The Beginner’s Guide to Endometriosis

About 10% of women will be diagnosed with endometriosis during their reproductive years. This very painful condition can present as pelvic pain, debilitating pain with periods, pain with intercourse and urinary and bowel problems. The endometrium, or lining of the uterus, is a very special tissue. It grows each month and then sheds away in the form of a period. In endometriosis, this tissue is found in places that it should not exist. It may occur in the fallopian tubes, the ovaries, the bowel and the bladder. In these places it behaves in the same way, but there is no escape. The tissue then produces areas of hemorrhage and sometimes cysts in the ovaries called ovarian cysts.

What causes endometriosis?

It is not known what causes endometriosis. One theory is that some of the lining of the uterus travels backwards in the pelvis instead of “out” during menstruation. This is called retrograde menstruation. Another theory is that the tissue is just formed by itself in those areas.

How is endometriosis diagnosed?

The diagnosis of endometriosis is very largely based on history and examination. If there are large hemorrhagic cysts on the ovaries, they may be seen on ultrasound. For the most part, the spots are flat and cannot be seen on ultrasound. These areas may be seen through a small surgical procedure called laparoscopy. Laparoscopy, though considered minor, still has risks so the diagnosis is made clinically and treated as the first step.  

How is endometriosis treated?

There are a number of hormonal treatments used for endometriosis. Most women will have successful remission with these treatments. Occasionally, surgery to “clean up” the areas of endometriosis may be required. This treatment may be successful to resolve pain and scarring but does not “cure” the underlying disease as new lesions may form at a later time.

There are many organizations that provide support and helpful information about endometriosis.

https://endometriosis.ca/ – The World Endometriosis Society- research and advocacy

https://endometriosis.org/ – Provides information to help women become informed and empowered

Until there is a cure, we can at least manage pain and live full lives with endometrisosis.

Dr. Bhooma Bhayana

Dr. Bhooma Bhayana is a family physician in London and the mother of two young men and proud grandmother of three! She continues to find wonder and enjoyment in family practice despite more than 30 years on the job!