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A Call for awareness and education on the silent and distressing disease-Endometriosis!

Endometriosis Woes

Its not Life threatening, BUT its definitely “Quality of Life” Threatening Condition!

Most people know endometriosis as a condition that can cause infertility, but the commonest symptom is pain. Pain with periods, pain with sex, pain opening their bowels, or pelvic pain on most days of the month. Many women with endometriosis become pregnant easily.

Endometriosis is common, but because many women don’t talk about their symptoms, we often don’t realise that it affects between 1 in 10 and 1 in 20 women. For many years, endometriosis was thought to be an uncommon condition of women in their 30s and 40s. We now know that it is a common condition of women in their teens and 20s.

The lining of the uterus is called endometrium. This is the tissue that grows each month and bleeds away during a period. When tissue like endometrium is found outside the uterus it is called endometriosis.

How is endometriosis diagnosed?

The only reliable way to diagnose endometriosis is by laparoscopy. This is an operation where a telescope is inserted through the umbilicus (belly button) to view the organs inside the pelvis. Endometriosis lesions can be clear, pink, red, brown or black.

An ultrasound examination is usually normal unless there are large cysts of endometriosis in the ovaries. These are called endometriomas or chocolate cysts. So, even if an ultrasound is normal, endometriosis can still be present.

What sort of problems can endometriosis cause?

Endometriosis presents in many ways. Common presentations include:

  1. Women with no pain, who are found to have endometriosis during investigation for infertility.
  2. Women who have severe period pain, often from their teenage years, but are well at other times of the month. Pain with periods is called dysmenorrhoea.
  3. Women who have a mix of pain symptoms on most days of the month. This is called chronic pelvic pain. They may have a variety of symptoms including sharp or stabbing pains, changes in bladder function or changes in bowel function.

How is endometriosis managed?

Each woman with endometriosis is different, so the best treatment for each woman will depend on what type of problems she has.

In couples who are unable to become pregnant:

In women with painful periods, but who are otherwise well the pain may be from the uterus, from endometriosis lesions in the pelvis or from both these areas:

In women with chronic pelvic pain, treatment is more complicated. Often there are many different symptoms, so no single treatment will fix all her problems. It is often helpful to write down each symptom and plan treatment for each one:

Many women with chronic pelvic pain also suffer tiredness and may feel generally unwell. Even when their symptoms improve, they require a lot of emotional support from their family and friends to return to an active and healthy life.

Written by; -Dr Susan Evans is a Pelvic & Laproscopic Surgeon & author of ‘Endometriosis and other pelvic pain’ written for women with endometriosis. It is available from her website:

She is also the co-founder of the Asia Pacific Endometriosis Alliance & co-founder of Australian Endometriosis Centre, Adelaide Branch.

Her books will be available in Singapore in the World Women Health 2009, November 28th 2-6pm. Suntec City – Rooms303-306.

Registration details at

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