Endometriosis 101
What is it?
It’s a condition where cells similar to those that line the uterus are found in other parts of the body, mainly in the pelvis and reproductive organs. This condition can cause mild to severe pain and may affect your fertility.
Endometriosis affects about one in seven women of reproductive age.
Symptoms
The exact cause of endometriosis is unknown, and endometriosis affects everyone differently.
It’s common for women to experience a slow and steady progression of symptoms, and the severity of symptoms is often related to the location of endometriosis.
While pelvic pain is the most common symptom, women with endometriosis have a higher risk of other pain conditions, such as migraines and arthritis. Back, bladder and bowel pain, and associated conditions, are also common in women with endometriosis.
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Pain is a common symptom of this condition.
Endometriosis can cause different types of pain.
For example:
painful periods
pain during or after sex
abdominal, lower back and pelvic pain
pain during ovulation, including pain in your thighs or legs
pain when doing a wee or poo
pain that gets worse over time
pain that stops you from doing things you usually do.
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Some women with endometriosis experience other symptoms, including:
bladder and bowel problems (e.g. the need to wee frequently, constipation or diarrhoea)
bloating around the time of your period
tiredness, especially around the time of your period
vaginal discomfort
mood conditions (e.g. anxiety and depression)
asthma.
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Most women with endometriosis have the same experience at menopause as other women. Menopause symptoms can range from no symptoms to severe symptoms.
But some women with endometriosis may experience increased pelvic pain in the lead-up to menopause. Your doctor can help you manage these symptoms if they develop – or return – at this stage of life. While uncommon, endometriosis can return with the use of menopausal hormone therapy (MHT).
Diagnosis
The average time to get a diagnosis is seven years. This is because symptoms vary between women, and symptoms can change over time. Also, period pain is often accepted as normal.
Ultrasound
The first step to diagnosing endometriosis is usually an ultrasound. Depending on the findings and your symptoms, you may be offered medical treatment, surgery, or if the ultrasound is normal, your doctor may suggest a different line of investigation for your symptoms.
Laparoscopy
Laparoscopy is keyhole surgery via the abdomen, performed under general anaesthetic. A laparoscopy will confirm the presence of endometrial tissue, which can then be treated during the operation. This operation is usually performed when an ultrasound has shown there is deep endometriosis and scar tissue, or when a woman has prolonged difficulty falling pregnant.
Severity
The American Society for Reproductive Medicine has created a staging system for endometriosis. Endometriosis may be classified in stages 1 to 4. The stages are based on the location, extent and depth of endometrial tissue seen during surgery, but they don’t always reflect the severity of symptoms.
For example, a woman with stage 1 endometriosis may have more pain than a woman with stage 4 endometriosis.
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There are small endometrial patches or plaques, inflammation and mild adhesions (bands of scar tissue that form between two surfaces inside the body).
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As above, but there are many patches and there may be some scarring. There may also be adhesions between the uterus and the rectum.
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As above, but there are also adhesions on the ovaries.
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As above, but there are also many implanted endometrial patches, patches that may form scarred nodules, adhesions to other organs such as the bladder and bowel, and changes to the shape of pelvic organs.
How yoga can help
Several studies also show that yoga can specifically help with endometriosis.
A small study from 2017 found that women who practiced yoga for 90 minutes twice a week had less pelvic pain than those who did not do yoga.
Targeted, feminine yoga can create easy flow and motion to reduce stagnation and encourage fluid, cleansing cycles and a state of mind that allows release.
More recently, researchers found that practicing yoga may affect the stress pathways that cause pain from endometriosis, reducing pain and improving the quality of life in people with endometriosis.
When to see your doctor
If symptoms are affecting your quality of life, talk to your doctor.
It can be really helpful to keep a diary of your cycle, menstrual pain, other pain or symptoms to discuss with your doctor of gyno.
It’s not OK or normal to have severe period pain.