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Health

26th Mar 2024

Understanding Endometriosis: Expert explains symptoms, treatment and dispels myths

Sophie Collins

Endometriosis

Endometriosis is a chronic and often misunderstood condition that silently affects millions of women worldwide

In Ireland alone, endometriosis is estimated to impact around 155,000 women, highlighting the urgent need for heightened awareness and proactive measures in addressing this debilitating disease. 

Often misdiagnosed as other conditions such as IBS or ovarian cysts, endometriosis poses significant challenges to both physical and psychological well-being. 

Despite its prevalence, there is still a lack of conclusive understanding regarding what causes it. 

Nikki Shearer, Clinical Nurse Manager at the Beacon Hospital, highlighted the importance of early intervention and specialised care in managing the condition. 

Endo
Nikki Shearer

Speaking to Her.ie, she emphasised that debilitating symptoms such as excruciating menstrual pain should not be dismissed as normal, and urged those affected to seek guidance from a gynaecologist as soon as possible. 

“Endometriosis is often misdiagnosed as IBS, ovarian cysts, or other conditions that can cause pelvic pain, which can have devastating effects on the physical and psychological well-being of the women who have to live with this debilitating disease.

“It can cause serious pain, severe bleeding, infertility and poorer quality of life. However, everyone’s experience on this journey will be different and symptoms can significantly differ.”

Nurse Shearer delved into the complexities of endometriosis, shedding light on its definition and diagnostic challenges. 

She explained that endometriosis involves the presence of tissue similar to the uterine lining outside the uterus, affecting 6–10% of women globally.

Despite its widespread impact, the diagnostic journey for many people is fraught with delays and misinterpretations, contributing to prolonged suffering and reduced quality of life. 

“At present, the only way to conclusively stage endometriosis is laparoscopic inspection, preferably with histological (microscopic) confirmation which explains the diagnostic delay of endometriosis,” Shearer said. 

“The diagnosis of endometriosis based on symptoms alone is unreliable. So far, non-invasive diagnostic approaches such as ultrasound, MRI or blood tests do not have sufficient diagnostic power.” 

Shearer also confirmed that “no blood tests exist for the diagnosis of endometriosis”.

Endometriosis

Recognising the varied manifestations of endometriosis, Nurse Shearer outlined key symptoms to watch out for, including pelvic pain, heavy menstrual bleeding, and discomfort during bowel movements or urination. 

She stressed the importance of early detection and comprehensive assessment to tailor treatment strategies effectively. 

While the exact cause of the condition remains unknown, advancements in treatments offer hope for improved symptom management. 

Nurse Shearer discussed various therapeutic options, ranging from pain relief medications to surgical interventions. 

Additionally, she highlighted ongoing research efforts, such as clinical trials exploring novel non-hormonal treatments, signalling potential breakthroughs in the management of this complex condition. 

“There are treatments available which may help with the symptoms. Firstly, your healthcare provider will consider pain relief, including anti-inflammatory medication. 

“Alternative options can also be considered, for example, heat packs, TEN stimulation, acupuncture, reflexology, physical therapy and diet. 

“Your doctor will also discuss medication to suppress ovarian function and endometrial tissue progression, this can include the oral contraception pill, progesterone-only pill, contraceptive patch or an intrauterine system, or medicines called gonadotrophin-releasing hormone (GnRH) analogues. 

“Sometimes, finding the right treatment for you can be difficult and you should be informed about the risks and benefits.”

On the topic of new treatments coming down the line, she said: “There are clinical trials by the University of Scotland for a new drug for endometriosis, dichloroacetate (DCA) is on the horizon which potentially breaks down cells related to Endometriosis, this would be the first-ever non-hormonal, non-surgical treatment for endometriosis with the prospect for better management and relief of symptoms.”

Speaking about the concerns surrounding fertility, Nurse Shearer dispelled misconceptions regarding endometriosis as a definitive cause of infertility. 

Endometriosis

While the condition may impact reproductive health, she reassured people that conception is still possible with appropriate medical guidance. 

“Endometriosis is not the cause of infertility; however, it can be associated with fertility problems. 

“In some cases, even with severe endometriosis, natural conception is still possible.  

“If you suspect you have endometriosis and you are struggling to get pregnant, discuss this with your healthcare provider, you may require a referral to a Gynaecologist who specialises in reproductive surgery.”

For those navigating the uncertainties of endometriosis, Nurse Shearer spoke of the importance of proactive communication with healthcare providers, advocating for personalised care plans tailored to each person’s needs. 

By fostering a supportive environment and empowering patients with knowledge, she aims to combat the stigma and isolation often associated with endometriosis. 

Endometriosis presents challenges, but with increased awareness and collaborative efforts, strides can be made towards improved diagnosis, treatment, and support services. 

As Nurse Shearer aptly reminds us, every journey begins with a single step towards understanding and advocacy. 

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