Main
- Endometriosis — the growth of tissue similar to the inner lining of the uterus outside it: on the ovaries, tubes, peritoneum.
- Painful periods, pain in the lower abdomen, during intimacy and bowel movements — common signs that interfere with everyday activities.
- Diagnosis begins with a conversation and examination by a gynaecologist, then ultrasound, tomography, laparoscopy and biopsy.
- The condition is managed by a gynaecologist: they select hormonal therapy, painkillers, and when indicated — surgical removal of the lesions and rehabilitation.
- There is no specific prevention: regular check-ups, a symptom diary, a healthy lifestyle and treatment of pelvic inflammation help.
What is endometriosis
Endometriosis is a condition in which tissue similar to the lining of the uterus grows outside it. Such areas can cause pain and discomfort, especially during menstruation, and sometimes affect the ability to become pregnant.
What happens in the body
Endometriosis is associated with the appearance of tissue similar to the lining of the uterus in places where it normally should not be. This tissue can be located on the ovaries, fallopian tubes, peritoneum and other pelvic organs. Under the influence of hormonal changes, such areas respond to the menstrual cycle in the same way as normal endometrium. They swell and then shed, but there is no way out for them. Because of this, irritation occurs around the tissues, and adhesions and small scars form. A woman may notice a dragging pain in the lower abdomen, increased discomfort on the days of menstruation and pain during intimacy. If the dragging sensations repeat from month to month and interfere with everyday activities, it is worth discussing this with a doctor.
What causes it to develop
- Hereditary predisposition: if close female relatives had a similar condition, the risk is higher, so it is important to tell the doctor about the family history.
- Disturbances of hormonal balance: fluctuations in hormone levels affect the growth of the tissue, so the condition is often associated with changes in the cycle.
- Features of the immune response: the immune system usually removes cells that have ended up in the wrong place, but when it malfunctions they take hold and continue to grow.
- Previous operations on the pelvic organs: interventions can contribute to the transfer of cells to neighbouring areas, which becomes one of the provoking circumstances.
- Early onset of menstruation or its long duration: the longer and more often menstrual shedding occurs, the higher the likelihood of such areas appearing.
Who faces this more often
Endometriosis is more often detected in women of reproductive age, but this does not mean that it occurs only in them. The frequency is influenced by heredity, features of the cycle and previous operations on the pelvic organs. If menstruation began early or lasts long, the likelihood of facing such a condition is higher. Disturbances of hormonal balance, as well as features of the immune response, also play a role. In some women, a dragging pain in the lower abdomen repeats from month to month and noticeably interferes with work and rest. Others do not notice anything unusual for a long time, and then the changes are found by chance when they consult about another matter. Therefore, with regular discomfort on the days of menstruation, it is reasonable not to postpone a visit to the doctor.
What symptoms can occur?
Endometriosis manifests in different ways: in some women the symptoms are severe, in others almost unnoticeable. It is important to understand which signs require a routine visit to a gynaecologist and which require immediate help.
How it is noticed at the very beginning
Endometriosis often begins with pain during menstruation, which women put down to tiredness or ordinary malaise. The pain may intensify with each cycle and gradually interfere with work, study and everyday tasks. Many notice that the usual painkillers stop helping, and endurance becomes the only way to wait out the period. Discomfort appears in the lower abdomen or lower back that does not go away after rest. Over time, pain during sexual intercourse or during bowel movements is added to this. The woman begins to avoid situations associated with these sensations and postpones a visit to the doctor. If menstrual pain interferes with life month after month, it is worth booking a routine appointment with a gynaecologist without waiting for the symptoms to worsen.
Signs that occur most often
- Painful periods: the pain does not go away after ordinary painkillers and interferes with usual activities, which distinguishes it from tolerable discomfort.
- Pain in the lower abdomen or in the pelvic area: the sensations persist outside menstruation and may appear on different days of the cycle.
- Pain during sexual intercourse: this sign is often kept quiet, although it noticeably reduces the quality of intimate life.
- Pain during bowel movements or urination: unpleasant sensations at these moments require attention, as they affect daily comfort.
- Discomfort or pain in the lower back: pulling sensations in the lower part of the back are not always related to exertion and may intensify on certain days.
- Difficulty conceiving: if conception does not occur for a long time, this is a reason to discuss the condition with a gynaecologist.
When to seek help urgently
Examinations and tests
Examinations for endometriosis are needed to confirm the doctor's assumption and assess the spread of the process. Below is a breakdown of how diagnosis begins, what each examination shows and which documents to bring to the appointment.
How the examination begins
Diagnosis of endometriosis begins with a conversation and examination by a gynaecologist, not with imaging tests. The doctor clarifies in detail the complaints, the nature of the pain and the history of menstruation, including their regularity and heaviness. A gynaecological examination allows assessing the condition of the pelvic organs and noticing lumps or painful areas. Based on the results of the conversation and examination, the specialist decides which additional methods are needed in a particular case. Non-invasive methods are often sufficient to form an idea of what is happening. The final diagnosis sometimes requires visual confirmation during surgery if the examination data and images diverge. Therefore, information collected in advance about the cycle and previous examinations noticeably helps the doctor to build the order of further steps.
What is prescribed and what it shows
What is worth preparing for the appointment
- Discharge summaries: take all the conclusions of previous visits to the gynaecologist so that the doctor can see the dynamics of observations.
- Cycle calendar: mark the dates and nature of menstruation over several months, this helps to assess regularity.
- Examination results: bring the images and descriptions of the ultrasound examination and tomography, if they have already been performed.
- Description of pain: write down when and where the pain occurs, how severe it is and what makes it worse.
- Questions for the doctor: formulate in advance what you want to clarify about your sensations and further steps.
Which doctor should I see?
If endometriosis is suspected, you see a gynaecologist: they manage this condition and determine whether other specialists are needed. Below is what happens at the first appointment and what the care consists of.
Which specialist manages this condition
Endometriosis is managed by a gynaecologist, and it is to them that patients are referred for pain related to menstruation. At the first appointment, the doctor clarifies the history of the complaints, their connection with the cycle, and also gathers information about previous examinations and surgeries. They assess the general condition, the nature of the pain and how the symptoms affect daily life and work. Plans for pregnancy are discussed separately, since this determines the choice of further approach. If there is no specialist gynaecologist nearby, you can start with an appointment with an obstetrician-gynaecologist at your place of residence. If involvement of other organs is suspected, the doctor may refer you to related specialists for joint follow-up. This route helps avoid losing time and prevents going through the same stages again with different doctors.
What the treatment consists of
- Selection of hormonal therapy: the doctor chooses an option taking into account the symptoms, age and plans for pregnancy in order to contain the growth of the lesions.
- Painkillers as prescribed: they are used to reduce pain, but the selection remains with the doctor, not with the patient independently.
- Surgical removal of the lesions when indicated: surgery is considered when conservative measures are insufficient or there are specific clinical grounds.
- Physiotherapy and rehabilitation: these approaches help to recover after the intervention and gradually return to usual activity.
- Follow-up and pregnancy planning: regular visits allow the approach to be changed in good time and questions of conception to be discussed taking the condition into account.
What depends on the patient themselves
The regularity of follow-up with a gynaecologist directly affects how manageable the condition remains. If visits are postponed, the doctor does not see the changes and cannot adjust the care in good time. It is useful to keep notes about the pain, its connection with the cycle and how it affects work and sleep. Such notes make the conversation at the appointment specific and help describe more accurately what has changed since the last visit. It is important to report new complaints, even if they seem insignificant or unrelated to the main topic. Adherence to the agreements on the prescribed therapy and the timing of the follow-up appointment also remains on the patient's side. An open conversation about plans for pregnancy allows the doctor to build the approach in advance rather than change it in haste.
What helps prevent an exacerbation?
There is no specific prevention of endometriosis, since its causes are not fully understood. However, everyday habits, attention to one's condition and regular visits to a gynaecologist help to notice changes earlier and ease the course.
What to change in habits
A healthy lifestyle remains the foundation that a person influences on their own, without a doctor's help. Regular moderate physical activity maintains the tone of the pelvic muscles and improves blood circulation in the pelvic organs. A balanced diet with enough vegetables and fibre helps the bowels work and reduces the load on neighbouring organs. Adequate sleep and giving up smoking reduce the constant strain on the body and its hormonal background. Timely treatment of inflammatory diseases of the pelvic organs reduces the risk of further complications and flare-ups. Discussing contraception methods with a doctor allows choosing the option that suits this particular person. Keeping a diary of how one feels helps to notice what the intensification of pain or worsening of the condition is connected with. Such a diary should be shown to the doctor at an appointment in order to adjust everyday habits together.
What should be kept under control
- How one feels on different days of the cycle: note the nature and intensity of the pain in order to see whether the condition changes over time and what influences it.
- Regular check-ups with a gynaecologist: they help to notice changes in time and discuss suitable options of care before things get worse.
- Inflammatory diseases of the pelvic organs: their timely treatment reduces the risk of complications, so one should not put off a visit when alarming signs appear.
- Method of contraception: it should be discussed with a doctor, since different options affect the course of the condition and general well-being in different ways.
- Lifestyle: sleep, diet, activity and giving up smoking are what a person is able to change on their own and what noticeably affects the condition.
- Records of observations: a diary with dates and a description of sensations makes the conversation with the doctor specific and helps not to miss anything important.
How often to see a doctor
Regular check-ups with a gynaecologist are needed even when one feels well and nothing is troubling. Endometriosis can follow a wavelike course, and a calm period does not mean that observation is no longer required. At a check-up the doctor assesses the general condition, clarifies the complaints and, if necessary, discusses suitable options of care. If the pain intensifies, the nature of the discharge changes or new unpleasant sensations appear, the visit should not be put off until the planned date. Discussing contraception methods with a doctor and timely treatment of inflammatory diseases of the pelvic organs are also part of regular monitoring. Maintaining a healthy lifestyle reduces the strain on the body but does not replace observation by a specialist. Therefore it is reasonable to agree with the doctor on a convenient rhythm of visits and to keep to it, rather than coming only during a flare-up.
What is worth remembering
Endometriosis requires paying close attention to your body and regular follow-up with a specialist. Below are the main conclusions that will help you make informed decisions.
Main conclusions
Endometriosis does not always manifest clearly, so tolerating pain and expecting that everything will go away on its own often delays a visit to the doctor for years. Putting it off leads to the changes becoming more widespread, and selecting treatment becomes more difficult. It is important not to compare your condition with someone else's experience: for one woman endometriosis is almost unnoticeable, while for another it causes severe pain and disrupts the usual rhythm of life. Regular follow-up with a specialist helps to notice changes in time and adjust the approach. Endometriosis is a condition in which consistency matters: do not skip scheduled check-ups and tell your doctor about new sensations. If the pain intensifies or interferes with work and rest, this is a reason to seek help without delay, rather than waiting for a convenient moment. Endometriosis is not a death sentence, but it requires attention to yourself and a willingness to discuss any changes with your doctor.
