Endometriosis affects more than 1 in 10 women in the United Kingdom yet it is a condition seldomly discussed and takes an average of 9 years to receive a diagnosis.

What is it?

Endometriosis is a medical condition where tissue similar to the lining inside the uterus (called the endometrium) starts to grow outside the uterus. This tissue can be found on the ovaries, fallopian tubes, or other organs.

(Diagram from Cleveland Clinic 2021)

Why it can be painful:

1. Tissue Growth and Inflammation: Just like the normal uterine lining, this misplaced tissue thickens and breaks down each month during periods. However, since it’s outside the uterus, it has no way to exit the body. This causes inflammation, which can lead to pain, swelling, and irritation in the surrounding areas.
2. Scar Tissue and Adhesions: Over time, the inflammation can cause the tissues to stick together in ways they normally wouldn’t. This scar tissue, called adhesions, can cause organs to fuse together, making movement and normal functioning more painful.
3. Pain During Periods (Menstrual Cycle): Since this tissue still responds to hormonal changes, those with endometriosis may experience severe cramps, lower abdominal pain, and back pain during periods. This can be way more intense than typical period cramps.
4. Chronic Pain: The ongoing inflammation and irritation can lead to chronic pain, which might not just happen during periods but could be a constant issue, affecting daily life.
5. Pain during / after sex (dyspareunia): Inflammation caused by endometriosis can make sex painful during and after. Endometriosis can also cause tension in the muscles of the pelvic floor resulting in muscle spasms during sex.

How can endometriosis be treated?

The choice of treatment depends on the severity of the symptoms, the extent of the endometriosis, and whether the patient is trying to become pregnant. Here are the main options:

1. Pain Relief Medications
Over-the-Counter Painkillers: Medications like ibuprofen or paracetamol can help reduce pain and inflammation.
Prescribed Medications: Doctors may prescribe stronger pain medication.

2. Hormonal Therapies
Birth Control Pills: These can help regulate or stop periods, reducing pain and slowing the growth of endometrial tissue.
Hormonal Patches, Rings, IUD/IUS (intrauterine device/system): Similar to birth control pills, these provide hormones that can help manage symptoms.
Progestin Therapy: Progestin-only pills, injections, or implants can help reduce or eliminate menstruation, which may lessen pain.
GnRH Agonists: These medications create a temporary menopause-like state to reduce estrogen levels, which slows the growth of endometrial tissue.
Danazol: This is a synthetic hormone that can help reduce symptoms by decreasing estrogen levels.

3. Surgery
Laparoscopy: A minimally invasive surgery used to diagnose and remove or destroy endometrial tissue. It can provide relief from symptoms and improve fertility.
Hysterectomy: In very severe cases, the uterus (and sometimes the ovaries) may be removed. This is usually considered only if other treatments haven't worked and if pregnancy is no longer a concern.

4. Lifestyle and Home Remedies
Heat Therapy: Using a heating pad or hot water bottle on the pelvic area can help relieve cramps and pain.
Exercise: Regular physical activity can help reduce pain and improve overall wellbeing.
Diet and Nutrition: Some people find that certain dietary changes, like reducing caffeine or increasing omega-3 fatty acids, can help manage symptoms.

5. Alternative Therapies
Acupuncture: Some people find relief from pain through acupuncture, a practice involving inserting thin needles into specific points on the body.
Herbal Supplements: While not universally recommended, some may find relief with herbal remedies. Always consult a healthcare provider before starting any supplements.

6. Fertility Treatment
If endometriosis affects fertility, treatments such as in vitro fertilization (IVF) may be recommended to help with conception.

7. Psychological Support
Counselling or Therapy: Talking to a mental health professional can help manage the emotional and psychological impact of living with endometriosis.

It's important to work with a healthcare provider to determine the best treatment plan for your specific situation. They can help tailor treatments to effectively manage symptoms and address any concerns about fertility or quality of life.

How can we support our loved ones with endometriosis?

People suffering from endometriosis may often choose not to talk about it due to taboos and social stigmas surrounding women's health or just because it's personal and they don't want to, which is also okay. The best way to support loved ones who you know suffer from endometriosis is to be there for them without judgement. They may need support with the physical pain, especially during their periods so it is nice to offer any assistance whether this may be helping them with meals or small things like helping with dishes, little acts of kindness can make a huge impact for them. Endometriosis can also have heavy impacts on their mental health, living with chronic pain and other impacts of the illness such as issues with fertility can take a toll on their mental wellbeing so offering support or just a shoulder to cry on can really help your loved one.

Support groups

If you are suffering with endometriosis there are many support groups across the UK in person in hospitals or online, for example facebook groups which can be a nice way to receive support and advice from others with endometriosis. Endometriosis can often be dismissed or misdiagnosed and taking part in these groups can also help provide support to advocate for yourself both in the medical system and in daily life.