In a decision celebrated by women across the nation this week, the Australian Government announced that it will implement the first national action plan for endometriosis.  The groundbreaking new plan aims to improve the awareness, understanding and treatment for condition which affects an estimated 1 in 10 Australian women.  A number similar to that of diabetes get which currently receives about 5% of the funding through the National Health and Medical Research Council.  The lack of awareness also leaves suffers undiagnosed for an average eight to nine years.

A call for more research into endometriosis will be issued starting with $160,000 in immediate funding for continued research into the use of genomics to investigate better treatment strategies.

What is endometriosis?

The endometrium normally resides in the uterus, forming the uterine lining, and is expelled and rebuilt each month during menstruation.  Endometriosis is a condition in which endometrial tissue grows outside the uterus.  In women suffering endometriosis, displaced endometrial tissue is most commonly found on the ovaries, in the fallopian tubes, the outer wall of the uterus, the ligaments of the uterus or ovaries, in the bowel, the ureters or the bladder.  However, endometriosis can occur anywhere in the body.

For women with endometriosis, the displaced endometrial tissue responds and performs in the same way as the endometrium forming the uterine lining.  The displaced tissue builds up as the body moves towards ovulation and then breaks down and bleeds during menstruation.  This bleeding can trigger inflammation and pain and over time can lead to scarring, known as adhesions.  Endometriosis has a significant impact on fertility and is a causative factor in 35 – 50% of fertility issues in women.

The cause of endometriosis is largely unknown and symptoms can vary greatly.  Most common symptoms of endometriosis include

  • Severe period pain (or pain may last all month long)
  • Lower abdominal pain or back pain
  • Heavy bleeding and/or clotting
  • Abnormally long or short cycles
  • PMS (Pre-menstrual syndrome)
  • PMT (Pre-menstrual tension)
  • Painful intercourse
  • Abdominal swelling
  • Infertility

As these symptoms are somewhat vague and can occur without the presence of endometriosis, some women are not aware they have endometriosis until it is discovered during unrelated surgery or when trying to fall pregnant.  Therefore early diagnosis and prevention of endometriosis can be difficult.

Endometriosis does appear to have a genetic connection and is commonly seen in mothers, daughters and sisters.  Endometriosis is also found to be associated with a relative estrogen to progesterone excess. 

How do I know if I have it?

Although the symptom picture of endometriosis varies greatly, if you are having difficulty falling pregnant and are experiencing any of the below symptoms, you should consult your health care professional.

  • Severe period pain (or pain may last all month long)
  • Lower abdominal pain or back pain
  • Heavy bleeding and/or clotting
  • Abnormally long or short cycles
  • PMS (Pre-menstrual syndrome)
  • PMT (Pre-menstrual tension)
  • Painful intercourse
  • Abdominal swelling

Most diagnoses of endometriosis occur during a laparoscopy, when gynaecologists can see the misplaced endometrial tissue.  During this procedure, small incisions are made between the navel and the pubic bone, through which a thin instrument with fibre optics is inserted so the surgeon can view the inner organs.  The exact location of the incisions depends on your surgeons experience and your unique presentation.  Sometimes a laparoscopy is simply performed as a diagnostic tool, or in more severe cases, endometrial tissue as well as any scar tissue and adhesions can be removed.  Speak to your Health Care Professional if you are concerned about whether you may have Endometriosis.

Endometriosis and fertility

Mild endometriosis may have little, if any, impact on fertility.  In fact some women may never be aware that they have it.  However, more severe endometriosis can have a significant impact on fertility and your ability to fall pregnant.  The displaced endometrial tissue can damage to internal organs including the fallopian tubes, ovaries and uterus.  Scarring can hinder or block the passage of the egg and sperm making fertilisation difficult or impossible.  Scarring on the uterus may prevent a fertilised egg from implanting.  If endometriosis is present on the ovaries, eggs may be damaged resulting in decreased ovarian reserve and reduced egg quality and quantity.  The continual bleeding of displaced endometrial tissue also increases inflammation and congestion within the body.

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