Endometriosis impacts 1 in 10 women. Recognize the warning signs.

Understanding Endometriosis: A Personal Journey and Medical Insights British singer and songwriter Ella Henderson has shared her personal e...

Understanding Endometriosis: A Personal Journey and Medical Insights

British singer and songwriter Ella Henderson has shared her personal experience with endometriosis, a condition that affects one in 10 women and those assigned female at birth in the UK. In January, she received an official diagnosis, which she described as both devastating and empowering. “The last few years have been a little bit of a roller coaster,” she said in an Instagram video. “I’ve really been struggling not only with stomach bloating and physical pain but also with my mental health on the basis that I thought at one point that this was just all in my head and I wasn’t really believed.”

Henderson emphasized how the diagnosis helped her take control of her own body. “I feel very fortunate that I was able to have a laparoscopy earlier this year to find out what I do have. Speaking to other women who have endometriosis and learning about it and understanding it more, and about how to live with it, has been so crucial to me feeling like I am not alone.”

Her openness about the condition has been praised by Emma Cox, CEO for Endometriosis UK. She commended Henderson for sharing her story in such an open and frank way, highlighting the significant impact the condition can have on all aspects of someone’s life. “Ella’s willingness to share her story will no doubt help others in their diagnosis journey; helping them access the care they need.”

What is Endometriosis?

Endometriosis is an oestrogen-driven, chronic inflammatory condition where tissue similar to the lining inside the uterus (endometrium) grows outside the uterus, leading to various symptoms, including painful periods. According to Mr Hemant Vakharia, a consultant gynaecologist specializing in endometriosis and advanced minimal access surgery at London Gynaecology, the condition is often categorized into four main types based on the location, amount, and depth of endometrial lesions.

Here are some of the different types:

• Peritoneal (superficial) endometriosis – found mainly on the pelvic peritoneum.
• Ovarian endometriosis (endometrioma) – when endometriosis cysts are found in the ovaries.
• Deep endometriosis – found in locations such as the bladder, bowel, and recto-vaginal septum.
• Extra-pelvic endometriosis – when endometriosis is found outside the pelvis, such as the thorax or caesarean scars.

Common Symptoms of Endometriosis

Painful periods, known as dysmenorrhoea, is a common sign of endometriosis. Endometriotic cells are stimulated by hormones in your natural cycle, which causes inflammation and pain. Another typical sign is dyspareunia, the medical term for painful intercourse. The inflammation can lead to structures in the pelvis sticking together and also lead to thickening of tissues developing. As a result, patients with endometriosis can have pain with intercourse.

Endometriosis can also impact your bowels. In patients who have endometriotic deposits on the bowel, or in those where the inflammation has caused their bowel to stick to other structures, it can be painful to open their bowels. This can occur with their periods or all the time. Other issues include chest pain during your period, difficulty conceiving, and ovarian cysts.

Diagnosing Endometriosis

If you suspect you have endometriosis, it is a good idea to speak to your GP first. They will take a history from you and examine you. Often, they will request an ultrasound of the pelvis and discuss the results with you. However, endometriosis does not always show up on standard imaging, such as ultrasounds or MRIs. This is especially true in superficial endometriosis, where the signs can be very subtle or when the disease affects areas not easily visualised.

If you have been told your scan is normal but have persistent symptoms, such as chronic pelvic pain, heavy periods, or pain during sex, it’s essential to advocate for yourself and seek a specialist for further evaluation.

When to Seek Medical Help

It can be difficult to differentiate between ‘normal’ periods and ‘heavy or painful’ periods, as there is often no objective way of comparing. A lot of women just put up with that ‘time of the month’ and are told to get on with it. However, if you have to put your life on hold for those few days or if your sex life is affected by pain during sex, it is time to take note and ask for some tests.

Keeping a diary to track when your symptoms occur and how intense the pain is can be helpful. Note down if you have to take painkillers and how many. If the symptoms are affecting your life and you have to take time off work, that is also a significant factor.

Treatment Options for Endometriosis

Patients can be treated with the combined pill, progesterone-only pill, progesterone intrauterine device, or surgery. Sometimes, medications that induce a temporary menopause by blocking hormonal signals to the ovary which reduces stimulation of the endometriotic tissue are used. This option is often used before surgery for severe disease.

A laparoscopy will allow diagnosis and excision of disease which can improve symptoms. In patients with severe disease, they may need a two-stage procedure.