Endometriosis

What is endometriosis?

Endometriosis happens when cells that are similar to the lining of your womb grow in other parts of your body. These cells can grow on your ovaries, tubes that carry eggs, or the lining inside your pelvis. Sometimes they can even grow on your bladder, bowel, or rarely in your chest.

The problem is that these cells still act like they're in your womb. During your period, they try to break down and bleed, but the blood can't leave your body. This causes pain and other symptoms.

What are the symptoms?

During your period, you might have:

• Very bad period pain that stops you doing normal activities
• Heavy bleeding where you need to change pads or tampons every 1-2 hours, or blood soaks through to your clothes

At any time, you might have:

• Pain in your lower tummy and back
• Pain when you go to the toilet for a poo or wee
• Pain during or after sex
• Feeling extremely tired all the time
• Trouble getting pregnant
• Feeling down or worried

Red flag symptoms - see a doctor urgently if you have:

• Pain or bleeding in your chest
• Being short of breath
• Coughing up blood

When should you see your GP?

Speak to your GP if:

• You think you might have endometriosis
• Your symptoms are affecting your daily life, work, or relationships
• You've had treatment but your symptoms haven't got better or are getting worse

How is it diagnosed?

It can take a long time to diagnose endometriosis because the symptoms are similar to other conditions. Your GP will ask about your symptoms and family history.

They might do:

• A physical check of your tummy and pelvis
• An internal examination
• Blood tests

If they think you might have endometriosis, they may:

• Refer you to a specialist doctor called a gynaecologist
• Give you medicines to help with symptoms

Further tests might include:

• An ultrasound scan (on your tummy or inside your vagina)
• An MRI scan
• A procedure called laparoscopy, where a tiny camera looks inside your tummy through a small cut

What treatments are available?

There's no cure for endometriosis, but treatments can help manage symptoms:

Medicines:

• Painkillers like paracetamol and ibuprofen
• Hormone treatments like the contraceptive pill (but not if you're trying to get pregnant)

Surgery:

• To remove areas of endometriosis
• To remove fluid-filled sacs on ovaries
• In severe cases, to remove the womb or ovaries
• Sometimes to remove parts of bladder or bowel if affected

Living with endometriosis

Endometriosis affects everyone differently. With treatment, many people can manage their symptoms well. However, you might have long-lasting symptoms that affect your daily life for many years.

The good news is that symptoms usually stop after the menopause.

Getting support

Living with endometriosis can be tough both physically and emotionally. Support is available from:

• Your GP and specialist doctors
• Endometriosis UK (helpline: 0808 808 2227)
• The Endometriosis Foundation
• Online communities and local support groups

Remember, you're not alone, and help is available.

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Based on NHS.uk guidance. Written by Dr Krishnan Pasupathi, NHS GP.