Endometriosis

About endometriosis

Endometriosis is a condition where tissue, similar to the lining of the uterus, grows in other parts of your body.

Endometriosis affects one in 7 women in Australia.

The condition is associated with pain and inflammation.

Symptoms of endometriosis

Endometriosis affects everyone differently. Common symptoms of endometriosis include:

• severe period pain
• deep pain during or after sex
• infertility
• persistent pelvic pain
• heavy periods.

Less common symptoms include:

• bowel symptoms (for example, bloating, constipation, diarrhoea or pain when doing a poo)
• feeling very tired
• back pain
• sleep problems
• headache
• urinary symptoms (for example, pain when weeing or blood in your wee)
• allergies.

Causes of endometriosis

We don't know exactly what causes endometriosis. It's a complex condition that depends on the oestrogen hormone. But it may be influenced by other factors.

Backwards (retrograde) menstruation

When you have a period, blood flows out of your vagina. But it can also flow backwards along your fallopian tubes into your pelvic area. Nearly all women experience this, but the blood is usually absorbed or broken down in the body. In some women, the endometrial tissue starts to grow in the pelvic area.

Genetics

Genetics play an important role, but genetics don't fully explain why some women develop endometriosis and others don't.

How body systems work

Researchers are looking at different factors that might cause endometriosis. For example, how the immune and hormone systems interact.

Risk factors for endometriosis

You can't change some potential risk factors for endometriosis, such as your birth weight and when your first period started. But you can seek help early if you have symptoms, such as severe period pain.

Getting a diagnosis

It can take several years to get a diagnosis for endometriosis. This is because symptoms vary between women, symptoms can change over time, and some symptoms overlap with other conditions.

Early diagnosis and treatment of endometriosis will help you manage the condition and improve your quality of life.

The recommended way to see if you have endometriosis is with imaging technology, such as ultrasound.

Treatments for endometriosis

There isn’t a single 'best' treatment for endometriosis that works for everyone.

Your medical team should consider your symptoms, preferences and priorities when recommending treatment options.

Pain control

Your doctor may recommend pain-relief medicines, such as paracetamol and non-steroidal anti-inflammatory drugs (for example, ibuprofen) for temporary relief. But if they don't help with the pain, you may need other types of pain management.

Hormone medicines

Hormone medicines aim to reduce pain and the severity of the endometriosis by slowing the growth of endometriosis.

Depending on your situation, your doctor may recommend:

• the Pill
• progestogen (for example, pills, injections or IUD)
• gonadotrophin-releasing hormone (GnRH) treatment
• a combination of medicines known as 'combined relugolix treatment.'

Ask your doctor about the benefits and risks of each treatment.

Surgery

Most surgery for endometriosis is performed via keyhole surgery (laparoscopy). The aim of surgery is to remove endometriosis, repair damage to organs and improve symptoms.

The first operation has the best chance of removing the endometriosis. Every surgery comes with the risk of complications, so it’s important to minimise surgeries where possible.

Combined treatments

Talk to your doctor about a combination of surgery and ongoing hormone medicines. They may recommend you use hormone therapy to reduce pain and the return of symptoms, if you don’t plan to get pregnant straight after surgery.

Other treatments

Many people use non-medical options to manage symptoms of endometriosis. For example, cognitive behavioural therapy (CBT), diet, yoga and acupuncture. These approaches may help some women cope with the condition, but we need more evidence to show they help relieve symptoms.

Where to get help

• GP (doctor)
• Gynaecologist
• Endometriosis Australia
• Jean Hailes for Women’s Health for more detailed information, related resources, articles and podcasts
• Women's Health Clinics can help you with free information, specialist care and services for women's health issues and conditions
• The Aboriginal Women's Health Clinic is a dedicated health service for Aboriginal and Torres Strait Islander women in Victoria. The clinic provides a range of health services for women's health issues and concerns
• The Virtual Women's Health Clinic is a free telehealth service. You can access expert care, information and support on a range of women's health issues