More often than not, women are afflicted by unexplained stomach pain. Often the pain will go undiagnosed, and many are left despondent, unsure what is causing the discomfort they simply cannot shake. It is one of the perils of women's health, and a common culprit is endometriosis. A condition impacting a large amount of Australian women, knowing what endometriosis is and the symptoms to look for is one way you can look after your own health. Of course, it is always best to speak with your health professional swiftly about any concerns you may have about your own health. Read on to learn more about the disease, its causes and the treatment available.

What is endometriosis?

You have likely heard of – or know someone with – endometriosis as one in nine Australian women develop the condition by their 40s, and it causes thousands of hospitalisations each year. It is a progressive, chronic condition and can be painful and impact fertility. 

Endometriosis is when the endometrium cells similar to that which line the uterus (womb) begin to grow in other parts of the body, typically the pelvis falling victim. Even though these cells are not in the uterus, they still respond to signals from the ovaries. Thus, the endometriosis tissue fills each month and bleed when a woman is menstruating. Over time, this can lead to inflammation and scarring, causing organs to stick together in places, with this known as adhesions. 

What are the symptoms? 

The symptoms of endometriosis are similar to that of typical period pain, yet on a much higher pain scale. It can leave some women in debilitating pain, impacting their ability to complete daily tasks, work or socialise. 

Common symptoms of endometriosis include: 

• Abdominal or pelvic pain before and during a period, after intercourse or when urinating. This pain is often also felt in the thigh of leg and may worsen over time
• Heavy periods or irregular bleeding, or bleeding longer than normal. 
• Feeling bloated with or without pain 
• Fatigue, particularly around when a period is due 
• Not being able to fall pregnant. 

What causes endometriosis?

In what seems to be a common theme with pain afflicting women, the cause of endometriosis is not known. However, there are a few factors that can put women at risk of developing it, including: 

• Retrograde menstruation. This is when instead of blood flowing out of the body, some travels into the fallopian tubes and into the pelvis. This blood may contain cells from the endometrium and it some cases can stick onto the surface of the pelvic organs and start growing.
• A family history of Endometriosis means you may have an increased risk of developing the condition. Those with a close relative affected by the condition are seven to 10 times more likely to develop it. 
• Normal pelvic tissue can turn into endometriosis, a process called metaplasia. 

Other contributing factors which may indicate endometriosis include: 

• Long, heavy periods 
• Frequent periods 
• Shorter menstrual cycles 
• Commencing your period before the age of 11
• Immune system problems 
• Low body weight 
• Excess alcohol consumption 

How is endometriosis diagnosed?

Endometriosis is often missed by medical professionals and can take several years to be diagnosed. The average period before diagnosis is a hefty seven years of living in the unknown, not understanding why you feel the way you do. Many women may find out they have the condition when they are speaking with a doctor about infertility, or when being operated on for a different reason. 

The only way to confirm an endometriosis diagnosis is to have a laparoscopy, a procedure allowing doctors to look for endometriosis tissue in the abdomen. This is followed by a biopsy, where a small sample of the tissue is taken and examined. 

There are also stages of endometriosis, and they include the following: 

• Stage/grade I (mild): small patches of endometriosis inside the pelvis.
• Stage/grade 2 and 3 (moderate): the disease is more widespread and may be found on the ovaries and parts of the pelvis, alongside significant scarring and adhesions.
• Stage/grade 4 (severe): it has spread to most of the organs in the pelvis. 

How can it be treated?

People with endometriosis will be cared for by a gynaecologist and it can usually be treated with medicines, surgery and complementary treatments like physiotherapy and psychology. The treatment you receive will depend on the following: 

• Symptoms presented
• The severity of the endometriosis 
• Whether you plan to become pregnant

Medicines for endometriosis commonly prescribed include hormone-based treatment, including the pill, or an implant or IUD. Hormone treatments may reduce pain and growth of the endometrial cells, however they work only as long as they are taken. Thus, if you stop taking them, the endometriosis may come back. 

Surgical treatments is undertaken with the aim of removing as much endometriosis as possible, with the options including laparoscopic surgery whereby a small incision is made in the abdomen to remove the endometrial tissue. In severe cases, a hysterectomy may be recommended. 

If you have any symptoms or concerns about your health, talk with your health professional.

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