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Battling endometriosis

Endo pain
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GROUP SUPPORT: There is help available for women suffering from endometriosis.

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It is a condition that affects millions of women worldwide and according to an international study, the chronic pain experienced by women who suffer from endometriosis accounts for a significant loss of productivity.

In 2011 the Global Study of Women's Health recruited over a thousand women around the world to complete a survey about how endometriosis had impacted on their lives.

The results highlighted the plight of thousands of women, including many in New Zealand who suffer from the inflammatory disease.

On average women with endometriosis experienced a delay of seven years from the onset of symptoms until they were finally diagnosed and treated.

According to Endometriosis New Zealand, the delay in diagnosis often happens because women think their symptoms are normal and in some cases, doctors might not attribute the symptoms to the disease, or delay referral to a specialist.

For many women whose symptoms go undiagnosed for years their quality of life is significantly impaired.

According to the study, women with endometriosis suffer a 38 per cent greater loss of work productivity and often find that non-work related activities, such as looking after children, exercise and housework are impaired.

What is endometriosis?

According to the World Endometriosis Society, the condition occurs when the tissue found on the lining of the uterus (the endometrium) grows outside the uterus.

This growth induces a chronic inflammatory reaction that may cause the formation of scar tissue.

The tissue may grow on the pelvic peritoneum (the membrane lining the walls of the abdomen) ovaries, bladder and bowel.

One in 10 women are affected by endometriosis during their reproductive years, which is approximately 176 million women around the world.

There is no known cure for endometriosis and although it can be treated effectively with drugs, most treatments are not suitable for long-term use due to side effects.

Surgery can be effective to remove endometriosis lesions and scar tissue, but the success rates are dependent on the extent to the disease and the surgeon's skills.

What are the symptoms?

Painful periods, painful ovulation, pain during or after sex, abnormal bleeding, chronic pelvic pain, bloating, diarrhoea constipation, pain with bowel movements, painful wind, fatigue and infertility are some of the common symptoms.

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Endometriosis New Zealand says that doctors may misdiagnose the condition, commonly endometriosis may be diagnosed as Irritable Bowel Syndrome ( IBS), appendiciti,  pelvic inflammatory disease of primary dysmenorrhoea (painful periods).

How does the doctor know what it is?

Laparoscopic surgery is the only definitive way to diagnose endometriosis which is usually removed at the same time.

Laparoscopy is also known as key-hole surgery. Where a laparoscope is inserted through a small incision at the base of the navel so the internal organs can be seen.

According to Endometriosis New Zealand, the success of surgery depends on how much of the endometriosis lesions, cysts and adhesions can be removed.

While endometriosis can impact a woman's fertility, the sooner the disease is recognised and treated, early intervention can avoid compromised fertility.

Treatment

In addition to surgery, medical intervention can also provide relief from symptoms, depending on your age, the severity of your symptoms, and the extent of the endometriosis.

In New Zealand, you can access an appointment with a gynaecologist by getting your GP to refer you to a DHB in your area.

According to Endometriosis New Zealand, while medication can't improve fertility outcomes, it can help with the symptoms of the disease.

Oral contraceptives (the pill) are often prescribed for you to try first if it's appropriate. The pill can be used effectively to relieve symptoms and regulate periods. The pill can also mask the symptoms of endometriosis and is not a diagnosis.  It's important to work with your doctor to find the pill that is best suited to you. Depo Provera injections may also be offered .

Hormonal medications aim to reduce the growth of endometriosis by suppressing oestrogen production. Sometimes these drugs are used in conjunction with surgery to 'dampen down' active endometriosis. Hormonal medications can have significant side effects with questionable long term benefits. Therefore it is important to understand how they work so you can make informed choices.

Intrauterine device or system (IUS) is often used to treat heavy bleeding, can lessen the symptoms of endometriosis and reduce the likelihood of recurrence of endometriosis.

Pain medications are available without prescription and advice should be sought from a pharmacist to ensure the brand you are buying is going to give you the best relief for your type of pain. Sometimes combinations of drugs (eg an anti-inflammatory and a pain killer taken together) can be very effective but it is crucial that you seek expert advice from your doctor or specialist.

Endometriosis and fertility

According to Endometriosis New Zealand, most women with the disease are not infertile, so if you do not want to become pregnant then reliable contraception is important.

Endometriosis can compromise fertility in some women, though the reason is not always clear.

In some instances it might be because the pelvic organs have become distorted, making it difficult for the tubes to pick up and egg from the ovary to transport it to the uterus.

Surgery to remove the endometriosis and IVF are both effective in improving fertility though.

Resources

Ministry of Health
http://www.health.govt.nz/yourhealth-topics/diseases-and-illnesses/endometriosis

Insight Endometriosis
http://www.insightendometriosis.org.nz/

Endometriosis New Zealand
http://www.nzendo.co.nz/

- © Fairfax NZ News

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