Endometriosis is a disorder that can affect women at any age and is often misdiagnosed. If left untreated it can cause a lot of pain and complications, including infertility.
Unfortunately, often symptoms are misconstrued as being due to alternative, incorrect causes. This is a condition that cannot be reversed, only treated. As such, the need to correctly identify the need for a gynaecological referral in the first instance, either at GP or A&E level and thereafter the need for the gynaecological team to treat correctly and quickly is vital.
What is endometriosis?
Endometriosis is a condition where tissue similar to the lining of the womb starts to grow in other places, such as ovaries and fallopian tubes. It can also spread to bowel and bladder.
In endometriosis, cells like the ones in the lining of the womb grow elsewhere in the body. These cells react to the menstrual cycle each month and also bleed. However, there is no way for this blood to leave the body.
Endometriosis can cause the following complications:
- Severe pain
- Formation of scar tissue
- Adhesions, in which tissue binds pelvic organs together
- Fertility problems
Symptoms of endometriosis
The symptoms of endometriosis can vary. Some women are affected more than others.
However, the main symptoms of endometriosis are:
- Pain in lower tummy or back (pelvic pain) – usually worse during the period
- Cramps one or two weeks around menstruation
- Heavy menstrual bleeding or bleeding between periods
- Pain during or after sex
- Pain when peeing or pooing during your period
- Feeling sick, constipation, diarrhoea, or blood in pee during the period
- Difficulty getting pregnant
- Lower back pain that may occur at any time during your menstrual cycle
Some women might have no symptoms at all. Therefore, it is still important to have regular gynaecological appointments during which the gynaecologist will examine you an advice if there are any abnormalities. Failure to pick up the signs of endometriosis, even if a woman does not present with any symptoms, can represent a negligent treatment.
Endometriosis can cause a lot of pain for some women who might want quick relief from their symptoms. However, it is important to understand that while endometriosis can be managed, it cannot be cured.
Endometriosis can be treated conservatively. However, on some occasions surgery might be offered; especially if the condition is not improving.
The best way to detect endometriosis is by laparoscopy procedure. Therefore, in some cases where the cause of the pain is not clear from standard imaging and examinations, the treating doctor should offer an exploratory laparoscopy.
The most common treatment options for endometriosis are as follows:
- Hormone medicines and contraceptives
- Surgery to cut away patches of endometriosis tissue
- An operation to remove part or all of the organs affected by endometriosis – such as surgery to remove the womb (hysterectomy)
A failure to consider all endometriosis treatment options and properly advise the patient about the available options and the consequences of the treatment would represent a breach of duty.
When considering the appropriate treatment options the doctor should also take into account woman’s age and her family status, for example, if she has any children.
This is important because some of the treatment options (such as hysterectomy) could result in a woman becoming infertile. Therefore, a failure to address this would represent a breach of duty by your doctor.