Diagnosis cannot be made from symptoms alone and if endometriosis is suspected then you will require a minor procedure called a laparoscopy which is performed under a general anaesthetic. During the procedure Mr Curtis will be able to identify little clusters of bluish-black spots or read areas dotted about the inside of your pelvis. Sometimes a biopsy (sample) will be taken to confirm the diagnosis.
Once endometriosis has been diagnosed it can be managed effectively.
Endometriosis is painful because it continues to respond to your hormones each month which means that it bleeds when you have your period but the blood has nowhere to go. The pain caused by the condition usually starts a few days prior to your period, lasts throughout and can also cause pain at other times of the month as well. It can cause pain during sexual intercourse and for some hours after you have had sex. The problems caused by this condition can also make it difficult for a woman to become pregnant as it can cause damage to the reproductive organs.
Endometriosis occurs when some of the endometrium manages to travel outside the womb into another part of your body. Commonly this can be around the pelvis, in the ovaries or fallopian tubes and very rarely it can also be found in other parts of the body such as the lungs or kidneys. It is not clear why this happens but it is thought that the endometrium may be carried to other parts of the body in the blood, or that when your period occurs the endometrium does not shed fully and some manages to travel back up the fallopian tubes and is released into the pelvis.
The inside lining of the womb (uterus) is called the endometrium and every month the hormones in your body cause the lining of the womb to thicken. Then, when you ovulate, an egg will be released and if this egg is fertilised and you become pregnant the embryo will implant itself in the endometrium and start to develop. If fertilisation of the egg does not occur then the endometrium will not be required and therefore sheds itself which causes you to bleed, or in other words, have a "period".
Unfortunately there is no known cure for endometriosis but there are ways to help alleviate your symptoms and make the condition more manageable. Your specific treatment will depend on your personal circumstances and Mr Curtis will go through all of the options available to you along with the risks and benefits of each. Typical treatments include:
Medical treatment which includes hormonal drugs and painkillers. The hormonal drugs help to reduce the amount of endometriosis you have and act by disrupting your monthly cycle and stopping your period. Without your period the endometriosis will not bleed and therefore your pain will be relieved.
Surgical treatment will depend largely on the site of the endometriosis, your age and whether or not you have had, or wish to have children. Minor cases of endometriosis in younger women still wishing to have children in the future, can be treated by burning with a hot wire (diathermy) or laser beam. This type of treatment can usually take place whilst you are already under general anaesthetic undergoing a laparoscopy for diagnosis. In older women more radical treatment involves the removal of your womb and ovaries (hysterectomy). By removing the ovaries you will stop your body from producing a large quantity of the hormones that cause endometriosis to grow and develop. However, removal of the ovaries means that you will become postmenopausal and therefore you may require hormone replacement therapy (HRT) to alleviate the symptoms of menopause.