Contact us:

Endometriosis

Endometriosis is often associated with infertility.

What is Endometriosis?

Endometriosis is a condition in which cells lining the inside of the uterus (the endometrium) are found in other parts of the body. With each menstrual cycle, under hormonal influence, the endometrium is shed and tissue which is outside the uterus also bleeds. This bleeding causes inflammation and therefore scar tissue, which increases in size with subsequent periods and can in time involve other organs and tissue with adhesions.

Where is it found?

Endometriosis is most commonly found on or in the ovaries and on the peritoneum (internal lining of the abdomen) particularly on the uterosacral ligaments, which support the uterus. Other sites include the uterus, bladder, Pouch of Douglas, bowel and operation scars.

Endometriomas or chocolate cysts are endometriosis within the ovary.

It can be found in other parts of the body such as retina of the eye or lungs, although this is extremely rare.

Symptoms

Endometriosis can cause a wide range of symptoms, which include increasing menstrual pain not responding to the contraceptive pill or simple pain killers.

Cycles of lower abdominal pain and symptoms affecting the bladder or bowel function. Sometimes symptoms may not be cyclical if due to scar tissue secondary to endometriosis.

Heavy or irregular periods, including premenstrual spotting.

Pain with intercourse.

Infertility

Non-specific symptoms such as bloating and tiredness.

Many women including teenagers experience symptoms for a considerable period of time before a diagnosis is made as symptoms are similar to many other conditions.

How is endometriosis diagnosed?

Endometriosis can only be diagnosed by seeing the areas of endometrial cells inside the abdomen and this can be done by laparoscopy. This procedure is performed by a gynaecologist under general anaesthetic. Several small cuts are made in the abdomen near the navel and just above the pubic hairline. Through one of these cuts a tube with a light (a laparoscope) is passed to see the pelvic organs such as ovaries, tubes, bladder, bowel and surface of the uterus.

What causes endometriosis?

The exact cause is unknown and possible causes may include:

Cells from the endometrium are deposited by the backflow of menstrual blood (retrograde menstruation).

Transportation to distant sites such as lungs and retina by the blood stream and the lymph system.

Development of endometrial cells during the formation of cell lines in the foetus (metaplastic theory).

Changes in immune system.

Possible hereditary factors.

What treatments are available?

The type of treatment used will depend on many factors including age, desire for children in the future, severity of symptoms and extent of disease.

Treatments are aimed at relieving and reducing symptoms to improve well being and include:

Hormone Therapy – these drugs suppress the menstrual cycle and therefore inhibit the growth of the endometriosis areas but will not remove it. Adhesions do not respond to drug therapy.

Surgery – “conservative” surgery is used to try to restore the function of any damaged organs to reduce symptoms and to improve fertility. It involves removing as much of the endometriosis, scar tissue and adhesions as is possible.

Endoscopic (or keyhole) surgery using laser or diathermy is performed whenever possible as only a laparoscopy is required. However, sometimes a laparotomy is needed to remove deep deposits or affected bowel.

Alternative treatment – herbal remedies, dietary change, acupuncture, reducing stress and exercise may reduce pain but have not yet been proven effective in controlled studies.

Sometimes endometriosis may recur after treatments and recurrence is more common if the disease is severe, or only drug treatment has been used.

Support

The Endometriosis Association is committed to providing support and information to individuals and the community. It offers a Support Service, 24 hour paging service, conducts regular information meetings and provides a newsletter and library service.

Return to top

Wesley Monash IVF
Diary,

Job Opportunities