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Endometriosis awareness has increased over the past few years in large part due to Endometriosis UK. Over the last decade, the organisation has raised the condition's profile within the general public and had a parliamentary group put together. Current work is being done to improve treatments, as well as try and enhance education for GPs for endometriosis as a women's health condition, in order to reduce the timeframe it takes for it to be diagnosed. According to Dr Chris Guyer,
The awareness of endometriosis within the workplace will only come with better understanding and recognition. It’s not dissimilar with the story of HRT and the menopause that is recently being managed in the workplace as a condition. It is important to keep the conversation going in order for action to be taken.
The impact endometriosis has on fertility may vary from person to person, but should not be underestimated. While the majority of women, affected by mild to moderate endometriosis, will still be able to conceive naturally, those with a more severe form of the disease will begin to have fertility-related problems because of the way in which endometriosis alters the anatomy in their pelvis. Current research points to the possibility that the inflammatory response may impact egg production and possibly fertilisation and sperm as well. Oftentimes these afflicted women will require IVF treatment to start a family.
Those with endometriosis who are experiencing a delay in conceiving naturally should not delay in seeking out a fertility specialist, in order to assess the need for further testing and treatments such as IVF.
How is endometriosis recognized? According to Dr Chris Guyer,
Pain is the main symptom which includes premenstrual and menstrual pain, some people might also have pain and discomfort when emptying the bladder, opening the bowels and during intercourse. These are the key symptoms that the majority of women with endometriosis will experience. Our advice has always been that if the pain doesn’t seem like an ordinary period pain, then seek advice from a GP who should be able to explore the possibility of endometriosis. It’s important to press for a diagnosis to be made as soon as possible.
An earlier diagnosis may allow those with the disease to manage the symptoms effectively. However, more research is still necessary to better understand the gynaecological condition, its causes, and how to treat it. Based on current knowledge, an underlying genetic pre-disposition may alter the immune system, allowing the disease to occur.
Endometriosis UK data reveals that the average time between the onset of symptoms and diagnosis is seven years. What is the reason for the long delay in diagnosis? Dr Chris Guyer explains,
Historically, many women will visit their GP, however it’s often mistaken for menstrual symptoms, especially when women first start their periods. This will be managed with pain killers or the contraceptive pill without a diagnosis being made.
There will be some women who don’t have symptoms or perhaps they feel that their symptoms aren’t a problem for them but of course they do have endometriosis. It won't be until they are trying for a pregnancy that they realise there is a problem. They may require a laparoscopy before they pursue fertility treatment, which may also enhance their ability to fall pregnant naturally.
Endometriosis can negatively impact daily life, for instance causing difficulty with work as well as calling in sick, lowering overall productivity. The pain and stress symptoms can also bleed into home life, relationships, and sleep, setting the stage for further symptoms such as insomnia, fatigue, anxiety and depression.
In order to manage the symptoms, Dr Chris Guyer suggests lifestyle changes such as dietary changes. Alternative treatments such as acupuncture, reflexology and mindfulness have also been met with varying degrees of success. However, those seeking treatment for fertility should be sure to meet with an endometriosis specialist to discuss their disease and specific symptomatology with a trained professional.
It’s important to stress that if a woman is looking to have treatment to ensure whoever is doing it is recognised as a specialist in endometriosis. Previously endometriosis sat within the remit of general gynaecology, but we now have endometriosis specialists who have an invested interest in managing the condition, and as they are doing it frequently, they are better at it.
Since pain is the main symptom, it is one of the first things treated, for example through anti-inflammatory medicines combined with pain relief. Hormonal treatments, such as the contraceptive pill, are intended to suppress some of the hormonal drive in order to reduce the inflammatory response.
Finally, a laparoscopy surgical procedure is another option to try to remove the endometriosis, especially in cases when the endometrium, usually only present in the uterus, also occurs outside of the uterus. In a laparoscopy, a little camera goes through an incision in the belly button area in order for doctors to see inside the abdomen and pelvis and identify the obvious signs of endometriosis forming.
If you suspect you or your partner may have signs of the disease or simply wish to learn more, be sure to attend our upcoming awareness webinar with Dr Chris Guyer.
We are now fortunate to have a network of endometriosis centres up and down the UK making it much easier for people to access a specialist, here at TFP we have our own specialists along with links to endometriosis centres.