Dr Ting Hua Sieng
Obstetrician & Gynaecologist
Source: Getty Images and Shutterstock
Endometriosis is a condition in which tissue that is similar to the lining of your uterus (the endometrium) grows outside of the uterine cavity and spreads to the ovaries, bowel, and tissues lining your pelvis.
The abnormal tissue can cause the area it affects to become inflamed. It can thicken, break down and remain in your pelvis, causing severe pain during your periods, and in some cases even bind pelvic organs together. There is also a risk of infertility, meaning that women who are trying for a child may face difficulty in becoming pregnant.
You may experience intense pain even though you have a mild form of the disease, or you may have a serious case and yet feel no pain at all. Your degree of pain should therefore not be used as an indication, stage or absence of the disease.
If you have two or more of the following symptoms, do see a gynaecologist for a more accurate diagnosis and treatment plan:
There are several theories about the cause of endometriosis. While the exact cause of endometriosis is unknown, here are a few factors that can possibly lead to the condition:
Regardless of the cause, it is important that the condition is accurately diagnosed so that appropriate treatment can be received. Your gynaecologist will request for your medical history and perform a physical exam to feel for any tell-tale cysts in your abdomen or scars behind the uterus. You may be sent for an ultrasound which can identify cysts linked to endometriosis.
To get an accurate diagnosis, your gynaecologist may order a laparoscopy (a minimally invasive surgery), which allows the surgeon to view the inside of your pelvis and remove offending tissue at the same time.
While there is no cure for endometriosis, the good news is that, once diagnosed, it can be managed through the reduction of your symptoms and management of potential complications.
Your gynaecologist will recommend more conservative medical treatments to see if your condition responds well before resorting to surgery. As everyone’s response to treatment is unique, there is no way to know how you will respond until you undergo different treatment options. Your gynaecologist will work with you to find the best option for you.
Discuss with your gynaecologist and be open about your mental health as this condition can take an understandable toll, especially in the stage where you are trying to find out which treatment works, dealing with intense pain and handling any fertility issues.
Here are the possible treatments your gynaecologist may take you through:
About one-third of women with endometriosis face difficulty getting pregnant. Those with a milder form of the condition may be able to conceive and carry a pregnancy to term without assistance, although the condition will have to be monitored throughout pregnancy.
If endometriosis is diagnosed early, your doctor may discuss the possibility of trying for children earlier rather than later as fertility risks grow with the disease.
When you are ready to try for a baby, your gynaecologist will recommend surgery to remove the endometriotic cysts. If this doesn’t work in your case, undergoing fertility treatment may help.
Managing chronic pain is a further complication of endometriosis. Work with your doctor to manage this as it can be debilitating and affect your daily routines.
Unsuccessful management of the pain or growing fertility concerns can cause depression and anxiety. Do be open with your gynaecologist about how you are feeling.
If you have endometriosis and decide not to receive treatment, your condition can grow more severe, and you may develop chocolate cysts otherwise known as ovarian endometriotic cysts. These are cysts containing old blood within the ovaries. In some cases, chocolate cysts can stop the ovaries from working and cause infertility.
If you suspect you may have endometriosis, book an appointment with your gynaecologist to receive a diagnosis. Even if your symptoms appear to be manageable now, the condition can worsen over time and lead to more difficulties in managing symptoms or complications such as infertility.