Endometriosis affects around 10% of women in the UK, with many dealing with the effects of the condition throughout their lifetime. Individuals can mistake the condition for period pain, making it even more important than ever to know the causes, symptoms and treatments of endometriosis.
Many individuals remain unaware they have this condition as it can take, on average, around eight years to receive a diagnosis.
Endometriosis is a condition where cells similar to those found in the lining of the uterus grow outside of it, commonly in the pelvis. The condition can also be found in the ovaries and other pelvic organs, like the bowel or bladder. In very rare cases, endometriosis can be found in other parts of the body, such as the brain, lungs and skin.
The cause of this condition is unknown and can lead to severe pelvic pain during periods, though some individuals may experience no symptoms at all.
Endometriosis has four stages, which are characterised by the location, size, and depth of the tissues growing outside the uterus.
Stage one – minimal: This is when you have small spots of endometriosis that cause inflammation in or around the pelvic cavity.
Stage two – mild: Symptoms involve light lesions and shallow implants of endometriosis that develop on the ovary and pelvic lining.
Stage three – moderate: This stage involves implants that are deeply embedded in the ovaries and on the pelvic lining.
Stage four – severe: This is the most advanced stage of endometriosis. It involves deep implants on the pelvic lining and ovaries and depending on the patient’s diagnosis, there may also be lesions on the fallopian tubes and bowels.
The symptoms of endometriosis can vary in intensity, ranging from moderate to severe and can cause significant pain, especially during menstrual periods. These include:
Pelvic pain: The most common sign of endometriosis is pelvic pain which is often associated with menstrual periods. The severity of this pain and cramping can vary and may increase over time.
Painful intercourse: Discomfort during or after sex is a common symptom of endometriosis. The pain often gets worse during your period when the tissue is most inflamed.
Pain with bowel movements or urination: Endometrial cells that normally grow in the womb can also develop on the bladder or bowel. This bowel endometriosis can mimic symptoms of irritable bowel syndrome (IBS), leading to constipation, diarrhoea, and bloating. The symptoms may progress and cause an overactive bladder as well.
Excessive bleeding: Many women experience heavy periods and may pass clots in their menstrual blood. Furthermore, as the endometrial cells grow larger, it can result in increased bleeding.
Leg and/or pelvic pain: The abnormal tissue growth caused by endometriosis can put significant pressure on the pelvic nerves, causing leg and pelvic pain. For some women, the pain is so severe, that it makes walking difficult.
Persistent exhaustion and tiredness: Almost half of women with endometriosis experience frequent fatigue, with many experiencing insomnia, depression and stress. Fatigue in women with endometriosis may result from inflammation in the body that activates the immune system.
Spotting between periods: Spotting is light bleeding that occurs between periods, lasting for two days or more. This bleeding can be caused by endometrial polyps or additional tissue that grows within the body, leading to bleeding throughout the month.
Coughing blood: In rare cases, when endometrial tissue grows on the lungs, some women may cough blood. However, it is important to know that this symptom is extremely rare and only occurs in severe cases of endometriosis.
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Reviewed by Justin Chu, Medical Director at TFP Oxford Fertility.
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