Endometriosis is a chronic disease that affects as many as 10% of women. Dr. Dropin wants increased knowledge among both women and healthcare professionals, so that more people can get help with the symptoms as early as possible.
In patients with endometriosis, tissue of a similar type to the lining of the uterus (endometrium) grows outside the uterine cavity. It can grow in one or more other places in the body and the most common places to find the diseased tissue are in the fallopian tubes, ovaries, peritoneum, intestines, bladder and vagina. Adenomyosis is another condition in which endometrium grows into the muscle wall of the uterus. This article focuses on endometriosis.
What symptoms can endometriosis cause?
Not everyone is aware that they have endometriosis before being examined for involuntary infertility. The symptoms can be diffuse and can be confused with other conditions. When you have menstruation and the endometrium bleeds in the uterus, it will also bleed in the other locations where the abnormal tissue grows. It leads to inflammation, blood clots, scar tissue and pain. The symptoms can therefore easily be confused with conditions from the organs that are affected. For example, endometriosis of the bladder can be confused with urinary tract infection. In the gut, it can be interpreted as part of the irritable bowel.
Endometriosis is characterized by bleeding disorders and pain during menstruation, ovulation and intercourse. Fatigue and anemia are also common ailments. It is important to point out that the symptoms mentioned here can also be signs of another disease and it is important to exclude other conditions as part of the study.
Why can it be difficult to make a diagnosis?
The symptoms of endometriosis can easily be confused with conditions of the organs affected. For example, endometriosis of the bladder can be confused with urinary tract infection. In the gut, it can be interpreted as part of the irritable bowel. Often the symptoms can worsen over time when you have had many menstrual periods that have affected the tissue time and time again. This will make the diagnosis clearer as the years go by and it is easier to link it to e.g. cyclical pain. Estrogen is a prerequisite for the development of endometriosis. The symptoms occur at childbearing age and will for most people subside during menopause. Birth control pills can be used as part of the examination, if the pain decreases when using the pills, it can give a good pointer.
Are there any who are more prone to endometriosis than others?
Yes, what you do know is that it is a hereditary factor. If women in your family have endometriosis, you are more likely to be predisposed to the disease. It has also been seen that the risk increases with the number of years of uninterrupted menstruation. Pregnancy and hormonal contraception will have a calming effect.
How can I tell if I have endometriosis?
Peephole surgery where you can take a sample of the tissue that grows in abnormal places is the method that can certainly detect endometriosis. But before you get there, you want to map as much as possible. It is important to keep a diary of the menstrual cycle, symptoms and pain, then you and the doctor will have a better starting point for seeing connections early in the process. As the years go by and the pain may have become chronic and no longer dependent on the cycle, it will be easier to remember the course if you have written down along the way. Ultrasound and MRI examination may be necessary as part of the examination, but will certainly not be able to rule out endometriosis.
How is the diagnosis made?
A regular gynecological examination with ultrasound can not say for sure whether you have endometriosis or not. Blood tests can't either. MRI and ultrasound can sometimes be helpful. Laparoscopy is the only method that can surely make the diagnosis and it makes many people go a long way before they get an answer.
When the surgeon looks into the abdominal cavity using small cameras (peephole surgery), the endometriosis change will look like small blue-red fluid-filled cavities or brown areas. They can be only a few millimeters in size the size of an orange. In the ovaries, they can look like something called "chocolate cysts".
In Norway, it takes an average of 7 years before the diagnosis is made. Therefore, the doctors and gynecologists in Dr.Dropin have a special focus on gynecological diseases about which there is little knowledge among the population and health professionals. We want to make the symptoms known so that more people can get help early.
Is there treatment?
Endometriosis is a chronic disease that cannot be cured. However, one can alleviate the course, symptoms and consequences with the help of hormone therapy and surgery. The best starting point is if the diagnosis is made early in the course and before the abnormal tissue has damaged the places where it is located. In some people, the condition is discovered by chance following another surgery and will not need treatment if it does not cause symptoms or injuries. Birth control pills are usually to start with and try for 6 months before evaluating the result. Alternatively hormonal IUD. Painkillers such as Paracet and Ibux can relieve menstrual cramps. In some cases, the endometrium is removed by surgery.
Why does endometriosis cause pain?
The mucosal-like tissue that makes up the endometriosis is affected by hormones in the same way as the normal tissue in the uterine cavity. When you are affected by hormones in your cycle, endometriosis will also be affected. In the uterus, the blood will be expelled by bleeding from the vagina, but by endometriosis located elsewhere where it has no way to find a way out and will form small blood cysts.
Those with endometriosis often experience severe pain during menstruation that has a poor effect of analgesics. Somealso experiences pain during ovulation and in the days before menstruation begins. The pain outside the uterus is located where the endometriosis grows. Be it bowel movements during bowel movements, shock pain during intercourse, pain during urination. Some people also have these pains constant and cycle-independent if the pain has persisted over time or the endometriosis is pressing on nerves and painful areas. Going with pain over time can result in decreased sleep quality, altered appetite and fatigue. There is no clear link between the prevalence of endometriosis and the degree of pain. Endometriosis is treated if it causes pain, heavy bleeding and involuntary infertility due to endometriosis.
How can Dr.Dropin help?
How can Dr.Dropin help you?
At Dr.Dropin, we have general practitioners and gynecologists who have good knowledge of women's health and we focus on this in our internal training program. All our doctors receive regular lectures on women's health and gynecology from experienced specialists in the field.
Our own gynecologist Azita Mahmoudaner specializes in fertility and is writing a doctorate on PCOS. Endometriosis is also one of her core areas.
You can book an appointment in one of our clinics with both a general practitioner and a gynecologist. At the gynecologist you will have an ultrasound performed. We put women's health first and want to meet our patients with care and high professional competence.
Do not hesitate to get in touch
Do you have more questions about endometriosis or other gynecological diseases? Contact us or we will help you as best we can.