Six signs you might have endometriosis
The condition is pretty common, yet it still takes an average of seven-and-a-half years to get diagnosed. As it’s Endometriosis Awareness Month, Liz Connor finds out more
Awarene ss around endometriosis – the chronic and sometimes debilitating gynaecological condition that affects 10% of women worldwide – is finally growing, thanks in part to celebrities sduch as Lena unham and Whoopi Goldberg speaking out about their experiences, but there’s still a way to go.
Ink,thite’s Ubelieved that one-in-10 women of reproductive age are affected, yet according to the cuharity Endometriosis K, it takes seven-and-a-half years on average to be diagnosed.
There’s no single cure for endometriosis but getting the right treatment and advice can make a big difference, and surgery can sometimes help – which makes being aware of the potential signs and symptoms all the more important.
With Endometriosis Awareness Month taking place throughout Mamrcrha,mherrer, aza, consultant gynaecologist at The Lister Hospital (part of hcahealthcare.co.uk), explains more...
Whatexa ctly is endometriosis? eendom“triosis occurs when the tissue lining a woman’s uterus (called the endometrium) grows in other areas of the body – for example, in the fallopian tubes, on the ovaries, or in the tissue lining the pelvis,” explains Amer.
He says the endometrial cells found outside the uterus behave in the same way they would inside the womb, mimicking the menstrual process by building up and breaking down monthly.
However, unlike with a period, the blood has nowhere to escape.
“As a result, it can sometimes accumulate, triggering cysts on the ovaries or elsewhere in the abdomen, and making the organs inside the abdomen stick together,” says Amer. This can lead to severe pain that can have a significant impact on quality of life.
Whatc ausesit?
Theexact cause of endometriosis is still unknown, but Amer says there are several theories.
“The most accepted theory is retrograde menstruation,” he says.
“This is where the womb lining doesn’t leave the body properly during a period, but travels back up the fallopian tube and embeds itself in the organs surrounding the pelvis.
“Another theory is that endometriosis could be inherited genetically, as it is often diagnosed in sisters and daughters of women who have the condition.
“Other considered causes include circulatory spread (where tissue particles spread around the body in the bloodstream), immune dysfunction, environmental causes (where environmental toxins penetrate the body and reproductive system), and metaplasia (where cells outside the uterus change into endometrial cells to adapt to their environment).” Symptoms to lofookr?out
Eendom triosis symptoms can sometimes be vague, or easily dismissed as just a ‘normal’ part of having a period. However, these are some of the key warning signs:
■■ Very painful and heavy periods: Many women with endometriosis will experience very painful periods, that are occasionally very heavy.
“Because most women will suffer with some degree of cramping when they are approaching their menstrual cycle, it can be hard to judge what is ‘normal’ pain and what is ‘abnormal’ pain,” Amer acknowledges.
“If you are experiencing menstrual pain that prevents you from working or going about your usual day-today activities – and over the counter painkillers are doing nothing to improve the pain – make an appointment with your local GP, as this could be a sign you have endometriosis.”
■■ Pelvic pain: Ongoing pelvic pain could also be an indication.
Amer says this is triggered by the endometrial tissue and cells which are spreading around your reproductive organs.
“The pelvic pain is cyclical initially but as the scarring increases, the cyclical nature changes into chronic pelvic pain,” he notes. ■■ Painful intercourse: “Depending on the location of the endometrial tissue or cells, some women with endometriosis may experience pain during sex,” says Amer.
“If the tissue is stretched during intercourse, pain can be significant, and for some, sexual penetration is not possible.
“Pain on deep penetration is another sign of scarring inside due to endometriosis.
“It’s important to note that pain during sex can come from a variety of causes, so you should see your GP to get this checked out regardless of whether or not you think endometriosis is the root cause.”
■■ Subfertility: Some women with endometriosis will experience difficulty in becoming pregnant, says Amer.
“One common theory (for this) is that the inflammation and irritation caused by endometriosis can affect the women’s ‘fimbria’, which picks up the egg and transports it into the Fallopian tube,” he explains.
“Swelling and scarring of the fimbria could mean that the egg may never reach its destination. The fluid in the abdomen can also hinder the meeting of sperm and egg, hence making it difficult to get pregnant.”
Not everybody with endometriosis will experience fertility difficulties, however. “It’s thought that (those with) minimal to mild endometriosis have an almost normal chance of conception, however for those with moderate to severe endometriosis chances of natural conception are reduced,” says Amer.
■■ Pain while using the toilet: Endometriosis can cause pain during bowel movements. Amer says: “It’s estimated that around 60% of women with endometriosis will develop at least one symptom in their gastrointestinal tracts.”
This is because endometrial implants can develop in certain areas of the bowel or on nerves and ligaments around the bowels, causing pain throughout this area. You might also experience episodes of diarrhoea, constipation and uncomfortable bloating as a result.
Pain during urination is also common. “When the endometrial cells embed themselves into organs – like the bladder – they tend to burrow deep within the walls of the organ. These cells then react in the same way as they would in the womb, and lead to blood becoming trapped within the organs, which in turn becomes inflamed.
“If your bladder is affected by endometrial cells then you may experience pain during urination, or an overactive bladder, where you have feelings of urgency or frequency,” Amer notes.
■■ Chronic fatigue: “Around half of women diagnosed with endometriosis will experience chronic fatigue,” says Amer.
This is believed to be caused by the ongoing inflammation inside the body. “Because the body is continually attempting to heal and repair the inflammation wounds that endometriosis is causing, this can trigger a variety of immune responses and result in significant fatigue,” Amer adds.
Heavy periods can lead to low iron levels too, which can also be a common cause of fatigue in women.
Whatshdoyuolu do?
Ify ou’reexperiencing any of the symptoms associated with endometriosis, have a chat with your GIP. t might be worth keeping a symptom diary, to take with you to the appointment.
■■Formore information, see endometriosis-uk.org
WOFETEN talk about living mindfully, but what about eating that way too?
There are three aims of this mindfull eating exercise: to focus your attention on eating, and when you get distracted, gently bringing your attention back to the task at hand; to adopt an attitude of genuine curiosity to see if you can discover something new about eating; and to really savour the experience, the enjoyment of eating.
Sit comfortably and have a small piece of food to hand, for example, a raisin, a square of chocolate or a small piece of bread.
Take the piece of food between your thumb and index finger. Look at it as though you are a small child who has never seen anything like this before. Hold it up to the light and move it around; notice the textures on the surface, the shape, the contours and the edges.
Gently squidge it between your thumb and finger – does it shift? Is it hard or soft? Really get a sense of the texture underneath your fingertips.
Now hold it beneath your nose. Breathe in. What can you smell? Is it strong or subtle?
Gently rest it on your lower lip. Notice what happens inside your mouth. Do you notice any changes in temperature? Do you notice a change in the saliva in your mouth?