Endometriosis - August 2023
What is endometriosis?
Endometriosis is a chronic disease which causes tissue cells, similar to the uterine lining, to grow outside the uterus (womb). Although outside the uterus, this tissue still responds to chemical messages from the ovaries during menstruation which causes the abnormal tissue to bleed. This process often leads to inflammation, pain, and scarring, and can cause internal organs to bind together (also known as adhesions). Reports show that 1 in 9 women in Australia will develop endometriosis by the age of 40. Research conducted in June 2019 by EndoActive and Ernst and Young found endometriosis costs the Australian economy $7.4 billion a year in lost productivity.
Symptoms:
- Pelvic or abdominal pain before and during menstruation, sex or toileting
- Abdominal, pelvic and/or lower back pain
- Heavy and/or irregular periods
- Changes in bowel or urination habits including increased frequency, and bleeding
- Feeling bloated
- Nausea
- Infertility
- Fatigue
- Depression or anxiety relating to the pain
What causes endometriosis?
The cause of endometriosis is unknown. It cannot be prevented, and there is no cure. However, symptoms can be managed with medicine or surgery. While the cause remains unknown, there are certain factors that place women at greater risk.
- Retrograde (backwards) menstruation is one potential risk factor. This occurs when menstrual bloods travels backwards via the fallopian tube and into the pelvic cavity. For some women, endometrial cells contained within this blood adhere to the pelvic organs and begins to grow.
- Ordinary pelvic tissue can also turn into endometriosis in a process called metaplasia.
- Women whose immediate relatives have endometriosis are up to 10 times more likely to develop the same condition.
Diagnosing endometriosis
If a person or their doctor suspects endometriosis, the doctor will start by performing a health assessment with focus on symptoms and menstruation. Endometriosis may need to be confirmed via laparoscopic surgery that allows doctors to explore the abdomen for endometrial tissue and obtain a biopsy for testing. Because of this, endometriosis can take an average of 7-years to be diagnosed. It is often missed with some women finding out they have the disease whilst being investigated for infertility or during unrelated surgery. If you suspect your symptoms may be endometriosis talk to your doctor.
There are 4 stages of endometriosis:
Stage 1 (mild) – a few small patches of endometriosis scattered throughout the pelvis.
Stage 2 and 3 (moderate) – endometrial tissue is widespread and is present on the ovaries and other areas of the pelvis. There may also be additional adhesions and/or scarring.
Stage 4 (severe) – most of the pelvic organs are affected
Treatment:
Treatment of endometriosis may involve medication, surgery, physiotherapy, psychology, and other complimentary treatments. These treatment options will depend on the individual’s symptoms, plans for pregnancy, and severity of the disease.
- Medications may include analgesia for pain relief, and/or hormone-based therapies such as the contraceptive pill, implant or IUD. These hormone treatments may reduce the growth of endometrial cells thus reducing pain.
- Surgical treatment is used to diagnose the disease, and is also used to remove as much endometrial tissue and adhesions as possible.
- Physiotherapy may assist with bowel and bladder symptoms.
- Psychology may be beneficial in helping the individual deal with and manage chronic pain
- Regular exercise – aim for 30-minutes for activity daily
- Eating a well-balanced diet
- Massage
- IVF may help women with infertility
It is important to remember that although endometriosis can be treated, it is not curable, and symptoms may return. Speak to your GP for further information.
For more information, click on the links below:
Endoactive, & Ernst & Young. (2019). The cost of endometriosis in Australia. Ernst & Young. https://endoactive.org.au/wp-content/uploads/29May2019-FINAL-The-Cost-of-Endometriosis-in-Australia-EY-EndoActive-Report.pdf
https://www.healthdirect.gov.au/endometriosis
https://www.who.int/news-room/fact-sheets/detail/endometriosis
https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/endometriosis
