Living with endometriosis: A silent struggle

Written in association with: Mr Shaheen Khazali
Published: | Updated: 02/09/2024
Edited by: Conor Lynch

Endometriosis is a chronic and often painful condition affecting millions of women worldwide. It occurs when tissue similar to the lining inside the uterus, known as endometrium, begins to grow outside the uterus. This abnormal tissue growth can cause a variety of symptoms, ranging from mild discomfort to debilitating pain, and can significantly impact a woman's quality of life.

Symptoms and diagnosis

The symptoms of endometriosis vary widely among individuals, which often makes diagnosis challenging. The most common symptom is pelvic pain, particularly during menstruation. However, the pain associated with endometriosis often extends beyond the menstrual cycle, affecting women throughout the month.

 

Other symptoms include painful intercourse, excessive menstrual bleeding, fatigue, and infertility. Some women may also experience digestive issues, such as bloating, constipation, or diarrhoea, particularly during their periods.

 

Diagnosis of endometriosis typically involves a combination of medical history, physical exams, imaging tests like ultrasounds, and sometimes laparoscopy, a minimally invasive surgical procedure. However, because symptoms can mimic other conditions, endometriosis is often misdiagnosed or diagnosed late, sometimes after years of discomfort.

 

Causes and risk factors

The exact cause of endometriosis remains unclear, though several theories exist. One theory suggests that retrograde menstruation, where menstrual blood flows backward through the fallopian tubes into the pelvic cavity, may cause the tissue to implant outside the uterus. Genetic factors are also believed to play a role, as women with a family history of endometriosis are at a higher risk. Other potential factors include immune system disorders and hormonal imbalances.

 

Treatment and management

While there is currently no cure for endometriosis, various treatment options are available to manage symptoms and improve quality of life. These include pain management through medications like nonsteroidal anti-inflammatory drugs (NSAIDs) and hormonal therapies that aim to reduce or eliminate menstruation. In more severe cases, surgical intervention may be necessary to remove the endometrial tissue. Lifestyle changes, such as diet modifications and regular exercise, can also help manage symptoms.

 

Living with endometriosis

Living with endometriosis can be challenging, both physically and emotionally. Support from healthcare providers, family, and support groups is crucial in managing the condition. Raising awareness and advocating for better research and treatment options are essential steps in improving the lives of those affected by endometriosis.

By Mr Shaheen Khazali
Obstetrics & gynaecology

Mr Shaheen Khazali is an internationally renowned consultant gynaecologist and robotic and laparoscopic endometriosis surgeon based in London. He specialises in complex endometriosis and adenomyosis and other benign gynaecological conditions, including heavy periodsovarian cysts, and (chronic) pelvic pain. He has particular expertise in the management of severe endometriosis when the condition has affected other organs such as the bowel, bladder, ureters diaphragm and the pelvic nerves. He leads the Lister endometriosis multidisciplinary team consisting of surgeons from different specialties.

Mr Khazali, who consults privately at The Lister Hospital trained in London and Cambridge, and undertook higher specialist training at the prestigious John Radcliff Hospital in Oxford, before relocating to the south of England to accomplish further training in Poole, Southampton, and Winchester.

Notably, Mr Khazali is one of few surgeons worldwide with expertise in neuropelveology, a rising discipline which focuses on pathologies of the pelvic nervous system, enabling Mr Khazali to provide treatment for patients whose pelvic nerves are affected by endometriosis and preserve important nerves during excision of endometriosis. Mr Khazali is also a prominent expert in advanced robotic (with the da Vinci Xi robot) and laparoscopic surgery, and performs almost the entirety of his diagnostic and treatment procedures exclusively with a minimally invasive approach.

He is a regular invited speaker at international conferences on endometriosis and minimally invasive benign gynaecology and has delivered numerous workshops and masterclasses for other gynaecologists on endometriosis surgical management. He has performed many live demonstrations of his techniques to large audiences of surgeons across the world.

He is known for his empathetic patient-centred approach and for taking time to explain in detail, available options to his patients, empowering them to make the decision that is right for them.

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