health
ENDOMETRIOSIS
Symptoms that shouldn’ t be ignored
“ The two main complaints women present with when seeking assistance are ongoing pelvic pain and difficulty falling pregnant,” says Dr Benecke. That pain might appear during periods, sex, bowel movements or even urination, and it’ s not your average cramp.
Dr Stevens adds:“ Symptoms can begin as early as adolescence and often worsen over time if left untreated. Emotional health is also affected. Anxiety and depression are not uncommon in young women coping with chronic pain.”
But not everyone has the same experience. Some women have severe disease and little to no pain, while others are debilitated by even a few lesions.“ The severity of symptoms often does not match how much disease is found,” says Dr Stevens.
Why it’ s often missed
Despite its prevalence, endometriosis can be difficult to spot.“ The symptoms are often cyclical, meaning the pain is worse right before or during the period, but many women assume this is just normal,” explains Dr Benecke.
Add to that the fact that diagnosis traditionally required laparoscopic surgery, and it’ s easy to see why so many women wait years for answers. Fortunately, things are improving.“ There has been a significant shift in guidelines towards less invasive diagnosis,” says Dr Stevens, including a pelvic ultrasound and symptom-based approaches.
Still, both doctors agree that seeing the right specialist is essential.“ If first-line treatments for pelvic pain and infertility do not adequately manage or address these concerns, it could suggest the presence of an underlying condition such as endometriosis,” says Dr Benecke.
What about fertility?
Not all women suffering from endometriosis struggle to conceive, but around 30 – 50 % do. According to Dr Stevens, factors such as inflammation, adhesions and ovarian dysfunction may interfere with ovulation, fertilisation and implantation.“ Peritoneal inflammation and immune dysregulation can impair the egg, sperm, and embryo viability,” she explains.
That said, it’ s not the end of the road. Many women conceive naturally or with assisted reproductive technologies. If hormones and painkillers don’ t help, surgery may be considered.“ Excision of endometrial tissue requires significant surgical skill,” cautions Dr Benecke, who adds that the first surgery is fundamentally important to later outcomes.
Supporting teens with endo
It’ s particularly important for parents to know what’ s normal and what’ s not when it comes to their teen’ s menstrual cycle.“ Watch for signs like severe cramps unrelieved by common painkillers, heavy
1. Ovary 2. Uterus 3. Vagina 4. Endometrium 5. Cervical canal 6. Broad ligament 7. Fallopian tubes
bleeding and symptoms that interfere with school or activities,” says Dr Stevens. If these are present, seek evaluation sooner rather than later.
And don’ t downplay emotional symptoms either.“ The physical aspects of the condition frequently have dimensions that can be emotionally painful too, which necessitates empathetic, holistic treatment,” adds Dr Benecke. His multidisciplinary team includes psychologists, pelvic-floor physiotherapists, endocrinologists and more.
Endometriosis is a complex condition that can seriously impact physical and emotional health, but help is out there.“ Awareness of early diagnosis is fundamental,” urges Dr Benecke.“ No one should live in silence with the pain of endometriosis.”
If you’ re struggling with heavy periods, chronic pain, or fertility issues, don’ t dismiss it as something to power through. The first step towards relief might be simply starting the conversation. �
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