What is endometriosis?
Endometrial tissue has the potential to develop lesions, nodules, and cysts, primarily in the pelvis, the Pouch of Douglas, ovaries, bowel, ligaments, and bladder. Additionally, the formation of adhesions - fibrous scar tissue that causes internal organs or tissue to stick together - is possible. In advanced stages of the disease, endometriomas or cysts may develop on the ovaries.
Interestingly, the severity of symptoms experienced by an individual is not necessarily correlated with the extent of the disease. For instance, someone with mild endometriosis may suffer severe symptoms, while someone with more extensive endometriosis may experience milder symptoms. It is worth noting that not every individual born female with endometriosis will experience regular monthly symptoms.
In Aotearoa, it is estimated that approximately 120,000 individuals born female are affected by this condition, while no cases have been reported in individuals born male.
Common symptoms
Mate kirikōpū, also known as Endometriosis, is associated with a range of symptoms, including but not limited to:
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Pelvic pain, which is typically linked to menstrual periods but can occur at other times as well. The pain can be severe and debilitating.
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Bowel-related symptoms, such as bloating, painful bowel movements, and irregular bowel habits, which are similar to irritable bowel syndrome (IBS).
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Pain during or after sexual intercourse.
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Abnormal menstrual bleeding, such as heavy periods or bleeding between periods.
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Pain during ovulation.
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Sub-fertility or infertility.
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Premenstrual spotting.
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Cyclical bloated abdomen, constipation, or diarrhea.
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Immune system issues.
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Lower back pain.
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Constant tiredness or fatigue.
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Premenstrual syndrome (PMS).
Impact
Endometriosis may exert a profound negative influence on the lives of individuals with the disorder, adversely affecting the quality of life, participation in daily and social activities, physical and sexual functioning, relationships, educational and work productivity, mental health, and well-being.
What can symptoms be similar to?
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Irritable Bowel Syndrome
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Pelvic Inflammatory Disease
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Polycystic Ovary Syndrome
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Coeliac Disease
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Fibromyalgia
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Ovarian Cancer
Stages
the stage and type of your condition won’t affect your symptoms. For example, a person with stage 1 endometriosis may have worse pain than someone with stage 4.
1
Minimal or stage I endometriosis: typically, small patches, surface lesions or inflammation on or around organs in the pelvis.
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Mild or stage II endometriosis: more extensive than stage I but limited infiltration of pelvic organs. Limited scarring or adhesions.
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Moderate or stage III endometriosis: sometimes more widespread and starting to infiltrate pelvic organs, pelvic side walls or other structures. There may also be scarring and adhesions.
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Severe or stage IV endometriosis: infiltrative disease affecting the pelvic organs and ovaries, often with distortion of the anatomy and extensive adhesions.
Diagnosis: Studies conducted internationally indicate that there is often a significant delay in obtaining a diagnosis of Mate kirikōpū/Endometriosis. On average, it takes eight years from the initial consultation with a doctor regarding symptoms to receiving a diagnosis. For this reason, it is crucial to take an active role in seeking assistance and accessing treatment by discussing all of your symptoms with a medical professional.
To diagnose Mate kirikōpū/Endometriosis, a medical practitioner will begin by taking a detailed medical history and assessing the signs and symptoms. A pelvic examination may also be conducted, and other tests such as an ultrasound may be performed to evaluate the pelvis. While an ultrasound can be useful for identifying cysts linked to endometriosis (endometriomas), it is not a definitive diagnostic tool.
Laparoscopy is the only method to confirm a diagnosis of Mate kirikōpū/Endometriosis. This is a surgical procedure that is carried out under general anaesthesia by a specialist gynaecologist. During the procedure, the gynaecologist inserts a laparoscope (a long, thin tube with a tiny camera at its tip) through small incisions in the abdomen to examine the abdominal cavity and pelvis on a television monitor. This enables them to look for endometriosis, scarring, adhesions, and other abnormalities.
Medical treatment focuses on relief of symptoms through the use of pain-relieving medications and hormone treatment.
In cases of mild Mate kirikōpū/Endometriosis, pain medications such as non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen may be effective in relieving symptoms. However, in more severe cases, stronger medication may be required, and your doctor should develop a comprehensive pain management plan for you.
Hormone treatments are also available for Mate kirikōpū/Endometriosis. One such treatment is the contraceptive pill, which can help regulate and balance periods while alleviating distressing symptoms. It is crucial to receive a prescription for the most appropriate type of pill for your specific condition. The efficacy of hormone treatments varies and may be more effective for mild cases of endometriosis.
Surgical treatment
Laparoscopic surgery aims to remove endometriosis lesions and adhesions if found and restore normal anatomy. Whenever possible, laparoscopy will be undertaken in preference to laparotomy (open surgical procedure). Medical literature indicates surgical removal (excision) of endometriosis is the gold standard treatment. Therefore it is important that the gynaecologist has the appropriate surgical expertise to fully remove the endometriosis.
Hysterectomy
A hysterectomy is sometimes recommended where symptoms have significantly affected the quality of life and where future fertility has been ruled out. The ovaries may also be removed (oophorectomy). In these cases, it may be necessary to commence menopausal hormone therapy (formerly known as hormone replacement therapy or HRT) after surgery. Hysterectomy is not a cure for endometriosis but many find relief particularly if endometrial tissue was found in the muscles of the uterus (adenomyosis). It is vital that all areas of Mate kirikōpū /Endometriosis are excised at the same time.