Endometriosis

Unsure if the pain you experience during menstruation is due to endometriosis? Here’s what you need to know about the condition, including its symptoms, causes, and treatment options.

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Endometriosis is a condition where cells from the lining of the womb are found outside the womb, usually in areas such as on the ovaries, fallopian tubes, and tissues lining the pelvis. Left undiagnosed or untreated, endometriosis may lead to pain and discomfort, causing you to miss work or school, and even putting a strain on your sexual relationship.  

Read on to find out the common symptoms, causes, and treatment options for endometriosis.

Endometriosis: Causes

Endometriosis is neither contagious nor cancerous. It is a condition that develops several years after the onset of menstruation, mainly affecting women during their reproductive years.

Currently, the causes of endometriosis remain unclear. However, a common theory is that it may arise from the light backflow of blood during menstruation, which may carry tissues from the womb to the pelvic area via the fallopian tubes.

When menstruation ends either temporarily during pregnancy or permanently with menopause, the signs and symptoms of endometriosis may often improve or cease.

Risk Factors for Endometriosis

Endometriosis may be considered a common condition, but there are several factors that may place you at greater risk of developing the disorder.

These include:
Not having given birth before
Having a family history of the condition, especially among your mother and sisters
Anatomical abnormalities, such as a blocked vagina or an imperforate hymen that prevents the normal passage of menstrual flow
Being Asian or white 

Endometriosis: Symptoms

It is important to note that the symptoms of endometriosis may vary. Some women may not experience any symptoms at all, while others may present with more severe symptoms such as pelvic pain and dysmenorrhoea.

Common symptoms associated with endometriosis include:
Painful and heavy menstruation (also known as dysmenorrhoea)
Pain during or after sexual intercourse (or dyspareunia)
Lower abdominal pain or pelvic pain
Infertility or difficulties getting pregnant 
Painful bowel and bladder issues (with or without abnormal bleeding)
Fatigue

Endometriosis: Potential Complications

If left untreated, endometriosis may lead to potential complications including:
Impaired fertility: some women with endometriosis may have difficulty getting pregnant. The longer you live with the condition, the greater the potential damage to your fallopian tubes. As such, women with endometriosis should not delay having children 
Emotional distress: recurring pain associated with endometriosis may lead to depression, irritability, anxiety, anger, and feelings of helplessness

Endometriosis: Diagnosis Methods

Endometriosis is commonly diagnosed through:
A detailed assessment of your medical history and pelvic examination
Blood tests for a protein called CA 125, although your CA-125 level is not specific to endometriosis
An ultrasound scan to identify if there is an endometrial cyst (also known as a chocolate cyst) in your ovaries. A normal scan does not rule out endometriosis
A laparoscopy, which is often seen as the gold standard for the diagnosis of endometriosis as it allows the gynaecologist to see the pelvic organs clearly and definitively diagnose endometriosis

Endometriosis: Treatment Options

It is normal to want to seek quick relief from the symptoms of endometriosis, especially if the condition is disrupting your daily life. While there is no cure for endometriosis, there are treatment options that can help manage or reduce your symptoms and potential complications.

These include:
Pain relief: pain-relieving drugs that reduce inflammation and help to ease pain associated with endometriosis
Hormonal treatment: hormonal treatment aims to stop or reduce ovulation (the release of an egg) so as to encourage the endometriosis to shrink or disappear

Hormonal Treatment

Hormonal treatment methods include:
o The combined oral contraceptive (COC) pill (commonly referred to as the birth control pill) or patch
o Inserting an intrauterine system (IUS) into your womb to release a progestogen hormone to prevent pregnancy

Non-hormonal Treatment

Non-hormonal treatment methods include:
o Hormonal progestogens or testosterone derivatives
o GnRH (gonadotropin-releasing hormone) agonists

Surgery

Surgical removal of areas of endometriosis may involve methods including:
o Laparoscopic surgery, where a gynaecologist removes patches of endometriosis by destroying them or cutting them out by means of a keyhole surgery, also known as minimally-invasive surgery
o Laparotomy, which destroys or removes endometriotic deposits in the abdomen in cases of severe endometriosis

Living with Endometriosis

Endometriosis may be a chronic condition with no cure, but you can adopt strategies to reduce its impact on your daily life.
Seek support from endometriosis support groups and organisations that provide counselling, support and advice so you can better cope with the condition
Explore complementary therapies such as reflexology, traditional Chinese medicine, herbal treatments, and homeopathy, which may help relieve pain. Therapies such as relaxation therapy, transcutaneous electrical nerve simulation (TENS) therapy, and acupuncture may also help women with painful periods
Remove certain food types like dairy and wheat products from your diet. This may help relieve symptoms for some women

Do note that there is currently insufficient evidence to show whether these therapies are effective at relieving the pain associated with endometriosis.

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