This month is endometriosis awareness month, an initiative that aims to raise awareness for the 176 million women living with the disease worldwide, 1.5 million of those being in the UK – that is 1 in every 10 women being affected. It is a devastating and debilitating condition strongly associated with diagnostic delay: according to Endometriosis UK, research shows that there is now an average of 7.5 years between women first seeing a doctor about their symptoms and receiving a firm diagnosis.
What is endometriosis?
Endometriosis is a chronic condition that causes painful and/or heavy periods. Cells similar to those in the lining of the uterus are found elsewhere in the body, such as the ovaries and fallopian tubes, and each month these cells react in the same way as those in the womb, building up and then breaking down and bleeding. However, unlike the cells in the womb that leave the body as a period, this blood has no way to escape which can cause inflammation, pain, and the formation of scar tissue.
The cause of endometriosis is not known. Several theories have been suggested, including genetics; 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, or the spreading of endometrium cells through the body in the bloodstream or lymphatic system. But none of these theories fully explain why endometriosis occurs. It's likely the condition is caused by a combination of different factors.
What are the symptoms?
These vary in severity for each woman, but the most common symptoms of endometriosis include:
- Painful, heavy, or irregular periods
- Pain during or after sex
- Painful bowel movements
- Difficulties in conceiving
Women with endometriosis also report a range of other symptoms including pain when passing urine, back and leg pain, constipation or diarrhea, excessive bloating as well as a lack of energy and even depression. As these symptoms can also be attributed to many other conditions such as irritable bowel syndrome, endometriosis can often be misdiagnosed for a very long time. Usually, the diagnosis is confirmed by a surgical procedure called a laparoscopy which involves making a small incision, allowing a camera to be inserted to confirm the presence of endometrial tissue outside of the womb.
One of the most commonly reported symptoms is very chronic period pain, usually in the lead up to and during your period. Whilst some mild pain and discomfort is common during your cycle, severe and crippling pain is not and it should not be passed off as ‘normal’. If it is so severe that it is preventing you from carrying out your day-to-day activities, causing you to miss days of work and negatively impacting on your relationships, you should speak with your GP and ask for further investigations.
Can it affect my fertility?
Endometriosis does not necessarily cause infertility but there is a strong and undeniable connection with fertility problems and it is common in those women having trouble conceiving. Although the causes are not fully established, it is thought that endometriosis could prevent a natural conception because of damage to the fallopian tubes or ovaries. Adhesions could also be trapping the egg in the fallopian tube, stopping it from reaching the uterus. It can also cause a hormonal imbalance which can affect the regularity of your menstrual cycles. Recently, promising new findings from researchers at the University of Southampton and Princess Anne Hospital's Complete Fertility Centre has highlighted that endometriosis may affect the quality of eggs by preventing them from maturing properly and therefore meaning they cannot be fertilised. 
As it is so often misdiagnosed, or symptoms simply brushed off as just a ‘heavy, painful period’, endometriosis could go undetected as the underlying cause for many couples’ infertility. Something else to consider is that some women may have no symptoms at all and are unaware that they may have this condition that could be a contributing factor to their fertility issues. It is therefore important to ensure that your GP and fertility specialists investigate this as a possible cause whether you are displaying obvious symptoms or not.
What can be done to help?
Unfortunately, there is currently no cure for endometriosis but there are treatments that can help ease the symptoms so that the condition does not interfere with your daily life. Support from self-help groups, such as Endometriosis UK, can be very useful if you’ve recently been diagnosed and are learning how to manage the condition.
Your healthcare professional will consider many different factors when working out the best endometriosis treatment method for you, such as your age, the severity of endometriosis you have and the severity of your symptoms. These may include:
- Surgery - in the form of a hysteroscopy and/or laparoscopy to remove some of the tissue.
- Hormone treatment - this aims to block or reduce the production of estrogen which endometriosis responds to and grows when exposed.
- Pain relief – this could be from medication, physiotherapy, TENS machines or heat therapy.
- Holistic therapies – acupuncture and reflexology which provide pain relief, reduce inflammation and help to regulate hormone levels associated with this condition.
- Diet – as this is an inflammatory condition, having better nutritional awareness can help you manage and control it.
The founders of the Natural Fertility Clinic, Verity Paz and Katy Flello, both have personal experience of endometriosis and the impact it has on women’s health and well-being. After many years of suffering with the symptoms and the condition being undiagnosed, both successfully used acupuncture and reflexology along with a carefully managed diet to ease the symptoms and improve their fertility. This first-hand experience means that they fully understand the impact endometriosis can have and are in the best position to offer support and advice for managing endometriosis, in addition to many other related areas. Along with their team of highly trained therapists, they are passionate about providing the best possible care for their clients, helping to improve their quality of life through a range of holistic treatments such as reflexology, acupuncture and massage as well as diet and nutritional advice.
If you think you may be suffering with endometriosis or have recently been diagnosed, please contact the team at the clinic for a free telephone consultation to discuss your personal situation in more detail and find out how they can support you further.
By Suzanne Higgins