Endometriosis

What is endometriosis?

Endometriosis is a painful, and often emotionally draining, condition that affects 10% of women globally.^[1] It happens when cells usually found in the uterus are found growing in other areas such as the fallopian tubes and ovaries. During menstruation the tissue that has grown fills with blood and ruptures this can cause painful symptoms and heavy periods.

There’s no cure for endometriosis but there is a range of different treatments available to help manage its symptoms.

Hormonal treatments and painkillers can be used. In some cases surgery may be considered to remove endometrial tissue from the uterus and surrounding area.

Who gets endometriosis?

Endometriosis can affect any woman of reproductive age.

Whilst a definitive cause of endometriosis hasn’t been identified, some studies have suggested that there are some possible risk factors associated with its development.

There’s some evidence to suggest that it could be genetic, but a specific gene has not been identified.^[2]

Various risk factors have been identified including early periods, late menopause, smoking and a low BMI.

There are also some reports of endometriosis affecting post-menopausal women, but this is rare. If you notice symptoms of endometriosis but have already been through the menopause and have stopped having periods, it’s a good idea to talk to a clinician.

How common is endometriosis?

Endometriosis is one of the most common gynaecological disorders experienced by women and is prevalent across the globe. It’s frequently underdiagnosed in teenagers and younger women. When access to medical treatment and lack of female equality in some cultures are taken into account, the global figure of 10% prevalence can seem low.^[3]

What causes endometriosis?

No one exactly knows what causes endometriosis. The main symptom of abnormal cell growth in the fallopian tubes, ovaries and pelvic area has led medical professionals to suggest that retrograde menstruation could be a possible cause.^[1] Retrograde menstruation refers to menstrual blood and endometrial cells flowing out of the uterus and through the fallopian tubes. The cells then stick to organs in the pelvic cavity where they cause painful symptoms, especially during menstruation.

There are a range of other causes that have been suggested by scientists including genetics, immune disorders and the movement of endometrial cells through the lymphatic system.

Whilst further research into the causes behind endometriosis is needed, there are a range of treatment options available to help alleviate the symptoms associated with it.

What are the symptoms of endometriosis?

There are a range of symptoms associated with endometriosis. You may only experience one or two symptoms and their severity can differ from woman to woman. On average, it can take approximately eight years for a woman in the UK to get a diagnosis and access to treatment,^[2] and and it may be even longer than before the COVID-19 pandemic.^[3] This is often due to some of the symptoms being close to those associated with routine menstruation.

Although endometriosis is usually associated with pelvic pain and heavy periods, some women don’t report these symptoms and may only be diagnosed with endometriosis when they have trouble trying to conceive. Not everyone with endometriosis will experience fertility problems but if you have concerns about your fertility you should speak to a clinician.

Endometriosis symptoms can include:

• heavy periods
• irregular periods
• chronic pelvic pain
• pain in the lower back
• pain during sexual intercourse
• painful bowel movements
• difficulty getting pregnant

Can endometriosis lead to other problems?

There is a lack of understanding surrounding the cause of endometriosis, so it’s difficult to say for certain that it leads to other problems. But there are other conditions that it’s thought to be closely associated with.

Although many women with endometriosis are able to conceive naturally, it’s estimated that between 30-50% of women with endometriosis encounter problems with fertility when trying to conceive.^[4]

Some women with endometriosis develop cysts called endometriomas. These tend to form on the ovaries or around the fallopian tubes. They can fill with blood and cause pain and cramping in the pelvis. If they rupture they can be dangerous and require medical attention.

Endometriosis can impact other areas of your life. Fertility problems, chronic pain and problems with sexual intercourse can contribute to stress in relationships.

The pain caused by endometriosis can be severe and greatly affect your quality of life and mental health. That’s why it’s important to know that there are treatment options available and support from dedicated charities too.