Endometriosis: Be aware of the “silent disease”
Dr Sarah McDonnell
March is endometriosis awareness month. Endometriosis affects around 1 in 9 of all women of childbearing age and may be tricky to diagnose.
If you have any symptoms that could be due to endometriosis, it’s important to seek help, as delay in diagnosis can lead to long term problems.
As of October 2023: You can find details of how to access the Neighbourhood Medical grant funded endometriosis and pelvic pain clinic by clicking here.
What is endometriosis?
Endometriosis is a condition where cells similar to the cells that line the inside of the womb are found in other parts of the body.
Each month, these cells build up and then cause bleeding at the same time as a period occurs. This may lead to local symptoms due pain, inflammation and scar tissue formation as well as generalised symptoms.
Endometriosis is most commonly found in the pelvis. It can occur in more distant sites such as inside the bowel and even as far away as the lungs. It is usually a flat layer of cells, but sometimes cysts (fluid filled lumps) can form, which are called endometriomas. These may occur on the ovaries.
What signs and symptoms can endometriosis cause?
People may describe many different endometriosis symptoms including:
Painful periods
Lower abdominal pain between periods
Painful bowel motions
Discomfort when passing urine
Fatigue
These symptoms can overlap with other gynaecological conditions. The impact of endometriosis can be significant, ranging from debilitating period pain affecting work and social commitments, to chronic pelvic pain and fertility problems.
How can I find out if I might have endometriosis?
A good first step is to book a consultation with a GP, preferably one with an interest in or extra training in women’s and/or sexual health. The GP will ask you about your symptoms, including your periods and sexual history, as well as your future fertility plans or wishes. Depending on symptoms, an internal examination may be performed (mindful of any pelvic pain or trauma history) and it’s likely you will be referred on for further tests or to a gynaecologist.
What tests are used to diagnose endometriosis?
In order to check for endometriosis and other conditions with similar symptoms (such as fibroids or adenomyosis) you should be referred for an ultrasound scan, which is usually done with a transvaginal probe. This can also be done through your abdomen. although it is less accurate this way. As endometriosis is often flat, it can be hard to see on this type of scan and a normal ultrasound doesn’t rule out endometriosis. It helps if the scan is performed at a radiology clinic with an interest in this area of women’s health - the team at Neighbourhood Medical can advise you on your options.
Your GP may also perform a cervical screening test and some tests for pelvic infection, if your symptoms indicate a need for these tests.
The most accurate way to diagnose endometriosis is by keyhole surgery to look inside your abdomen and pelvis and see if there is endometriosis visible on the outside of the internal organs or on the lining of the pelvis. MRI scanning can also sometimes be used.
Do I have to have surgery for diagnosis before being treated?
Thankfully, no. Depending on the severity of symptoms, and whether or not a person is trying to become pregnant, there are simple ways to treat likely endometriosis. These include commonly used contraceptives such as the pill and the Mirena, which suppress the growth of the endometriosis.
For more severe symptoms and those with fertility concerns, your GP can arrange a referral to a public gynaecology clinic, or a private gynaecologist with an interest in this area.
At Neighbourhood Medical, the services provided by the GPs with a special interest in women’s health can help you to help diagnose and manage this important condition. They also have links with gynaecologists and women’s health physios who can work as a team to achieve the best outcomes.
If you would like some more information on endometriosis you can find it here on the Endometriosis Australia website and read about latest international evidence here.
