Pelvic pain: A guide to endometriosis

5 December 2017, Tuesday

Endometriosis

Pelvic pain is discomfort experienced in the lowest area of the abdominal region and pelvis. While all women may experience pelvic pain at some point in their life, in some cases it may be related to something serious. At the Pelvic Pain Clinic, we aim to provide holistic care and ongoing support to people suffering from pelvic pain.

What is endometriosis?

Endometriosis is considered a long-term or chronic disease and affects 10% of women worldwide. It occurs when the tissue making up the lining of the uterus (endometrium) is found growing on other areas of the body. These parts of the body are most commonly the pelvic organs, namely, the uterus, ovaries, vagina, ligaments, bowel, and bladder. Although endometriosis can occur in other parts of the body, away from the pelvic region, it is less common.  

The endometrial tissue found growing outside of the uterus form in clumps, called implants. These implants continue to behave as normal. The displaced tissue continues to go through the menstrual process, thickening, breaking down, and bleeding with each cycle. This is where the problem occurs, as the tissue which would normally be eliminated during menstruation is now trapped with nowhere to go, resulting in inflammation and scarring.

Causes of endometriosis

The exact cause of endometriosis remains unknown, however, there are a number of theories and explanations about its possible occurrence. These include:

Retrograde menstruation: This takes place when some of the uterine linings flow backwards, out through the fallopian tubes, instead of exiting the body. Endometrial tissue passing backwards through the fallopian tubes ends up in the abdomen. While 90% of women experiencing retrograde menstruation break down and absorb endometrial tissue without showing any symptoms, some will suffer from endometriosis.

Genetics: Often endometriosis is seen in females sharing a genetic link. This indicates that the disease could be inherited and passed down from one generation to the next. It is unknown why some families are more susceptible.

Compromised immune system: It has been considered that some women’s immune systems may not be able to fight off the disease effectively. It is possible their immune systems cannot remove the menstrual fluid in the pelvic cavity and the cells then change to endometrial cells. Women with endometriosis have shown decreased resistance to infections.

Symptoms of endometriosis

The most common symptom of endometriosis is pelvic pain, usually occurring at a similar time to menstruation, although it can be continuous. Unfortunately, while pain is a common symptom, it is not an indication of the severity of the disease and some women may have little to no pain at all. Pain might also come in the form of back pain, pain during bowel movements, and painful intercourse. Women with the disease may also experience heavy menstrual flows and periods lasting longer than seven days. Depression, anxiety, and tiredness could also be symptoms of endometriosis and should be taken into consideration if happening in conjunction with other symptoms.

Infertility affects between 30% and 50% of sufferers of the disease, and can often be the only symptom. Some women may not realise they have endometriosis until the time comes to fall pregnant and they seek fertility treatment.

Treatment

Unfortunately, it is impossible to completely cure endometriosis, however, there are many available treatments to help manage the pain, preserve fertility, and improve quality of life. Doctors will usually prescribe treatments depending on the severity of the disease and whether or not a woman wants to become pregnant. Here are some examples of treatment options:

Pain medication: Over-the-counter or prescribed anti-inflammatory pain medication is usually the first option for relieving mild symptoms of pain related to endometriosis. Simple measures such as hot water bottles can also be used to relieve abdominal pain.

Hormone therapy: The use of supplemental hormones can assist in reducing or eliminating pain. The fluctuation of hormones during menstrual cycles lead to the implants of endometrial tissue behaving like the uterus lining. The use of hormones to suppress this growth can help prevent new implants from forming. Hormonal treatments can come in the form of contraceptives. Treatment only inhibits the disease and symptoms will reappear if treatment ceases.

Surgery: Surgery can help diagnose and treat endometriosis. A surgical procedure, usually through a keyhole incision, helps to remove implants and cysts by cutting or burning them off. While the disease can come back after surgery, it helps reduce pain and assists with fertility. An extreme surgical option is a hysterectomy, however, these are rarely recommended.

Advice for sufferers of endometriosis

Maintain a healthy lifestyle

A healthy lifestyle may help to manage the symptoms of endometriosis. Regular exercise can help reduce pain and lower estrogen levels. Getting enough sleep is also recommended, as quality sleep can help boost the immune system. It’s best to reduce caffeine intake as this aggravates pain rather than helping it. Alternative treatments, including herbal remedies, may also be considered to help ease the pain.

Always seek help

Any and all symptoms indicating endometriosis should be checked by a medical professional. While it is possible some women don’t experience any symptoms, there are many who experience mild to severe pain relating to the disease. Consulting a professional will help with the management of pain and greatly improve quality of life. The Pelvic Pain Clinic consists of a number of qualified healthcare professionals specialising in diagnosing and treating pelvic pain. Contact us with any queries or book an appointment here.

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