Signs and symptoms of endometriosis: Everything you need to know

Endometriosis is a condition that isn’t discussed enough, given that it can affect women of any age and affects a lot more of us than we realise. It’s a condition where tissue similar to the lining of the womb starts to grow in other places, such as the ovaries and fallopian tubes.

This is a long term condition that can have a significant impact on women’s lives and yet so many women are not aware of the signs and symptoms of this disease that is affecting 10% of women – that’s 176 million worldwide or else they are confusing it with the normal period symptoms.

It is important to know that there are treatments that can help with the effects of endometriosis, so knowing the symptoms is essential to identifying it in order to get treatment.

The symptoms can vary greatly form woman to woman. Some women are more adversely affected than others, who may not have as noticeable symptoms. However, there are some major signs from the NHS that there is consensus about that women should try to look out for:

• pain in your lower tummy or back (pelvic pain) – usually worse during your period
• period pain that stops you doing your normal activities
• pain during or after sex
• pain when peeing or pooing during your period
• feeling sick, constipation, diarrhoea, or blood in your pee during your period
• difficulty getting pregnant

You may also have heavy periods. You might use lots of pads or tampons, or you may bleed through your clothes.

In order to see if these symptoms are endometriosis, you will need to see a doctor or GP to confirm it. Something that may be helpful to do before seeing your doctor is keeping notes of when your symptoms arise, how painful or extreme they are and how often it’s happening. If these symptoms are having a major impact on your life, it’s important to see your GP as soon as you’re able to.

Although it may seem obvious to you what you’re experiencing, endometriosis is actually difficult to diagnose. Because the symptoms vary greatly, they overlap with many other conditions and illnesses that may be difficult to rule out.

During your GP appointment, your doctor will ask about your symptoms – which is why it’s great to have the notes on hand – and may ask to examine your tummy and vagina. Depending on whether or not they think you have endometriosis, they may recommend you begin treatment.

If treatments do not seem to be having any effect on the symptoms, you may be referred further, to a gynaecologist for more tests like an ultrasound or a 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 unfortunately the only way to be 100% certain you have endometriosis.

While there is no cure for endometriosis, there are lots of treatments that can help to ease the symptoms and their effect. According to the NHS, these include:

• painkillers – such as ibuprofen and paracetamol
• hormone medicines and contraceptives – including the combined pill, the contraceptive patch, an intrauterine system (IUS), and medicines called gonadotrophin-releasing hormone (GnRH) analogues
• surgery to cut away patches of endometriosis tissue
• an operation to remove part or all of the organs affected by endometriosis – such as surgery to remove the womb (hysterectomy)

You and your doctor will discuss which option is the best for you and may even suggest allowing the symptoms time to improve on their own.

The problem with endometriosis – apart from pain as well as the physical and mental impact – is that it can make getting pregnant very difficult or even impossible. Even removing endometriosis tissue does not guarantee that a woman would be able to conceive or will not experience difficulty conceiving. The surgery can cause further problems with infection, bleeding or damage to organs which can lead to infertility. Be sure to speak with your surgeon to ensure you understand all the risks before undergoing surgery.

Endometriosis is a condition that takes a toll not only on your physical health but also your mental health. Along with these physical signs, some women can experience feelings of depression, due to the impact that the physical signs are having on their day to day lives and their futures.

It is important to be informed and to be in contact with a support group. Your GP may be able to recommend one.

One of the more difficult aspects of diagnosing and being diagnosed with endometriosis, is that it is unclear what causes it. There are several theories, such as;

• genetics – the condition tends to run in families, and affects people of certain ethnic groups more than others
• retrograde menstruation – when some of the womb lining flows up through the fallopian tubes and embeds itself on the organs of the pelvis, rather than leaving the body as a period
• a problem with the immune system, the body's natural defence against illness and infection
• endometrium cells spreading through the body in the bloodstream or lymphatic system, a series of tubes and glands that form part of the immune system

But none of these theories fully explain why endometriosis happens and it's likely the condition is caused by a combination of different factors.

For more information, see here.