Endometriosis: Common Signs and Symptoms

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Endometriosis is known as tissue similar to the endometrium (inner lining) of the uterus, growing on the outside of the uterus. The tissue growing on the outside of the uterus can lead to inflammation and scar tissue. Endometriosis is labelled as a chronic disease accompanied by severe pain during periods. The cause of endometriosis is still idiopathic (unknown). It can also affect women who are trying to conceive.


An Overview of Endometriosis

Endometriosis starts from the first menstrual cycle and will be part of your life until menopause. There are four different types of endometriosis namely, superficial endometriosis, cystic ovarian endometriosis, deep endometriosis and in rare cases, endometriosis has also been found on the outside of the pelvis. There is no known cure for endometriosis, doctors are only treating the symptoms at the moment. It is important to schedule an appointment with your doctor if you think you might have endometriosis. The earlier it gets treated the better. 


What Causes Endometriosis?

There are many different reasons why endometriosis would develop. Some think that it is because of retrograde menstruation. This is when endometrial cells will flow back into the fallopian tubes during your menstrual cycle. This can result in endometrial-like cells depositing outside of the uterus where they can start to implant and grow. Some say endometriosis is due to cellular metaplasia. This is when cells change from one form to another. Cells on the outside of the uterus can just start to change and form endometrial-like cells. Others say that endometriosis can be because of stem cells which spread through the body. Oestrogen levels are also linked to endometriosis, but more research still needs to be conducted to form a conclusion. 


Symptoms of Endometriosis

The most common symptom of endometriosis is extreme pain during your menstrual cycle and experiencing a heavy flow during your cycle, however, endometriosis symptoms vary from person to person. While some women have severe symptoms, others may not have any noticeable signs.

Common symptoms of endometriosis include:

  • Pelvic Pain: Persistent pain in the pelvic region, often worsening during menstruation.
  • Menstrual Irregularities: Heavy menstrual bleeding, prolonged periods, or irregular cycles.
  • Pain During Intercourse: Discomfort or pain during sexual intercourse, especially deep penetration.
  • Chronic Pelvic Discomfort: Pain or pressure in the pelvis that may be present throughout the menstrual cycle.
  • Gastrointestinal Issues: Digestive problems such as diarrhoea, constipation, bloating, or nausea, especially during menstruation.
  • Fatigue: Persistent fatigue or low energy levels, which may interfere with daily activities.
  • Infertility: Difficulty conceiving or recurrent miscarriages may indicate endometriosis, although not all women with endometriosis experience fertility issues.
  • Painful Urination or Bowel Movements: Discomfort or pain during urination or bowel movements, especially during menstruation.
  • Lower Back Pain: Chronic or intermittent lower back pain, often associated with pelvic discomfort.
  • Other Symptoms: Some women may experience other symptoms such as bladder discomfort, allergies, or respiratory issues, although these are less common.

For certain individuals, endometriosis can significantly impact their quality of life and occasionally contribute to depression.


Diagnosis of Endometriosis

Endometriosis will be suspected if you complain about extreme chronic pain and bleeding. It is often difficult to diagnose endometriosis as the symptoms mimic symptoms of other conditions. Some forms of endometriosis would require ultrasonography or MRI (magnetic resonance imaging) tests to detect the endometrial tissue. Surgical laparoscopy can also be used to diagnose endometriosis. Your gynaecologist can also use an ultrasound to check for endometriosis, the ultrasound will be done through the vagina to determine whether you have ovarian endometriosis.


Treatment for Endometriosis

There is no cure for endometriosis, but there is treatment for the related symptoms. It is advised that you speak to your healthcare provider about the best option for pain relief medication. Paracetamol and ibuprofen are available over-the-counter without any doctor’s prescription. Sometimes the doctor will prescribe hormonal medication such as oral contraceptives to help with endometriosis from worsening. Fertility medications can be used for women with endometriosis, who are struggling to fall pregnant. Treating endometriosis early can slow down the progression and decrease long-term side effects. 

There is also the option to scrap the endometriosis surgically. This is where the doctor will use a small sterile instrument and remove the endometrial-like tissue from the affected area. This surgical procedure can trigger your body to repair the scraped site and release hormones that will make the uterus lining more receptive for an embryo to implant. 


Is Endometrial Scraping Painful?

You might feel light menstrual-like cramps after the procedure, this is normal. Everyone has a different response to pain and has a different pain tolerance. The procedure however should not be extremely painful. The duration of this uncomfortable pain will be short. You might experience bleeding for a few days after the procedure. 


Can Endometriosis Affect My Menstrual Cycle?

Endometriosis can affect your menstrual cycle. Women with endometriosis can experience extreme menstrual cramps and have a heavy flow during each cycle. It is recommended that you use pain medication such as ibuprofen and paracetamol for the abdominal cramps as well as take iron supplements to help stabilise iron levels when you are having a heavy flow.


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