Endometriosis: symptoms, diagnosis and treatment

In addition to pain during periods, pain associated with intercourse is also a typical symptom of endometriosis. Sometimes this pelvic pain can last throughout the cycle. Pain can also be associated with endometriotic ovarian cysts (chocolate cysts or endometrioma) and involvement of bowel. Bowel involvement (rectovaginal septum endometriosis) is relatively uncommon but may lead to severe symptoms during periods.

Clinical history and examination often make the diagnosis of endometriosis obvious. If the endometriosis involves the ovaries, these cysts can be diagnosed during an ultrasound scan.

A laparoscopy (look inside the abdomen with a telescope) is the best way to confirm endometriosis. This procedure is carried out under general anaesthetic and often treatment can be performed at the same time.

Endometriosis can be treated by medical or surgical means. Tri-cycling the contraceptive pill (taking 3 packs together without a break) is the easiest way of treating endometriosis. This way you achieve a longer gap between periods giving your body a window of opportunity to heal the endometriosis.

Laparoscopic (key-hole) surgery is often the best way to cure endometriosis. Endometriosis can be either excised or ablated during key-hole surgery.

If you are trying for a pregnancy, pregnancy itself can act as treatment for endometriosis as you don’t get periods for up to 12 months if pregnant!

Recurrence of endometriosis occurs in 15% of cases. Your surgeon may recommend either taking hormone injections or tri-cycling the pill after your procedure. Some coils are also associated with reduction in risk of recurrence.

Endometriosis can make it more difficult for you to get pregnant depending on the degree of involvement. Surgical treatment of endometriosis is associated with increase in the chances of spontaneous conception and also of IVF pregnancy rates.

If you have endometriosis and are pregnant it is unlikely to cause pregnancy complications. In fact pregnancy can sometimes reduce the symptoms, although these can return after birth and breast feeding when the cycle returns to normal.

Our nutritional therapist, Laura Southern says “Yes, nutritional support can play a role in helping the endometriosis sufferer by supporting the immune system and inflammation as well as detoxification pathways. Because endometriosis is thought to be an oestrogen dominant condition, liver and digestive support through food is paramount.”

A diet to support an endometriosis sufferer should be:

• High in brightly coloured, fresh vegetables to support both immunity and detoxification. Favour the green ‘brassica’ family, such as broccoli, Brussel Sprouts and kale, and add lots of deep red and purple vegetables; beetroots, purple ‘heritage’ carrots, red onions, red cabbage. Stir fries and soups can be utlitised to maximize vegetable intake.
• Include lots of foods rich in ‘essential fat’ for their anti-inflammatory benefit. Eat oily fish (salmon, mackerel, trout, herring, sardines) 2-3 times a week, and consume a handful of raw nuts and seeds daily. Try almonds, pumpkin seeds, pine nuts, walnuts, chia seeds and use a good quality olive oil or flax oil on salads. Additionally reduce reliance on caffeine, tobacco and alcohol which all place strain on the liver.

Nutritional support for endometriosis is available at London Gynaecology, please book a nutritional consultation with our Nutritional Therapist