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Endometriosis

What is endometriosis?

Endometriosis is a common condition affecting 1 in 10 women in Australia that can cause pelvic pain and difficulty getting pregnant. 

Endometrium is another name for the tissue lining the uterus or womb. Endometriosis happens when cells that are normally found inside the uterus grow outside of the uterus. These cells can grow in the pelvis but are also  found in the ovaries and the fallopian tubes.

What are the symptoms of endometriosis?

Some women with endometriosis have no symptoms or problems, but this isn’t always the case. 

Common symptoms include:

  • Pelvic pain
  • Period pain
  • Back pain
  • Low energy
  • Pain during or after sex
  • Pain when passing urine
  • Pain while passing a bowel motion

Other symptoms of endometriosis can include:

  • Trouble getting pregnant
  • Growths on the ovaries

All of these symptoms have other possible causes, but it’s important to tell your GP or nurse if you experience any of them. You’ll most likely be referred to a specialist gynaecologist. 

How is endometriosis diagnosed?

The first step is for us to talk about your symptoms and periods followed by a physical examination to help determine if you may have endometriosis. 

An ultrasound may be able to show if you have endometriosis cysts, called endometriomas, on the ovaries but it cannot detect superficial endometriosis. 

A definitive diagnosis cannot be made until you have a laparoscopy. 

What is a laparoscopy? 

A laparoscopy is a procedure using a small telescope with a camera that’s inserted through a tiny incision in your belly button to have a closer look at the organs around your uterus. A laparoscopy is the only way to diagnose endometriosis and help show its severity. A biopsy or pathology test will be taken to confirm the diagnosis.  

How is endometriosis treated?

The good news is that endometriosis can be treated and there are several treatment options:

  • Medication
  • Hormonal treatment
  • Laparoscopic surgery
  • Surgery to remove organs

Medication

Medication doesn’t get rid of endometriosis but can help relieve the pain. There are different types of pain relief and if one doesn’t work, we can try another type of medication. 

Hormonal treatment

The contraceptive pill or a Mirena IUD can be an effective way to manage endometriosis if you’re not trying to fall pregnant. 

Laparoscopic surgery

If medication doesn’t diminish your symptoms, the next step will be to discuss surgery. 

Laparoscopic or keyhole surgery might be an option if you have:

  • Severe localised pain in a specific area that’s tender on examination
  • A growth or mass in the pelvic area
  • Trouble getting pregnant

The goal of surgery is to remove endometriosis and scar tissue. Approximately 75% of women who have this surgery have less pain for several months after surgery. However, this surgery isn’t a permanent cure and it’s likely the endometriosis tissue will grow back and your pain will return unless you choose to start using the contraceptive pill or an IUD.

Surgery to remove organs

There are different types of surgery depending on the severity of endometriosis and whether you’d like to get pregnant:

A hysterectomy is surgery to remove the uterus or womb.

A salpingo-oophorectomy is surgery to remove the ovaries and fallopian tubes. It isn’t always necessary to remove the ovaries to treat endometriosis.  

Whatever treatment you choose, we’ll discuss your options – and the likely outcomes – together. 

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