What Is Endometriosis 

Endometriosis is a disorder in which tissue similar to the endometrium (the lining of the inside of the uterus) grows outside the uterus, most commonly in the fallopian tubes, the ovaries, the urinary bladder, or the peritoneum. This tissue responds to the hormonal changes of the menstrual cycle, causing inflammation, pain, and in some cases is associated with subfertility. It is a common benign condition that affects about 10% of women of reproductive age and is closely linked to anxiety, as women with endometriosis are more likely to experience anxiety disorders due to chronic pain and other complications that affect their quality of life.

Symptoms of Endometriosis 

Endometriosis is characterised by symptoms that present in different ways from woman to woman, as some may experience mild symptoms while others have more severe symptoms. The most characteristic symptom is pain in the abdominal area. Other common symptoms include:

●    dysmenorrhoea with severe period pain, often resistant to simple painkillers.

●    pain during urination or bowel movements.

●    gastrointestinal disturbances, including diarrhoea, constipation, or blood in the stool, particularly during menstruation.

●    nausea.

●    heavy bleeding during the period.

●    pelvic pain, constant or recurring, in the pelvis or lower abdomen.

●    pain during or after sexual intercourse (dyspareunia)

●    fertility problems due to inflammation or adhesions caused by the condition.

What Causes Endometriosis  

The causes of endometriosis remain unclear, but the leading theories about how it develops include the following:

●    retrograde menstruation through the fallopian tubes

●    metaplasia of endometrial cells at the new site

●    immune alteration of the environment where it implants

●    subsequent development of sterile inflammation

The likelihood of developing endometriosis is higher in women who:

●    have not had children

●    have periods that last 7 days or longer

●    have a short menstrual cycle (less than 25 days)

●    experience severe period pain during menstruation or before it starts

How Endometriosis Is Detected – Diagnosis     

The diagnosis of endometriosis is a multifaceted process that combines clinical examination, imaging methods and, in some cases, surgery. A clinical examination may reveal painful nodules or masses, while an ultrasound and magnetic resonance imaging (MRI) can identify cysts or adhesions in various pelvic organs. However, the only definitive way to diagnose endometriosis is laparoscopy, during which a direct and accurate assessment is made of the extent and characteristics of the condition, as well as a biopsy for histological examination.

Treatment 

Treatment for endometriosis, while it may lead to complete elimination of the disease, often does not result in its permanent disappearance, as endometriosis tends to recur over varying periods of time. The goal of treatment is to relieve symptoms and improve fertility, where required. The approach is individualised and is based on factors such as age, symptoms and a woman’s personal goals, such as the desire to have children. The main treatment options for endometriosis include:

●    painkillers: Non-steroidal anti-inflammatory drugs such as ibuprofen are recommended in cases with mild symptoms.

●    hormonal therapy: The use of medications such as gonadotropin-releasing hormone analogues (GnRH-a) can temporarily stop menstruation and reduce pain by suppressing periods for 3–6 months. It may, however, also cause weight gain and other menopausal-type symptoms as side effects during the time it is used.

●    hormonal contraceptives: They allow a woman to maintain a regular cycle while also improving symptoms such as pain during menstruation or sexual intercourse by preventing the growth of endometriotic tissue.

●    surgery: This is recommended for women with suspected severe endometriosis who experience significant pain or fertility problems, and it may be performed by laparoscopy or laparotomy, depending on the case. Recovery after surgery depends on the extent of the procedure and may take from a few days to several weeks.

Obstetrician and surgeon gynaecologist M.R.C.O.G., C.C.T. D. Koleskas, with excellent theoretical training and practical experience in obstetrics and gynaecology, is able to answer your questions about what endometriosis is, how it is caused and how it is detected. With a patient-centred approach, he prioritises open communication with his patients, listening to their concerns and understanding their needs. In 2009, he specialised in advanced laparoscopy at the hospital Royal Victoria Infirmary, Newcastle, where he performed a large number of laparoscopic  procedures for the treatment of endometriosis. Certification from the Royal College of Obstetricians and Gynaecologists of the UK: Benign Gynaecological Surgery: Laparoscopy, R.C.O.G.

For more information about endometriosis, the available diagnostic and treatment options, as well as their cost,  please contact the doctor and schedule your appointment.