Endometriosis

What is endometriosis?

Endometriosis is a common disorder that affects many women in New Zealand. It may be that up to 1 in 10 women are affected. It occurs when endometrial tissue, which should only be found in the uterus, also grows outside the uterus, such as on ovaries or the bowel. This can be very painful and is why women with endometriosis usually have pain around the same time as their period.

Symptoms

The most common symptom you may experience is pain with periods. Other symptoms include pain with deep intercourse, pain with bowel motions during your period and difficulty falling pregnant. You may become hyper-aware of an impending period.

Common symptoms in the premenstrual phase in women with endometriosis include bloating, spotting, pain and general irritability.

Endometriosis may cause difficulty conceiving and is something fertility specialists will consider as a cause of infertility.

Not all women with endometriosis will be symptomatic, in some women it may be diagnosed incidentally.

Treatment

If you are experiencing pain with periods or other symptoms as described we recommend review by an experienced practitioner in this area. It may be a trial of hormonal therapy is a reasonable first step before more intensive options are considered such as laparoscopic (keyhole) surgery.

If it is not causing symptoms or problems conceiving it may not require any treatment.

How we can help

If you think you may have endometriosis and would like to talk to us about how we can help, please feel free to contact us. You can also request an appointment online.

Further reading

Aceso blog

Videos

For the Endometriosis part of this presentation, fast forward the video to 07:17.

Further information

Symptoms

Bleeding between periods

This is quite common, and if you experience just a single episode you need not be overly concerned. Common causes are oral contraceptives and other hormonal therapies. Persistent bleeding may be caused by genital tract infections, polyps within the uterus or cervix, or possibly cervical cancer. Find out more

Heavy periods

Typically women may menstruate (bleed) for 2-5 days, and lose around 30-40ml of blood. Abnormally heavy bleeding is when: your periods last longer than 7 days; the volume is more than 80ml; there is flooding or clotting; you are anaemic. Find out more

Infertility

As many as 1 in 6 couples in New Zealand have difficulty falling pregnant. Some causes of infertility in men are issues with sperm quantity and quality. Causes of infertility in women include problems with ovulation, endometriosis, tubal blockage, and issues with egg numbers or quality. Find out more

Irregular or unscheduled bleeding

There are a number of causes of irregular bleeding, and our investigations will depend a bit on your age and fertility plans. Common causes can include endometriosis, infection, instability of the lining of the womb, ovarian cysts, perimenopause, polycystic ovarian syndrome, polyps, and early pregnancy. Find out more

Painful bowel movements

Painful bowel movements (dyschezia) are extremely common. Causes include constipation, anal fissures and irritable bowel syndrome. If you have severe endometriosis, you may suffer from dyschezia during your period. You may also have extremely painful periods and pain with deep intercourse. Find out more

Painful periods

The medical term for painful periods is dysmenorrhoea. You may describe it as pain, discomfort or cramps around the time of menstruation. There are 2 types of dysmenorrhoea: primary and secondary. Find out more

Persistent pelvic pain

If you have pain on and off for more than 6 months we call it 'persistent pelvic pain'. There are a number of conditions that can be involved, and sometimes more than one will be present. In some cases the cause is obvious, such as an ovarian cyst, or a urinary tract infection, but in other women the cause is elusive. Find out more

Prolonged periods

If your period lasts more than 7 days, you have prolonged bleeding. The term is often used synonymously with menorrhogia (heavy bleeding), but is more descriptive of periods that go on for an annoyingly long time. Find out more

Procedures

Endometriosis resection

This entails keyhole surgery, where a camera is placed through the bellybutton to view the pelvis. The abdomen and pelvis are carefully explored, and abnormal tissue removed. Cysts may also be removed from the ovaries. Find out more

Hysterectomy

A hysterectomy is when a woman's uterus is removed. This may be because methods to stop heavy bleeding are not successful, side effects of medications are intolerable, fibroids are problematic or endometriosis is severe enough that a more permanent solution is required. Find out more

Mirena

A mirena is a small plastic device placed inside the uterus with small strings extending out through the cervix. In addition to being used for contraception, mirena can be used to treat adenomyosis and endometriosis. Find out more Find out more