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Endometriosis symptoms

Endometriosis causes serious pain and cramps in some women, while others only have a little discomfort or notice nothing at all. Women usually have endometriosis symptoms during their menstrual period, but may also experience them at other times. The severity of symptoms does not always depend on things like the extent of endometrial tissue growth a woman has in her body.Endometriosis is a condition where the kind of tissue that normally lines the womb (endometrial tissue) grows in other parts of a woman’s body too. These “growths” are known as endometrial implants. They do not always cause pain. Endometriosis can lead to various symptoms, depending on things like how many endometrial implants a woman has, and where they are in her body. The most common symptoms are:Very painful menstrual periods (dysmenorrhea): When a woman has her period (menstruation), the muscles in the wall of her womb repeatedly tighten and squeeze in order to shed the lining of the womb. This can cause period pain. Women who have endometriosis may have particularly severe pain and cramping during their period. Many girls and women think this is normal because things have always been that way for them. It never crosses their mind that their severe period pain might be caused by a medical condition like endometriosis.Pain during sex (dyspareunia): This pain is usually described as burning or cramp-like pain. Sometimes women only feel it after they have finished having sex.Abdominal (lower belly) pain: Various degrees of pain may be felt in different parts of the abdomen, sometimes radiating to the back or legs. The pain is not necessarily associated with women’s menstrual period. Permanent (chronic) abdominal pain tends to be rare.Gastrointestinal (stomach and bowel) problems: If endometriosis affects a woman’s bowel, she might feel full or have painful bowel movements. If it affects her bladder, passing urine might hurt.General exhaustion: Severe and frequent endometriosis symptoms often lead to general exhaustion. This makes women less able to cope with physical and mental strain.All of these symptoms can be caused by other things too, so endometriosis cannot be clearly diagnosed based on these symptoms alone.

There is no evidence that hormonal suppression either before or after surgery for endometriosis is associated with a benefit

Endometriosis is caused by the lining of the uterus (endometrium) spreading outside the uterus. It can cause pelvic pain, painful periods and infertility. Common treatments are hormonal suppression with medical therapy to reduce the size of endometrial implants or laparoscopic surgery (where small incisions are made in the abdomen) to remove visible areas of endometriosis. There is no evidence that hormonal suppression either before or after surgery is associated with a benefit compared with surgery alone.

Hormone therapy for women with endometriosis and surgical menopause

Endometriosis is known to result in variable severity of symptoms. For some women bilateral removal of the ovaries (oophorectomy) with or without an hysterectomy may be required to manage symptoms. This brings women into premature menopause. It is thought that hormone replacement therapy may enhance the recurrence of the disease due to its effect on the remaining endometriotic deposits in the pelvis. Only two small randomised controlled were identified in the literature that looked at this problem. Further research is required to clarify the effect of different hormone replacement therapy types on the recurrence of the disease and the associated pain including during sex.

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