Endometriosis is a fairly common condition where cells similar to those found in the womb grow elsewhere in the body. It can affect every aspect of women's health including their ability to get pregnant, their energy levels, emotional state, sex life, and generally their overall quality of life.
Reaching the diagnosis of endometriosis can unfortunately turn into a very prolonged and painful journey, for women suffering from chronic pelvic pain, painful periods, painful sex, difficulty conceiving, painful bowel motions and and other symptoms of this common disease.
According to the recent research (Ballard et al), the time between a woman first visiting their family doctor about their symptoms and receiving a confirmed diagnosis of endometriosis by a gynaecologist is seven and a half years.
What are the reasons for this unacceptable delay?
One in ten women in the UK has endometriosis, however exact diagnosis can be difficult without a specific procedure called laparoscopy - a camera examination of the pelvis under general anaesthetic. Symptoms that are highly suspicious of endometriosis, for example extremely painful menstrual periods and painful sex, can be considered vague, non-specific, and even 'normal' by some health professionals. Symptoms also tend to vary from woman to woman.
The vast majority of patients with endometriosis are women of reproductive age, and can sometimes be very young. When they visit their family doctor with their complaints, they would normally receive sympathy, reassurance that 'this is not cancer' and very often advice to 'soldier on'.
If the problem persists and worsens, starting to significantly affect quality of life, sexual relationships, and general wellbeing, the hormonal treatment 'the pill' and pain killers are generally offered. These can sometimes help to ease the symptoms for a period of time. However, if symptoms get even worse, a doctor will normally request a pelvic ultrasound scan and refer the woman to a gynaecology clinic.
However, unfortunately, endometriosis is frequently not seen on the ultrasound scan and this can be for a number of reasons, sometimes due to the nature of the disease, skills of the operator, or due to the limitations of the equipment. For many women, diagnosis is typically only finally made during a laparoscopy, and if severe endometriosis is diagnosed the patient is then referred to a specialist multidisciplinary endometriosis centre for further investigations and advanced treatment.
An Endometriosis Centre is a specialist clinic where gynaecology endometriosis surgeons, specialist endometriosis nurses, colorectal (bowel) surgeons, urologists, anaesthetists, chronic pain specialists, gastroenterologists, and radiologists, specialising in endometriosis work together to help speed up the diagnosis process. They are able to discuss the treatment of patients with severe endometriosis on multidisciplinary team meeting and perform further extensive investigations.
Once the diagnosis is confirmed, patients are then offered several options for treatment - medical or surgical - taking into consideration individual circumstances, symptoms and fertility aspirations.
Having a diagnosis of endometriosis is the most important step in the management of the disease. It allows health professionals to determine the best treatment for each woman and make sure they are referred to the centre of expertise. It also allows the woman to feel that her pain and suffering is recognised, acknowledged, and that it is to do with a severe disease, which is sometimes very difficult to treat.
While there is no absolute cure, there are ways of managing endometriosis and coping with the symptoms to reduce the impact it has on quality of life.
Confirmed diagnosis of endometriosis enables women to access support services, charities and patient's groups that can help them, and this condition should absolutely meet understanding, sympathy and support from employers, colleagues and family.
Women who think they may be suffering from endometriosis can find out more about the condition and request an appointment at The Harley Street Clinic endometriosis centre here.