Endometriosis – What is it and why so important?
Endometriosis is a condition affecting up to 1 in 7 women and those assigned female at birth (AFAB) in Australia (that’s over 700,000 people). It is as a menstrual cycle dependent, chronic, inflammatory, far-reaching disease that commonly (but not always) causes pelvic pain. You can read the most recent Australian Institute for Health and Welfare report on endometriosis here.
Since the launch National Action plan for endometriosis in 2017, there has been been a lot of passionate advocacy to increase awareness of endometriosis and improve access to a broad range of services including patient education and peer support as well as diagnosis and treatment. Thankfully we are continuing to see the fruits of this labour with both the federal government and Queensland state government announcing millions in funding for endometriosis and pelvic pain services in February 2024.
What is endometriosis?
Endometriosis occurs when tissue similar to the cells lining the womb grow outside of the womb, most commonly in the abdominal cavity. There is some uncertainty as to why this occurs, and multiple factors are likely to be involved, including genetics. This endometriosis tissue responds to hormones – but instead if shedding like a normal period, it causes inflammation and scarring where it occurs. This may produce pelvic pain – but not always.
Some people with small amounts of endometriosis have a lot of pain, while others are completely symptom free and their endometriosis is found by chance when being investigated or treated for other medical conditions.
Endometriosis can be seen when we look inside the abdominal cavity with keyhole surgery (laparoscopy) or sometimes on specialized scans such as ultrasounds or MRI. There is currently no blood test to diagnose endometriosis, although the wide range of symptoms caused by this disease will often requires blood tests to check for other illnesses.
People suffering from endometriosis may experience any or all (or sometimes none) of these symptoms:
Painful periods, with pain getting worse and affecting more days of the month as time does by.
Chronic pelvic pain at any time of the month and/or painful sex
Heavy or irregular periods
Fatigue – this can be debilitating and otherwise unexplained
Nausea and other gut related symptoms
Bladder pain
Fertility problem
A lot to deal with, right? It’s no surprise that endometriosis causes a lot of individual suffering and costs (health and financial) and can have life changing impacts including on the families, partners and carers of those with endometriosis, as well as reducing social and economic participation due to absence from school and work.
WHAT WORKS TO HELP THOSE WHO HAVE ENDO OR PELVIC PAIN?
It’s important to consider the whole person when planning investigations and a treatment plan so each individual has their needs met, whether that be pain control, achieving pregnancy or just being able to work and exercise without bleeding and pain controlling their life.
Treatment of endometriosis with hormones and surgery may help with some of the symptoms, but sometimes chronic pelvic pain cannot be seen during surgery or might not go away even after surgical removal of lesions and/or hormonal treatment. About 50% of patients who get relief from surgery have pain back again by 5 years later.Pain and other symptoms do not necessarily correspond to how much endometriosis is found on a scan or at surgey.
We need to use all the tools at our disposal to help each individual – from medications and surgery, to nutrition, movement, physiotherapy, hypnotherapy, psychology and more. You can find information about all of this on our resources page.
This requires a coordinated team and a plan – which a women’s health GP is well placed to help with.
Many of the GPs consulting at Neighbourhood Medical have extensive experience and interest in the areas of women’s health, including endometriosis and pelvic pain. We also have strong links to others working in this area. Our approach to helping those with these symptoms enabled a successful application for funding towards our developing our endometriosis and pelvic pain services.
Our service includes two GP led clinics per week, bookended with nurse navigator appointments and follow up with telehealth and face to face appointments available.
We also provide access to allied health including physiotherapists, as well as education for patients and clinicians. Like all of the clinics funded, this is a pilot program and we can shape it to the needs of the patients we see.
Ultimately we need to help individuals with endometriosis to take control of their health and lives, and to reduce the burden of this disease on wider society. It's important – and it’s worth doing our bit to help address this common chronic disease.
For further information on the range of services and groups available to support those with endometriosis and pelvic pain please look at our resources page here
