As part of Endometriosis Awareness Month, we asked Dr Yogesh Nikam, Specialist Gynaecological Surgeon and Robotic Surgeon at Norwest Private Hospital to answer some frequently asked questions about endometriosis.

What is endometriosis?

Endometriosis is a common condition that can cause pain in the pelvis (lower belly) and contribute to having difficulty in getting pregnant. 

The “endometrium” is the name for the inner lining of the uterus (womb). With endometriosis, cells just like the endometrium are found outside of the uterus. These respond to the hormones from the ovary and cause inflammation and scarring inside the body, leading to pain. It is not clear what causes endometriosis. 

It affects 1 in 10 women – more than 830,000 (more than 11%) Australian women suffer from endometriosis at some point in their life. 

What are the symptoms of endometriosis?

Whilst some people with endometriosis have no symptoms, most have pelvic pain that stops you from doing your usual activities around or during your period. Pain can occur:

• Before or during period
• Between periods
• With bowel motion or whilst urinating (especially during period)
• During or after intercourse

Other symptoms may include:

• Trouble getting pregnant
• Chronic fatigue
• Abnormal vaginal bleeding
• Back/ leg pain with period

Many women do not recognise these symptoms as abnormal, and attribute them as “my normal period” – leading to delay in the diagnosis and treatment. On average, it takes 8-9 years to diagnose endometriosis from the onset of the symptoms.

Is there a test to diagnose endometriosis?

There is no simple test to diagnose endometriosis. The only way that the diagnosis of endometriosis can be made is via a laparoscopy, which is a surgical procedure to see inside the abdomen and pelvis with a thin telescope. Endometriosis tissue can be removed and tested to confirm the diagnosis.

Pelvic examination and ultrasound are helpful in excluding other causes of pelvic pain, however, does not ‘diagnose’ endometriosis. 

What are the treatment options?

While there is no cure for endometriosis, it can be managed and treated in different ways. The right treatment will depend on your symptoms and whether pregnancy is desired. Treatment options includes:

• Medical treatment – pain medicine, hormone medicine (e.g. birth control pills or Mirena IUD)
• Surgical treatment – operation with laparoscopy 
• Allied treatment – physiotherapy, psychology, alternative medicine etc.

There is no one best treatment, as treatments will work differently for different people. You may need to try different combinations of treatment to improve symptoms. 

Where can I get more information?

The Raising Awareness Tool for Endometriosis (RATE) is a quick electronic resource to help identify and assess endometriosis. Complete this questionnaire and discuss with your GP or gynaecologist about what to do and where to get help.