Endometriosis is a chronic and common gynaecological disease that affects about 10% of women of reproductive age. In endometriosis tissue from the interior of the uterus (endometrium) is growing outside of it and is most commonly found in the ovaries (endometriomas), fallopian tubes, peritoneum, intestine and bladder.
Symptoms
Symptoms may differ in every individual and there are also women who are completely asymptomatic.
- The most common symptoms of endometriosis are the following:
- Dyspareunia (pain during or after sexual intercourse)
- Dysmenorrhea (pelvic pain during menstruation
- Intermenstrual bleeding
- Dysuria (pain in urination) during menstruation
- Pain in defecation during menstruation
- Infertility
The intensity of symptoms depends not only on the size of endometriosis but also on the location of the disease and on the type of tissue affected.
Diagnosis
Endometriosis can be difficult to diagnose. Due to nonspecific symptoms, that often mimic other diseases, it may take years from the beginning of the symptoms to diagnose the disease.
Most significant methods for detecting endometriosis are the following:
- Medical history
Taking a thorough medical history is one of the most important tools in suspecting endometriosis. The symptoms of endometriosis are chronic and related to menstrual cycle in women of reproductive age. Also, some women may suffer from infertility whereas others may be completely asymptomatic. - Clinical examination
In some cases, clinical examination may show nodules that could be related to endometriosis, but in other cases, there might be no findings during the examination. - Gynaecological ultrasound
The gynaecological ultrasound is the method of choice to diagnose endometriomas (endometriosis of the ovaries). If the doctor conducting the ultrasound is appropriately trained, it might also be possible to detect endometriosis nodules in the intestine and the bladder.Dr. Tsoumpou has specialized in gynaecological ultrasound, with particular interest in the examination of women with endometriosis, at King’s College Hospital in London, which is a pioneering institution in gynaecological ultrasound at a global scale. - Blood tests
Blood tests (e.g. CA-125 exam) are not suitable for detecting endometriosis, as the results may be increased due to other diseases as well. - Laparoscopy
This is the gold standard method for diagnosing endometriosis. The surgeon may detect endometriotic lesions, assess their size and significance and remove them.
Endometriosis treatment
Treatment for endometriosis depends on the symptoms and aims to improve each woman’s quality of life.
- Painkillers
Simple painkillers like paracetamol or nonsteroidal anti-inflammatory drugs (NSAIDs) may relieve from pain caused by endometriosis. - Hormonal treatment
Endometriosis develops due to exposure to oestrogens. Hormonal treatments aim at reducing the levels of oestrogens in order to stop the development of the disease. Hormonal treatments are not suitable if a woman tries to get pregnant.
Hormonal treatments of endometriosis include:
- Contraceptive pill
Its use results in pain relief and reduction of blood loss during menstruation - Progestogens
Progesterone subdues the development of endometrium inside and outside of the uterus. - Intrauterine hormonal system Mirena
- Injectable hormones that cause artificial menopause are can be used usually for up to 6 months
Surgery
Endometriosis surgery is performed by laparoscopy. The purpose is to assess the extent of the disease and to remove endometriosis, causing as less damage as possible to the healthy tissues and especially to the ovaries and the fallopian tubes of women in child bearing age.
Endometriosis and fertility
Endometriosis may cause infertility as it often affects the anatomy and functioning of female reproductive organs, that is the ovaries and the fallopian tubes. The presence of endometriosis relates also to chronic inflammatory reaction that has adverse effects in fertility.
Surgical removal of endometriosis may not guaranty that you will conceive a baby, but the odds are improved. In cases of infertility that doesn’t respond to surgical treatment, IVF methods could be used.
Dr Tsoumpou is specialized in diagnosing and treating endometriosis. She believes in a personalized approach in treating endometriosis based on the specific symptoms of each woman.
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