Endometriosis

This is an inflammatory condition where cells originating from the lining of the uterus (endometrium) implants and grows in other places separate to the uterus such as ovaries, fallopian tubes, peritoneal lining, and bowel. Endometriosis can set off inflammation and damage to the organs where it lands due to scarring and adhesions. This can also result in infertility due to blockage of the fallopian tubes.

Symptoms include:

• Pain in the pelvis
• Extremely painful menstrual bleeds

• A pelvic examination will evaluate whether there is mobility or tenderness within the uterus or surrounding areas
• Ultrasound scan or MRI – this will assess whether there are large pockets of endometriosis (endometriomas) 
• Laparoscopy – This is where a camera is inserted into the pelvic cavity and the areas of endometriosis and associated scarring assessed. The endometriotic deposits can there be excised, cauterised or lasered, and the adhesions and scar tissue between the pelvic organs and bowel tissue divided, freeing up the bowel and leaving the patient much more comfortable. If there is a fallopian tube blockage, this can often be surgically treated with removal of the endometriosis and scarring, although the fallopian tubes may not be as competent or efficient because of damage.

"Switching off" the ovarian hormones which can worsen endometriosis is a common treatment. This includes continuous contraceptive pill, continuous progesterone, downregulating of the ovaries