Women's Health

Endometriosis: What is Endometriosis? Endometriosis Symptoms, Treatment, Diagnosis

Medically reviewed by Dr. Choo Wan Ling

Endometriosis is a condition where the endometrium, tissue from the lining of the uterus, forms and grows in places outside the uterus.

Symptoms of endometriosis vary from woman to woman. Up to 50% of women diagnosed with endometriosis experience infertility. Some women also deal with painful periods and painful sexual intercourse among other symptoms, while others experience no symptoms at all and discover endometriosis only after an infertility evaluation.

The following is a list of symptoms and potential risk factors of endometriosis. If you’re experiencing any of these symptoms, you could speak to an experienced gynaecologist from SOG.

• Infertility
• General Pelvic Pain
• Heavy Menstrual Periods
• Painful Menstrual Cramps
• Painful Sexual Intercourse
• Depression and Fatigue
• Bladder Problems
• Constipation/Diarrhea
• Family History of Endometriosis

How Is Endometriosis Diagnosed?

The only way to confirm a diagnosis of endometriosis is with diagnostic laparoscopic surgery. This is an outpatient procedure that involves making a small incision in the abdomen, through which the surgeon inserts a tube with a special camera and, if needed, small surgical instruments.

Laparoscopic Surgery for Infertility

To diagnose endometriosis, the surgeon will look for visual evidence of endometrial growths. If found, a biopsy of the tissue may also be performed to confirm things. The doctor should also use the surgery to evaluate the severity of the endometriosis (known as staging). In mild to moderate cases, your gynaecologist may even treat the endometriosis during the diagnosis surgery.

While laparoscopic surgery is the only way to confirm endometriosis, your doctor may order other tests including ultrasound, MRI, or CT scan to investigate cysts or other reasons for pelvic pain or infertility.

How Is Endometriosis Treated?

Treatment of endometriosis will depend on the severity of the disease – if you’re experiencing pain, your age, and on whether you want to get pregnant. Some treatments for endometriosis would lead to decreased fertility, which would not be an option if you’re trying to conceive.

Some treatment options if you’re trying to conceive include:

Laparoscopic surgery to remove endometrial growths, scar tissue, and adhesions caused by the endometriosis. This is not a cure, and endometriosis may return later. However, some women will have increased fertility for up to 9 months after surgery.

In mild to moderate cases, IUI treatment along with fertility drugs may be used.

The pain of endometriosis may be treated with over-the-counter pain medications, acupuncture and lifestyle changes, such as regular exercise and diet changes.

Surgery to remove endometrial growths is also an option in treating the pain of endometriosis.

If you do not want to get pregnant, treatment options may also include hormonal treatments (which stop ovulation and prevent pregnancy) or, in cases of severe endometriosis, hysterectomy.

Hysterectomy, which involves removing the uterus alone or sometimes along with the ovaries, is considered a treatment of last resort. You cannot get pregnant after hysterectomy.

Speak to your gynaecologist before exploring this option.