Endometriosis symptoms explained

Endometriosis is when womb-like tissue grows in places like the ovaries and fallopian tubes. Experienced gynaecologist, Mr Akobundu Nnochiri explains the common symptoms of this condition, which can seriously affect the health of women of all ages.

Period pains

Although this is one of the most common symptoms of endometriosis, if it occurs without any of the other symptoms, it’s likely to be unrelated. However, more severe period pains occur due to the increased inflammation caused by endometriosis, as well as the presence of other conditions like adenomyosis which often coexist with endometriosis.

Severe pain during intercourse

Endometriosis can cause large cysts to grow inside the ovaries or vagina which can lead to pain during intercourse.

Painful bowel movements

Endometriosis can cause the bowel to become attached to the vagina which can lead to painful bowel movements. This is most common during periods, but can also occur more regularly. Endometriotic cysts that put pressure on the bowel can also be a cause of pain in the bowels.

Shooting pain in the rectum

This is a common symptom of rectovaginal endometriosis due to growths around the uterosacral ligament and rectovaginal zone.

Rectal bleeding

Rectal bleeding usually occurs during periods, so often follows the same cycle and produces a darker blood, similar to when menstruating. You can usually differentiate it from conditions like piles or anal fissures which produce fresher blood.

Back pain

This often occurs in cases of endometriosis which spread to the uterosacral ligaments.

Thigh pain

Thigh pain usually occurs in cases of endometriosis in the ovaries, which cause the ovaries to stick to the side of the pelvis. The nerves then become irritated, resulting in thigh pain.

Urinary symptoms

In cases of endometriosis that affect the bladder, it’s common to experience bladder pain and difficulty holding urine. In a small number of cases, when endometriosis spreads to the bladder wall, patients my find blood in their urine.

How is endometriosis diagnosed?

Endometriosis is a medical condition where tissue similar to the lining of the uterus (endometrium) grows outside the uterus, causing various symptoms and pain. Diagnosing endometriosis typically involves a combination of medical history assessment, physical examination, and imaging studies. The most definitive way to diagnose endometriosis is through a minimally invasive surgical procedure called laparoscopy. Here's a step-by-step guide to the diagnosis of endometriosis:

Medical history and symptom assessment:

The first step in diagnosing endometriosis is to discuss your symptoms with a healthcare provider.

Physical examination

 A pelvic examination may be performed to check for any physical signs of endometriosis, such as tender nodules or masses in the pelvic area.

Imaging studies

While imaging studies like ultrasounds and MRIs cannot definitively diagnose endometriosis, they can help identify certain cysts or masses that may suggest the presence of endometriosis. Transvaginal ultrasound, in particular, can sometimes detect endometriomas (cysts filled with endometrial tissue) in the ovaries.

Blood tests

Blood tests are not typically used to diagnose endometriosis directly. However, they may be ordered to rule out other conditions that can cause similar symptoms.

Laparoscopy:

Laparoscopy is a minimally invasive surgical procedure in which a thin, lighted tube with a camera (laparoscope) is inserted through a small incision in the abdomen. This allows the surgeon to visualise the pelvic organs and identify endometrial tissue growths. Biopsy samples may also be taken during laparoscopy to confirm the presence of endometriosis.

Pathology examination

Tissue samples obtained during laparoscopy are sent to a pathology lab for examination. A pathologist will confirm the presence of endometrial tissue outside the uterus and assess the extent and severity of the disease.

It's important to note that the severity of endometriosis can vary widely, and the symptoms do not always correlate with the extent of the disease. Some individuals with mild endometriosis may experience severe pain, while others with extensive disease may have minimal or no symptoms.

If you’d like to discuss this or any other gynaecological issue with Mr Nnochiri, you can request an appointment by visiting his profile.