Brought to you by BMI Ross Hall Hospital

Dr Christopher Hardwick, Consultant Gynaecologist, explains 

HeraldScotland:

What is endometriosis?

Endometriosis occurs when there are cells similar to the cells that line the inside of the womb present on other organs. These cells may be on the womb, ovaries or the ligaments that hold the womb in place. Less frequently the cells and the endometriosis can be on the bowel or organs elsewhere in the abdomen. These cells respond to hormones from the ovaries and cause pain, inflammation and scarring. It isn’t known how or why endometriosis starts but some women are more likely to develop it, especially if they have relatives with the disease. It is a very common condition affecting 1.5 million women in the UK. 

Who does it affect?

Endometriosis can affect any woman but tends to cause symptoms in women when their ovaries are making eggs between puberty and the menopause so between about the ages of 13 and 50.

What symptoms does it cause?

Endometriosis typically causes pelvic pain but it can cause a wide variety of symptoms. Symptoms associated with endometriosis can include period problems, period pain, pain with intercourse, bowel disturbance and many others. It can also cause cysts of the ovaries. Endometriosis is more common in women who have problems falling pregnant and is present in 50% of women with infertility.

How is it diagnosed?

Endometriosis can be difficult to diagnose and typically women have symptoms for 7 years before receiving a diagnosis. This may be because it can cause a wide variety of symptoms. Also the symptoms of endometriosis may be similar to what some people or medical doctors regard as being part of normal life when in fact there is a serious condition present. 

The only definite way to diagnose endometriosis is by laparoscopy where a small telescope is inserted into the abdomen under anaesthetic to look at the uterus and ovaries.  The areas of endometriosis may look like clear fluid areas, blood spots or be solid collections of cells. Sometimes ultrasound scanning of the uterus and ovaries can help to detect endometriosis or ovarian cysts.

How is it treated?

Endometriosis has no cure but many treatments are available to help with the symptoms it causes.

It is often reasonable to treat symptoms that are likely to be due to endometriosis without the need for a laparoscopy using pain relief or contraceptives in the first instance. If a laparoscopy is performed then endometriosis should be treated at the same time by burning or removal, performed by a suitably trained gynaecologist. Less frequently endometriosis can be severe or cause ovarian cysts requiring major surgery although this is usually performed as keyhole surgery. It is recommended that major surgery for severe endometriosis is performed by trained gynaecologists in endometriosis centres where suitable support is available. 

Other hormonal treatments can also help with endometriosis such as hormone injections that can start a temporary menopause that can frequently reduce symptoms. 

Many other health professionals can help with the symptoms that endometriosis can cause such as pain specialists, physiotherapists, specialist nurses and clinical psychologists.

What help or advice is available?

Any woman who has a diagnosis of endometriosis or may have endometriosis should try and find out as much about the condition as possible. There is a lot of useful help available particularly from the charity Endometriosis UK which runs local support groups. There are many different ways described above to help with endometriosis and so different points of view and advise can all help. The NHS and Royal College of Obstetricians and Gynaecologists have useful websites. These are:

www.endometriosis-uk.org/

www.rcog.org.uk/en/patients/patient-leaflets/endometriosis/

www.nhs.uk/conditions/endometriosis/

For more information

enquiries.rosshall@bmihealthcare.co.uk or telephone 0141 303 1405