your body the endometriosis is. A small amount of tissue can be as painful as a large amount.

Diagnosis :

Endometriosis is diagnosed via an examination called a laparoscopy.

During a laparoscopy, you are given a general anaesthetic and a laparoscope (slender, tubular endoscope) is inserted through a small incision in your abdominal wall. The laparoscope has a tiny camera that transmits images to a video monitor for the Consultant to view the endometriotic tissue.

The Consultant can then perform a biopsy for laboratory testing or insert other surgical instruments to treat the endometriosis. You can usually go home the same day after you have had a laparoscopy.

Treatment

Your Consultant will discuss treatment options with you. Several factors will influence the recommended treatment options, such as

• your age
• your main symptom (pain, fertility problems)
• if you are planning a pregnancy
• if you have had any treatments previously
• if you are anxious about surgery

Although there is no cure for endometriosis, the aim of treatment is to ease the symptoms so that the condition does not interfere with your daily life. Treatment can help to relieve pain, improve fertility, slow the growth of endometriosis, and prevent the disease from coming back.

Treatments for endometriosis:

• Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen act against the inflammation and help to ease pain and discomfort
• Hormone treatments can limit or stop the production of oestrogen in your body. Removing exposure to oestrogen can reduce the endometriotic tissue and help to ease your symptoms
• Surgery can remove or destroy the areas of endometriotic tissue. The type of surgery used will depend on where the tissue is and how extensive it is.

Surgery

• The endometriotic tissue may be cut away, or be destroyed with heat from an electric current or a laser (endometrial ablation) or by directing a beam of helium gas to destroy the tissue. This can usually be done by a laparoscopy. The Consultant Surgeon will make small cuts in your abdomen and then use the laparoscope to view inside your pelvis and remove the tissue.
• If endometriosis is severe and extensive, you may need laparotomy surgery. This is open surgery and a larger cut will be made in your abdomen.
• If you have very severe symptoms, your doctor may advise you to have surgery to remove your womb, called a hysterectomy.

In many women endometriosis can come back after surgery. Your Consultant Surgeon may recommend that you take hormonal drugs after surgery to help delay the return of symptoms.