What causes endometriosis and what are the signs? A doctor answers our questions


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The need-to-know.

Marie-Claire Chappet
What happens if endometriosis is left untreated?
Endometriosis differs from person to person both in severity and symptoms. In the most extreme cases, endometriosis can begin to affect other organs in the pelvis, most commonly the bowel, ovaries or fallopian tubes. This can cause serious pain as well as impacting the function of these organs, which is why it is so important to begin treatment for endometriosis as soon as possible.
Can I get pregnant if I have endometriosis and can endometriosis cause infertility?
For most women, it will be the case that you can still get pregnant even if you have endometriosis. However, some women may need surgery in order to increase their chances of conception. In cases of severe and progressive endometriosis, it has the potential to cause subfertility (difficulty in conceiving) by affecting the ovaries, fallopian tube or the ability of the egg to travel from the ovary to the fallopian tubes.
Endometriosis can damage the ovaries or the fallopian tubes and in severe cases, one or both may have to be removed. Because of this, it’s important that the condition is diagnosed and treated as early as possible. Depending on factors such as your age and how advanced your endometriosis is, you may need IVF. If you have endometriosis and you are hoping to get pregnant, whether now or in the future, you should ask the advice of your specialist.
What should I do if I think I have endometriosis?
Endometriosis is a common condition and in most cases it is mild to moderate and limited to the pelvis. However, for some people the condition can cause serious problems. Early detection and early treatment will improve the quality of life of most people with the condition. If you think you have endometriosis, or have been diagnosed and are considering treatment options, be sure to speak to a gynaecologist who has a special interest in the condition.
What about the emotional effects?
Endometriosis can have a huge emotional as well as physical impact.

There’s a high level of depression among sufferers and it can affect careers, education, relationships, friendships and family life. It’s hard for non-sufferers to understand how painful and debilitating it can be. That’s where patient groups like
Endometriosis UK
come in. Women may not feel their doctor or nurse has time to talk about issues like how to tell your employer what’s wrong or how to access sex therapy. Patient groups have the experience and empathy to help, so give them a try.
Getting the treatment you deserve
If you don’t feel your GP is listening, ask to see another doctor at the practice, register with another practice or go to a walk-in clinic.
Take your pain & symptoms diary and use the consultation questionnaire (both free from the Endometriosis UK website) to get the most from each appointment.
“The European Society of Human Reproduction and Embryology (ESHRE) has published guidelines on the correct management of endometriosis,” says Dr Horne. “You can read the patient version online and check the care you’re receiving is in line with the ‘gold standard’.”
Your hospital may not have the best scanning equipment or most experienced radiographers. “So before having unnecessary abdominal surgery, it may be worth paying for a private scan using the latest transvaginal ultrasound scanners and dopplers (which measure blood flow),” says Bill Smith, head of ultrasound at London endometriosis specialists Clinical Diagnostics Services.
The UK has some of the best endometriosis surgeons and specialist centres. The British Society for Gynaecological Endoscopy (BSGE) has a list of accredited endometriosis centres, so you can visit its website and ask your GP to refer you to the hospital of your choice. Not all hospitals choose to join the scheme, though, so that’s not to say you won’t find an excellent gynaecologist who’s not on the list.”

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