What is endometriosis? It is a condition where tissue similar to the lining of the womb is found in the pelvis, around the womb, ovaries and fallopian tubes. It can affect 1 in 10 women and can be hereditary. It can be a long-term condition and will usually affect women in the reproductive years. There is no known cause but is dependent on hormones, meaning that symptoms may be worse around the time of menstruation.
Symptoms – this includes pelvic pain and painful irregular periods. It can cause pain during sex and can lead to fertility problems. Some women have pain related to bowels or bladder, pain in the tops of legs or lower back, whilst others may not experience any symptoms.
Referral – If any symptoms occur, your first port of call should be your GP or Practice Nurse. They will take a history of your symptoms, with your consent, may perform a pelvic examination, may organise a transvaginal ultrasound scan (TVUSS) and referral to general gynaecology may be required.
Diagnosis – A transvaginal ultrasound scan (TVUSS) may detect endometriosis, in which case appropriate treatment can be discussed with either your GP or gynaecologist. If the TVUSS proves inconclusive and symptoms continue, you may be referred to have a gynaecological procedure, called a laparoscopy, as a day case. In some cases, this can be undertaken at a Powys Hospital. If this is not possible, you may be referred to a neighbouring Health Board for the same procedure.
Treatment – This can be pain relief, physiotherapy and in some cases referral to pain management specialists may be required. Hormone treatment may be offered and, in some cases, surgical treatment to remove endometriosis disease may be required.
Support and follow up – This is offered by Powys Teaching Health Board Endometriosis/Women’s Health Clinical Nurse Specialist and Gynaecology clinics, Women’s Health Physiotherapists, Continence Nurse Specialists, through GP’s and Practice Nurses. Initial contact to the Endometriosis/Women’s Health Clinical Nurse Specialist can be made by emailing endometriosis.powys@wales.nhs.uk
For further information and support, refer to Endometriosis UK www.endometriosis-uk.org
National Institute for Health and Care Excellence (NICE) – Endometriosis: Diagnosis and Management: www.nice.org.uk/guidance/ng73
Royal College of Obstetricians and Gynaecologists (RCOG) https://www.rcog.org.uk/en/patients/patient-leaflets/endometriosis/
NHS Choices www.nhs.uk/conditions/Endometriosis/Pages/Introduction.aspx
Fertility Network UK http://fertilitynetworkuk.org/uk