When To See A Gp
See a GP if you have symptoms of endometriosis, especially if they’re having a big impact on your life.
It may help to write down your symptoms before seeing a doctor.
It can be difficult to diagnose endometriosis because the symptoms can vary considerably, and many other conditions can cause similar symptoms.
They may recommend treatments if they think you have endometriosis.
If these do not help, they might refer you to a specialist called a gynaecologist for some further tests, such as an ultrasound scan, MRI or laparoscopy.
A laparoscopy is where a surgeon passes a thin tube through a small cut in your tummy so they can see any patches of endometriosis tissue.
This is the only way to be certain you have endometriosis.
How Can I Prevent Endometriosis
You can’t prevent endometriosis. But you can reduce your chances of developing it by lowering the levels of the hormone estrogen in your body. Estrogen helps to thicken the lining of your uterus during your menstrual cycle.
To keep lower estrogen levels in your body, you can:
- Talk to your doctor about hormonal birth control methods, such as pills, patches or rings with lower doses of estrogen.
- Exercise regularly .2 This will also help you keep a low percentage of body fat. Regular exercise and a lower amount of body fat help decrease the amount of estrogen circulating through the body.
- Avoid large amounts of alcohol. Alcohol raises estrogen levels.3 No more than one drink per day is recommended for women who choose to drink alcohol.
- Avoid large amount of drinks with caffeine. Studies show that drinking more than one caffeinated drink a day, especially sodas and green tea, can raise estrogen levels.4
Pain Associated With Minimal Endometriosis
Minimal endometriosis does not mean minimal pain. In fact, the opposite may be true- minimal, smaller lesions can produce a large number of prostaglandins that can lead to major pain. While this is an older study and microscopic endometriosis is debated, it is an interesting study demonstrating the appearance of lesions and the related pain felt. The research was done using laparoscopy under IV conscious sedation. Researchers identified that more pain was felt by the patient for some colors of lesions versus other colors. They also discovered that palpation of the endometriosis lesions produced the pain of cramps, not the uterus. Location of the endometriosis lesions in certain areas reproduced pain in other areas of the body, such as lesions on the utero-sacral ligaments lead to cramps in the back or those on the side wall of the pelvis led to pain radiating down the leg.
- See what Nancy Petersen has to say about minimal endometriosis here.
- Video published by Dr. David Redwine on the appearance of endometriosis: The visual appearance of endometriosis and its impact on our understanding of the disease
- Demco, L. . Review of pain associated with minimal endometriosis. JSLS: Journal of the Society of Laparoendoscopic Surgeons, 4, 5. Retrieved from
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Endometriosis Of The Appendix
Endometriosis occurs when tissue resembling the endometrium starts to grow outside the uterus. This usually occurs in or around the reproductive organs. However, in rare cases, the disease can spread to other areas such as the bladder, kidneys, lungs, bowels, and appendix.
It is not clear how common endometriosis of the appendix is, and there is great variation in the rate of appendiceal involvement with numbers ranging from 1 to 22%.
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Indeed, both chronic fatigue and fibromyalgia are conditions that have been linked with endometriosis, though again it isn’t clear whether endometriosis causes these symptoms. Rather, it’s thought that women with endometriosis may simply have a higher incidence of many autoimmune conditions, including chronic fatigue as well as allergies, asthma, multiple sclerosis, lupus, hypothyroidism, and certain cancers.
In hindsight, Surgeoner believes that the fact that she used birth control pills through most of her 20s was probably a blessing, given that birth control is one of the key treatments for managing endometriosis.
Suppressive medications that is, birth control taken continuously is a mainstay of endometriosis treatment, says Leena Nathan, MD, an assistant clinical professor of obstetrics and gynecology at UCLA Medical Center. “The goal is to minimize or avoid a period as much as possible, she says, because that helps to avoid the pain and scarring from the period and can even prevent the progression of the disease. Certain types of birth control result in having a period only a few times a year, but, says Dr. Nathan, most of my patients are pretty savvy and know how to just skip the monthly placebo pills and go on to the next pack.
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Lack Of Progress In Endometriosis Pain Treatment And Research
In general, progress in endometriosis awareness and treatment has been slow since it falls within an under-funded field. Researchers and clinicians have acknowledged the need to allocate more resources to better understand endometriosis. Being a disease with a commonly delayed diagnosis, the need to train healthcare providers to recognize it is evident.
The progress for educating about and treating endometriosis has been slow, and little change has been made to treatment strategies over the past two decades.
“ore than half of endometriosis patients had been told by healthcare providers that nothing was wrong with them. This is a major concern.” –Sawsan As-Sanie, M.D., MPH
How To Be Taken Seriously By Healthcare Providers
It can be challenging to put your experience with pain into words during a short visit with a physician. Patients want to be able to explain the intricacies of their pain, and a number scale does not paint the whole picture for their healthcare provider to understand their experience.
Research about pain has found that there are at least five aspects to describing pain that are important to capture a patients experience. These areas are pain intensity, pain quality, pain location, pain interference, and pain temporality. Even though many people experience pain, there continues to be a gap when it comes to communicating about pain between patients and healthcare providers. Even though they want to gain as much insight as possible, patients have reported sharing their concerns during less than a quarter of visits with a healthcare provider.
Making physicians understand their pain is even more difficult for people with disabilities. The complexity of interaction between their disability and pain makes it harder for people with disabilities to explain their experiences. On top of this burden, practitioners have expressed feeling less comfortable communicating with patients who have physical disabilities.
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Endometriosis Overview: What Is Endometriosis
Endometriosis is a disease in which the endometrium is present outside of the uterus. Endometriosis most commonly occurs in the lower abdomen or pelvis, but it can appear anywhere in the body. Symptoms of endometriosis include lower abdominal pain, pain with menstrual periods, pain with sexual intercourse, and difficulty getting pregnant. On the other hand, some women with endometriosis may not have any symptoms at all.
Approximately 10% of reproductive-aged women have endometriosis. However, the true prevalence is unknown since the diagnosis requires laparoscopy to visualize and biopsy endometriosis lesions. Endometriosis is seen in 12-32% of women having surgery for pelvic pain, and in up to 50% of women having surgery for infertility. Endometriosis is rarely found in girls before they start their period, but it is seen in up to half of young girls and teens with pelvic pain and painful periods.
Pain In The Lower Back Abdomen Or Groin
As a teenager, I suffered from massive lower back pain during my period. Having no way of knowing this was not a normal symptom, my stepmother assured me it would get better. And in a way, her prediction was correct, except the pain migrated to my abdomen and inner thighs.
Sometimes the pain is sharp, other times its similar to the dull ache you experience post-ab workout. Dr. Levine explains why: The nerves associated with the deep pelvis overlap with the nerves of the lower-back, abdomen, groin, and lower extremities. Extreme inflammation and irritation can lead to chronic pain of these associated structures.
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The Illusive Condition Of Endometriosis
When the tissue lining of your uterus grows outside the uterus, this is known as endometriosis. It can grow on your reproductive organs like your ovaries, your bowel, or on the tissues lining your pelvic area.
Each month the hormones controlling your menstrual cycle irritate those misplaced tissues causing a myriad of symptoms. As time passes, the tissue will grow, thicken, and break down. When it does break down, it becomes trapped in the pelvis which leads to all kinds of symptoms.
What Other Health Conditions Are Linked To Endometriosis
Research shows a link between endometriosis and other health problems in women and their families. Some of these include:
- Allergies, asthma, and chemical sensitivities8
- Autoimmune diseases, in which the body’s system that fights illness attacks itself instead. These can include multiple sclerosis, lupus, and some types of hypothyroidism.9
- Certain cancers, such as ovarian10 and breast cancer11
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How Women Bipoc Lgbtqia+ Peoples Pain Is Downplayed By Healthcare Providers
Downplaying the concerns of women is a broadly recognized problem within the realm of healthcare. Compared to men, both doctors and nurses prescribe less pain medication to women post-surgery. This occurs, despite reports of pain being both higher and more frequent among women.
According to a study from the University of Pennsylvania, women wait an average of 16 more minutes compared to men to receive pain medication in the emergency room. They are also more likely to have their pain dismissed as emotional distress. Pain dismissal is no stranger to people with chronic illness. A large survey was conducted for women who experience chronic pain. The results show that 84% of women with chronic pain feel discriminated against based on their sex when seeking care.
It is not just women who are at risk of receiving less than optimal healthcare. In the United States, in particular, disparities in health and healthcare take a toll on non-white and non-CIS populations as well.
A post shared by Endo Black, Inc. on Sep 16, 2020 at 6:52am PDT
In the United States, healthcare does not look the same for all races and ethnicities. Minorities are less likely to receive optimal treatment compared to whites. The diversity of the workforce within healthcare is not representative of the diversity in the population.
Signs You May Have Endometriosis
Posted on by North Georgia Women’s Center
Endometriosis is a confusing condition with various symptoms, no symptoms, or severe symptoms. Its not always easy to diagnose, leaving many women to suffer with pelvic pain and other unpleasant symptoms for years. Here are six signs you may have endometriosis.
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Relationship Of Endometriosis To Infertility
Endometriosis is considered one of the three major causes of female infertility. According to the American Society for Reproductive Medicine, endometriosis can be found in 24 to 50 percent of women who experience infertility. In mild to moderate cases, the infertility may be temporary. In these cases, surgery to remove adhesions, cysts and scar tissue can restore fertility. In other cases a very small percentage women may remain infertile.
How endometriosis affects fertility is not clearly understood. It is thought that scar tissue from endometriosis can impair the release of the egg from the ovary and subsequent pickup by the fallopian tube. Other mechanisms thought to affect fertility include changes in the pelvic environment that results in impaired implantation of the fertilized egg.
Endometriosis Symptoms You Shouldnt Ignore
March is Endometriosis Awareness month and while the disease affects an estimated 200 million women worldwide like myself, and was one of the , endometriosis symptoms are often missed or ignored. And theres good reason why this occurs.
But first, let me dispel a pervasive and damaging myth about endometriosis: Its not that women are scared or embarrassed to share these symptoms or confide in their doctors. The problem is that many of us still dont know what the possible signs of endometriosis are. Had I known my debilitating cramps and chronic pelvic pain were an indication of something more serious than just an unfortunate menstrual cycle, I would have brought these concerns directly to my OB-GYN.
Many endometriosis symptoms have been normalized by our culture, hovering under the golf-sized umbrella with the label female problems. The injustice in this is when the invisible illness is diagnosed and managed earlier, women have better options and better help managing their pain. Even though there is no known cause or cure, a diagnosis is critical in creating a care plan with your doctor to help mitigate these symptoms and puts an end to the question, what on earth is wrong with me?
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How Does Endometriosis Affect Fertility And My Ability To Get Pregnant
Almost 40% of women with infertility have endometriosis. Inflammation from endometriosis may negatively impact the function of the ovary, egg, fallopian tubes or uterus. In addition, scar tissue that is often present in patients with endometriosis can cause blockage or distortion of the fallopian tubes so they are unable to pick up and transport the egg after ovulation.
Can Bowel Endometriosis Be Treated By Minimally Invasive Techniques
Yes, but only by an extremely experienced surgeon. Operating on or near the bowels can be very dangerous and only those surgeons highly skilled at video-assisted laparoscopy and robotic-assisted laparoscopy should be treating bowel endometriosis. In terms of experience and advanced skill, youve definitely come to the right place because Dr. Camran Nezhat and his brothers, Drs. Farr and Ceana Nezhat, were actually the ones who first performed these advanced minimally invasive surgeries for the treatment of all forms of endometriosis, including bowel endometriosis. They achieved this revolutionary change to surgery nearly 3 decades ago, in the days when others were still derisively dismissing minimally invasive surgery as barbaric. .
Because of their extensive experience, Dr. Camran Nezhat and his brothers have found that the more conservative procedure called disc excision of the bowel is better for the patient. A disc excision of bowel endometriosis is where a circular portion around the endometriotic lesion is removed and the bowel is then repaired with sutures and staples. Utilizing this conservative approach means that an entire portion of the bowel does not need to be removed, which reduces the risk of any potential complications. Only in selective cases where there is severe stricture of the bowel or conservative management has failed, is a complete bowel resection needed.
Other symptoms of bowel endometriosis include diarrhea the antithesis of constipation.
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Does Endometriosis Go Away After Menopause
For some women, the painful symptoms of endometriosis improve after menopause. As the body stops making the hormone estrogen, the growths shrink slowly. However, some women who take menopausal hormone therapy may still have symptoms of endometriosis.
If you are having symptoms of endometriosis after menopause, talk to your doctor about treatment options.
Endometrial Lesions Can Grow In A Variety Of Places In The Bodythe Location Of The Lesion Can Affect Your Symptoms
- Pain from an ovarian cyst called an endometrioma
- Pain above the pubic bone during urination
- Frequent and urgent need to urinate
The location of endometrial lesions can affect symptoms
The specific symptoms a woman with endometriosis experiences may be a result of where her endometriosis is located.
Expand the + for symptom information
Endometrial lesions are most commonly found in the pelvic area on organs such as:
- Rectovaginal septum
Since lesions can grow in a variety of locations in the body, this may explain why one woman may feel pain on the left side of her pelvis, while another may feel it in her abdomenthe pain often occurs where the lesions are located.
Some lesions can even form their own nervesanother reason there can be pelvic pain outside of the period. Over time, lesions can form scar tissue or adhesions between organsmeaning they stick togetherwhich can cause even more pain.
Rarely, lesions can be found in areas farther away from the pelvic area.
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Severe Endometriosis Pain Or Flares Described By Endowarriors
Flares take a devastating physical and mental toll on people with endometriosis. To better understand what some of them go through, we have gathered some quotes in which they explain what an endo flare feels like to them.
A post shared by Kristin Asker on Sep 21, 2020 at 10:53am PDT
“It literally feels like somebody is carving your insides out like a pumpkin with a knife that is on fire. It feels like there’s a cat trapped in your lower back and your lower abdominal trying to claw its way out. And it feels like there are fireworks exploding all over your body.”– Star Sinead Smith