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Globally the average statistics for women who suffer from endometriosis is around 10% of the female population of a childbearing age, which translates into around 176 million women worldwide.

In Ireland, around 100,000 women of childbearing age suffer from this condition. In 2013, the Irish Times published an article entitled, “Breaking the silence on endometriosis,” which featured a moving interview with author, Anna McPartlin, whom you may know from her novels. She was keen to help highlight this condition, which in some cases can take a number of years to diagnose. In her case, she has suffered extreme pain because of endometriosis; whereas some women have lighter symptoms of the condition.

What is endometriosis?

Endometriosis is a long term, common condition which affects numerous women significantly, whereas in others it may go undiagnosed. It occurs when the endometrium, which is the tissue that acts like the lining of the womb, goes to other parts of a woman’s body. It may be found in the fallopian tubes, the ovaries, around the bowel or bladder, or inside the tummy. It mainly presents in women of childbearing age, and is far less common in women who have already had their menopause.

What are the symptoms of endometriosis?

Endometriosis illustration

Image above by BruceBlaus. When using this image in external sources it can be cited as:Blausen.com staff (2014). “Medical gallery of Blausen Medical 2014“. WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.010. ISSN 2002-4436. – Own work, CC BY 3.0, Link

The symptoms of endometriosis are varied, as is the degree to which they affect different women. Some women are very badly affected, whereas lots of women may not even experience any notable symptoms.

Some of the symptoms you may experience if you have endometriosis are:

– Extremely heavy periods – where you may need to use many pads or tampons, in some cases blood may even soak through to clothes

– Very painful menstruation, medically called dysmenorrhea, which can be such extreme pain, that it doesn’t dissipate much even with the use of painkillers

– Pelvic pain, which is some cases may present around your period or in others it may be after sexual intercourse, or even all the time

– Low in energy, feeling tired much of the time

– Blood may also present via the anus or in stools,

– Painful intercourse

– Cycles of intestinal complaints: diarrhoea, bloating or constipation

– Bouts of difficult or painful defecation; medically called dyschezia

– Cycles of painful urination; medically termed dysuria

– Sometimes there may be blood present in the urine; which is medically called hematuria

– Cycles of shoulder pain

Symptoms may vary during the menstrual cycle as a woman’s hormone levels fluctuate. This means that symptoms could be worse at certain times in the cycle, especially prior to and during the woman’s period

What causes endometriosis?

Currently the causes of endometriosis are not known, although there are a number of theories, such as:

– It may be linked to genetics

– Retrograde menstruation: which is when part of the womb’s lining doesn’t exit the body, but intead flows via the fallopian tubes embedding itself on the pelvic organs

– It may be linked to immune system issues

– It may affect some ethnic groups

– It could be caused by the endometrium cells spreading themselves in the lymphatic system or blood stream

However none of these theories on their own offer a satisfactory explanation as to the causes of endometriosis. It is more likely that it is a combination of some of these factors.

While some women may go undiagnosed, others can suffer so extremely that it can hamper them from carrying out normal activities, and even lead to feeling depressed.

endometriosis

How can I find out if I have endometriosis?

If you have experienced any of the above symptoms, the first step is to go to your GP. Endometriosis can be challenging to diagnose because the symptoms vary a lot and on top of this, the symptoms which may present can be similar to those of other conditions. It could help to write down your symptoms before a visit to your GP.

Your GP may refer you to a gynaecologist, who will carry out a laparoscopy, which is a low risk surgical diagnostic procedure, that can diagnose if you really do have endometriosis. During laparoscopy a thin tube is passed via a small cut which is made in your skin so that the specialist can find any endometriosis tissues in other parts of your body.

How is endometriosis treated?

Currently there isn’t an actual cure for endometriosis, but there are treatments which may help ease your symptoms. These include:

– Contraceptives and hormone medicines: which include gonadotrophin-releasing hormone (GnRH) analogues, the contraceptive patch, an IUS: an intrauterine system or the combined pill.

– Anti-inflammatory medication to help with pain, such as ibuprofen

– In some cases surgery may be suggested. This may entail cutting away patches of the tissue, or in some cases organs that have been affected may need to be removed.

endometriosis in pregnancy

Endometriosis and conceiving

Endometriosis can sometimes make it difficult to conceive and in some cases it can be a cause of infertility. In some cases surgery may be suggested by your specialist. During the procedure endometriosis tissue is removed, which could incease your chances of conceiving, however it doesn’t guarantee that you will become pregnant. Additionally there are some risks that need to be considered, such as bleeding, infections or damage to the organs which have been affected.

In terms of statistics, the figures range from 30% to 40% of women who suffer from endometriosis may not be able to conceive. However many women who suffer with the condition are able to become pregnant naturally, or with some reproductive assistance.

Endometriosis in pregnancy

If you have endometriosis and become pregnant, your gynaecologist and medical team will focus on your condition. One of the largest studies to date, has found that endometriosis poses a significant risk for premature birth. Researchers discovered that women with the condition also have a higher risk of other pregnancy complications and were more likely to give birth through Caesarean section.

Below are some quotes from Dr. Falconer, the lead of this study.

“Because endometriosis is so strongly associated with infertility,” said Dr. Falconer, “we were not surprised to find that women suffering from it were of higher maternal age and had fewer children. However, after adjusting for maternal age and other confounding factors, the strong association between endometriosis and risky pregnancies still remained.

“Our research provides clinicians with important information in the search for the factors associated with premature birth. Given that endometriosis is relatively common in women of childbearing age, we hope that our results will lead to pregnant women with this condition receiving extra attention, thus enabling them to have normal pregnancies and give birth to healthy babies.”

This research was originally published in Human Reproduction. doi:10.1093/humrep/dep186

Endometriosis support

If you are diagnosed with endometriosis, the Endometriosis Association of Ireland offers support, facts, along with personal stories from other women. Their website is http://www.endometriosis.ie/ . Additionally they are on Facebook and other social media.

Endometriosis Association of Ireland

DISCLAIMER

All articles on the blog and website are intended as information only. Please do not consider any of the information provided here as a substitute for medical advice. At all times seek medical advice directly with your own doctor and medical team.

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