How to Advocate For Yourself: Navigating Endometriosis Care
Blog Health News 21st August 2024 Enquiries & appointments
In this article Gynaecology Specialist, Mr Ahmed El Gohari, gives an overview of endometriosis from causes and symptoms, to diagnosis and surgery.
What is endometriosis?
Endometriosis is a disease in which the same endometrial tissue, just like the tissue found inside the uterus, is instead found outside the uterus. This can lead to inflammation, adhesions and scars inside the abdomen and pelvis which can contribute to different symptoms which mainly consist of pain.
How common is endometriosis and is it cancer?
Endometriosis is a common disease and is estimated to be found in 1 in 10 women of childbearing age, however a large number of patients go undiagnosed. It can take up to 7.5 years for a patient to receive a diagnosis partially because the majority do not get seen by, or receive treatment from, an endometriosis specialist.
Endometriosis is a benign disease which means that it is not cancerous, but it still has a huge impact on affected people, their families, their work and the community.
What are the causes of endometriosis?
There are multiple theories explaining the causes behind endometriosis. One such theory is that it is hereditary, which means it runs in families. Other causes are thought to stem from autoimmune conditions, problems with menstrual periods and trauma/surgery to the uterus.
What are the symptoms of endometriosis?
Endometriosis symptoms are vague, meaning it’s difficult to identify if the symptoms stem from Endometriosis itself or another disease. There are a wide range of symptoms which can differ from one patient to another. Some of the symptoms include, but are not limited to:
- Lower abdominal and pelvic pain
- Pain during intercourse
- Painful periods
- Heavy periods
- Fatigue and lethargy
- Painful urination
- Pain inside the vagina
- Pain inside the rectum
- Pain when opening the bowels
- Chest and rib pain during periods
How is endometriosis diagnosed?
Diagnosis of endometriosis can be achieved by a combination of pelvic examination and imaging such as MRI and ultrasound scanning. Ultrasound scanning can be very challenging when trying to identify endometriosis, but it can identify adenomyosis which is endometriosis inside the muscles of the uterus. It can also help to identify endometriosis affecting the ovaries which presents as an ovarian cyst. MRI scans are better placed to identify severe endometriosis only.
Laparoscopy, or keyhole surgery, is the only method in which the surgeon is able to clearly see endometriosis and it is the only method to diagnose endometriosis at stages one and two. There are four stages with the first two considered as superficial. Meanwhile, stages three and four are considered as severe. Laparoscopy is, therefore, in my view the gold standard for diagnosis.
What are the treatment options for endometriosis?
Treatment of endometriosis will be dependent on the stage of the disease. Hormonal treatment helps to control the symptoms of endometriosis, but it does not eliminate the disease in its entirety.
Surgical intervention helps not only in managing the symptoms, but also in removing the disease tissue from the body. There are different surgical methods for treatment of endometriosis, such as:
- Ablation
- Laser
- Diathermy (Cauterisation)
- Excision
Gynaecologist Consultant, Mr Ahmed El Gohari Final Thoughts
I personally believe that surgical excision of endometriosis is the right approach in treating the disease as there is complete removal of the disease tissue from the body. It also aids in assessing the extent of the disease prior to removal and it reduces the risk of thermal injury to other organs such as the ureters and bowels. In addition to this it also helps to reduce the chances of recurrence of the disease.
Article produced by:
KIMS Hospital & Sevenoaks Medical Centre