A recent report by Australian Institute of Health and Welfare (AIHW) showed a 23 per cent increase in the rate of women and girls in Australia being admitted to hospital for endometriosis over the last decade.
On the back of last month’s Women’s Health Week and the recent release of The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) living evidence guidelines for endometriosis, we thought we’d take a closer look at this often-missed disease.
What is endometriosis?
Endometriosis is a long-term inflammatory, gynaecological condition where tissue similar to the lining of the uterus grows in other parts of the body.
Most endometriosis grows in the pelvic area and can be painful and debilitating. It has significant health, social and economic implications, often leading to reduced participation in schools, work, and sporting activities and reduced quality of life for sufferers.
It can also affect fertility. According to the World Health Organization, as many as 25-50% of women with infertility have endometriosis.
In Australia, at least one in 7 girls and women are affected by the disease.
What are the signs and symptoms?
Endometriosis has a diverse and complex range of symptoms, that can vary person to person, depending on where the endometriosis is.
More common symptoms include:
- severe period pain
- deep pain during or after sex
- infertility
- persistent pelvic pain (pain in your pelvic area that’s felt most days and lasts for more than 6 months)
- heavy periods.
Less common symptoms include:
- bowel symptoms (e.g. bloating, constipation, diarrhoea or pain when doing a poo)
- feeling very tired
- back pain
- sleep problems
- headache
- urinary symptoms (e.g. pain when weeing or blood in your wee)
- allergies
Because of the complexity and diverse range of symptoms that can be experienced by different people, there can often be delays and inconsistencies in diagnosing and managing the condition.
In fact, it can often take several years to get a diagnosis for many sufferers. The good news, however, is that’s now changing thanks to increased awareness of the disease coupled with advances in medical practitioners’ understanding of endometriosis and improvements in the medical technology available for diagnosis.
The Royal Australian and New Zealand College of Obstetricians and Gynaecologists has also developed this useful tool to help assess possible symptoms – Raising Awareness Tool for Endometriosis (RATE) – RANZCOG
What causes endometriosis?
While there is no known cause, certain things can put you more at risk, including:
- retrograde menstruation – when blood travels backwards into the pelvis and cells in the blood stick to pelvic organs and grow
- immune system dysregulation – people with endometriosis have higher rates of other immune-mediated conditions, such as lupus, multiple sclerosis, and inflammatory bowel disease
- a family history of endometriosis
Other contributing factors may include:
- long and heavy periods
- frequent periods or short cycles
- starting your period before 11 years of age
- having your first pregnancy when you are older
- low body weight
How is it treated?
If your doctor suspects you have endometriosis, they may refer you to a specialist for an internal ultrasound, which is the recommended way to look for signs of endometriosis. MRI scans may also be used.
While there is currently no known cure for endometriosis, symptoms can be treated with pain relief medicines, hormone-based medicines, or surgery.
For women experiencing bladder and bowel issues from the condition, pelvic floor exercises can help to ease symptoms.
Around one in three sufferers will experience trouble with fertility and may require fertility treatment, such as in vitro fertilization (IVF) to assist with pregnancy.
Endometriosis in Australia
As noted by the Australian Institute of Health and Welfare, endometriosis is the third leading cause of non-fatal disease burden among females due to reproductive and maternal conditions and affects one in seven women and girls.
There has been a notable increase in both the hospital rates and spending for endometriosis over the last decade.
In 2018, thanks to increasing rates and awareness of the disease, the Australian Government developed a National Action Plan for Endometriosis. It has since invested significant funding into research, education, and clinical management and care of endometriosis, including the development of specific Endometriosis and Pelvic Pain Clinics (EPPC) across Australia.
Earlier this year, RANZCOG also released updated guidelines to provide health professionals with evidence-based recommendations for the care of people with suspected and confirmed endometriosis – RANZCOG’s Australian Living Evidence Guideline: Endometriosis.
When to see a doctor?
If you have severe period pain that stops you from doing everyday activities, such as school and work, or regularly experience the signs and symptoms of endometriosis, book in with your GP.
Appointments at Illawarra Medical Centre can be made online or by contacting us directly on (08) 9208 6400.
For more information on this topic, visit:
- Australian Government Department of Health, Disability and Ageing – What we’re doing about endometriosis | Australian Government Department of Health, Disability and Ageing
- Australian Institute of Health and Welfare – Endometriosis, Summary – Australian Institute of Health and Welfare
- Endometriosis Australia – org
- Endometriosis WA – endometriosiswa.org.au
- Health Direct – Endometriosis – symptoms and treatment | healthdirect
- Jean Hailes – Endometriosis | Jean Hailes
- World Health Organization – Endometriosis