RU­RAL HEALTH MAT­TERS

Don’t grin and bear it – What you need to know about En­dometrio­sis

Dubbo Photo News - - News - Dr Sachin Ko­tasthane

En­dometrio­sis is one of the most com­mon health is­sues ex­pe­ri­enced among women and one of the lead­ing causes of in­fer­til­ity. It can im­pact on all as­pects of their life not just phys­i­cally and emo­tion­ally, but also on their re­la­tion­ships and their men­tal health. It is es­ti­mated about 700,000 Aus­tralian women – or one in ev­ery ten, be­tween the ages of 10 and 55 – will have en­dometrio­sis at some point in their life. It is also es­ti­mated that the dis­ease costs Aus­tralia about $6 billion an­nu­ally in lost pro­duc­tiv­ity as women re­quire time away from work.

What is En­dometrio­sis?

It is a re­cur­ring dis­ease which causes tis­sue sim­i­lar to the lin­ing of the womb to grow in other parts of the body. While en­dometrio­sis most of­ten af­fects the re­pro­duc­tive or­gans, it is fre­quently found in the bowel and blad­der and some­times in mus­cles, joints, the lungs and even the brain. In se­vere cases, en­dometrio­sis can cause pelvic scar­ring, block­ing of the fal­lop­ian tubes, and cysts known as ‘en­dometri­omas’ (choco­late cysts) which can stick to sur­round­ing or­gans – such as the bowel, blad­der and uterus – and can lead to in­fer­til­ity and the in­abil­ity to con­ceive chil­dren. Un­for­tu­nately it can be tricky to di­ag­nose, as only surgery to ob­tain tis­sue sam­ples can con­firm the dis­ease. A de­lay in di­ag­no­sis of be­tween 7 to 10 years is com­mon be­cause of mis­di­ag­no­sis and ‘nor­mal­is­ing’ of the pain felt by women and girls.

Don’t grin and bear it

It can be sur­pris­ing to find out that teenage girls are not too young to have en­dometrio­sis and genes may play a role. Ado­les­cent girls with a mother or sis­ter with en­dometrio­sis have an in­creased chance of also hav­ing the dis­ease, with two thirds of women ex­pe­ri­enc­ing symp­toms be­fore their 20th birth­day. Early treat­ment and di­ag­no­sis re­duce the long term im­pacts on en­dometrio­sis so don’t grin and bear it - pain is not nor­mal. If you or your daugh­ter is ex­pe­ri­enc­ing pain and dis­com­fort, miss­ing school, work, so­cial ac­tiv­i­ties or turn­ing to cof­fee and painkillers just to be able to carry on, then it is time to seek help and visit your lo­cal GP. Treat­ments for en­dometrio­sis in­clude: • Healthy diet and ex­er­cise – See­ing a di­eti­cian and al­ter­ing eat­ing habits along with reg­u­lar ex­er­cise about four times a week can re­lieve symp­toms nat­u­rally. • Pain man­age­ment – Treat­ing the pain with parac­eta­mol can ease symp­toms. A pain spe­cial­ist may be needed to help in se­vere cases.

• Phys­io­ther­apy – Spe­cial­ist pelvic pain phys­io­ther­apy is now recog­nised as an in­te­grated part of man­ag­ing pelvic pain.

• Surgery – Re­moval of the en­dometrio­sis via key­hole surgery confirms the dis­ease. It can also im­prove fer­til­ity rates in mild to mod­er­ate cases, with pos­si­ble re­peated surgery re­quired de­pend­ing on sever­ity. • Hor­mone treat­ment – Sup­pres­sion of fur­ther en­dometrio­sis by hor­monal methods (in­jec­tions, im­plant or the pill) can pre­vent new en­dometrio­sis from form­ing and may pro­vide respite from symp­toms.

• Fer­til­ity treat­ment – As­sisted con­cep­tion or IVF is an op­tion for women when preg­nancy does not oc­cur nat­u­rally.

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