Did you know it takes an average of 7.5 years for a woman to be diagnosed with endometriosis – a gynaecological condition surrounded by taboos, myths and a lack of awareness? New guidelines published today aim to speed up the diagnosis and treatment of women with endometriosis by highlighting symptoms to doctors, such as pelvic pain, painful periods, and infertility.
What do women need to know about this common condition? Professor Nick Raine-Fenning, a consultant gynaecologist and spokesperson for the Royal College of Obstetricians and Gynaecologists (RCOG), gives the low down on everything you need to know and why we should get talking about it today.
- Endometriosis is the second most common gynaecological condition in the UK. It affects between two and 10 women out of 100 women, usually during their reproductive years.
- It occurs when cells that normally line the womb are found elsewhere in the body such as on the ovaries or fallopian tubes, and around the womb near the bladder and/or bowel. These cells respond to the hormones produced by the ovaries each month and so also bleed when you have your period. There is, however, no way for this blood to leave the body.
- Doctors don’t know why endometriosis occurs but believe it may happen when cells that line the womb are carried to the pelvis during a woman’s period. Unlike the cells from the womb lining, which can leave the body through the vagina during menstruation, the endometriotic cells have nowhere to escape. This leads to pain and inflammation and, in some women, damage to the pelvic organs through the formation of scar tissue and cysts.
- Symptoms can include period pain that isn’t relieved by painkillers, irregular or heavy periods, pain during and after sex, pain or discomfort when going to the toilet, bleeding from the bottom or blood in the stool, and feeling tired all the time. The period pain is often severe and tends to occur before the period starts. Some women have no symptoms at all.
- Endometriosis can affect fertility. In minor cases of endometriosis, there is evidence that removing or destroying endometriotic tissue during surgery can improve a women’s chances of having a successful pregnancy, either naturally or following fertility treatment.
- Unfortunately, endometriosis is a long-term chronic condition that can significantly impact on a woman’s physical health, emotional wellbeing and daily routine. For some women, symptoms can stop them from doing their normal activities and may lead to feelings of depression and relationship difficulties.
- Endometriosis can be difficult to diagnose because every woman experiences the condition differently, and because symptoms can be similar to other illnesses such as irritable bowel syndrome or pelvic inflammatory disease. On average, it takes 7.5 years for a woman to be diagnosed with endometriosis. More needs to be done to speed up the time to diagnosis.
- There is currently no cure for endometriosis, but there are treatments which can help to ease the symptoms including anti-inflammatory painkillers, such as ibuprofen, and hormone medicines and contraceptives, including the combined pill, the contraceptive patch and the intrauterine hormonal system (Mirena coil). For some women, surgery is needed to treat or remove the endometriotic tissue especially when scar tissue and/or cysts are present. This type of surgery can be complicated but there are several centres of excellence in the UK.
- Some women find that lifestyle changes and natural remedies can help relieve some of the symptoms, such as exercise, a healthy, well-balanced diet and the use of a hot water bottle or taking a hot bath.
- Help is on hand. First, speak to your GP – they can refer you to a gynaecologist. It may help to write down your symptoms. If you have severe endometriosis, you may be referred to an endometriosis centre with specialist nurses, surgeons and teams of other specialists to look after you. Support is also available through Endometriosis UK, a national charity which works to increase the understanding of the condition through campaigning, awareness-raising initiatives and research. It offers a wide-range of advice and support through a helpline, information leaflets and support groups. The RCOG is also dedicated to raising awareness of the condition among GPs, other healthcare professionals and the public, to ensure women receive the best possible care. You can read the RCOG’s patient information leaflet on endometriosis here.