Do you know about Endometriosis?
6th March 2018
Over 1.5 million women in the UK are affected by Endometriosis, a condition where cells like the ones in the lining of the womb are found elsewhere in the body.
This Endometriosis Awareness Week we sat down with Consultant Obstetrician and Gynaecologist, Ms Eleni Mavrides, who forms part of the London Wellwoman Clinic, to discuss the often misdiagnosed condition.
Tell us about your experience in treating Endometriosis?
I am a Laparoscopic Surgeon at the Hospital of St John & St Elizabeth and I have specialised in Endometriosis extensively over the last 10 years.
How common is Endometriosis?
It’s very common, it is estimated that up to 7-10% of British women may have it but many aren’t symptomatic. The condition shares similar symptoms with a variety of other conditions. Recent studies show that it takes on average 7.5 years between women first seeing a doctor about their symptoms and receiving a firm diagnosis.
What are the symptoms to look out for?
The most common symptom is pelvic pain, this could be either cyclical periods, pain during intercourse or pain throughout the cycle. Other common symptoms include abnormal bleeding.
Who is at risk of developing Endometriosis?
Most typically it affects young women because they are in the pre menopause state. It is unusual to be affected after menopause, as this generally improves the condition. Endometriosis can present as early as the teenage years, with the typical age ranging from 20 to 40.
Can Endometriosis affect your fertility?
Yes, it can. Endometriosis is associated with a difficulty in getting pregnant. There are lots of other factors that could contribute to fertility issues with Endometriosis taking around 20% of the reason. We don’t fully know the mechanisms as to why Endometriosis affects fertility but occasionally if the condition is very advanced before any treatment, then scar tissue can affect the fallopian tubes.
Can sex be painful? What help would be given?
Every time you have a period Endometriosis causes scar tissue that behaves like the lining of the womb in different areas of the body, this is most common behind the womb attachment to the back bone. These areas get disturbed with sex or periods. Combined with the pill or coil, a patient will have improvement of symptoms but Endometriosis won’t be completely cured, as you are effectively putting the disease to sleep whilst avoiding surgeries.
Do you think initiatives such as Endometriosis Awareness Week are important?
I think they are absolutely crucial, as lots of women suffer in silence and have never even heard of the condition. It’s very important to make the general public aware of the symptoms and where to seek help. It’s paramount to help get an early diagnosis before the condition progresses as the condition can affect your entire life, both physically and mentally. Early diagnosis can ensure an appropriate treatment and solution before the condition worsens, there is currently a lot of work from the Royal College of Obstetricians and Gynaecologists to improve the outcomes.
What treatment options are currently available?
For younger women who suffer advanced Endometriosis we tend to give injections to stop periods, we make them temporarily menopausal as this helps with surgery. Initial treatment could begin with simple painkillers such as mefenamic acid. If the problem persists then stronger hormonal treatment would be recommended to stop the periods. This can be done by combining the contraceptive pill and progestins which should reduce periods in 12 months.
Surgical options include Laparoscopy, which is normally a telescope inserted through the belly button (small). This magnifies the image of the pelvis to look for Endometriosis; we tend to treat symptoms at the same time. Treatment would be laser or diathermy, adding heat to the area to burn or excise it. I always excise to remove tissue so it doesn’t come back and then send the sample to the laboratory. It could be from stage 1 to 4; stage 1-2 can be done in one stage whereas stages 3-4 are done in two stages, as we need to avoid bowel complications.