Endometriosis: why awareness from a young age is key

Ilanna Darcy

Chair, Endometriosis Association of Ireland

Endometriosis is frequently misunderstood, misdiagnosed and mistreated. It can manifest in many different ways and can wreak havoc across a person’s life.

Estimated to affect 1 in 10 women, endometriosis can be completely silent (asymptomatic) or viciously present. For many, it can have a significant impact on their quality of life, from preadolescence to post-menopause. In Ireland, around 155,000 women are affected, with symptoms and their severity varying.

Endometriosis early signs

Endometriosis is usually triggered by hormonal shifts occurring during teenage years. Pain and heavy periods are the most common symptoms, which can impact school, sport and social activity attendance. It is important that young girls know this is not normal.

Fertility considerations

Endometriosis is one of the leading causes of infertility. For some, especially those with silent endometriosis, a diagnosis might only be triggered while undergoing fertility treatment, so early awareness is key.

Endometriosis is one of the
leading causes of infertility.

Perimenopause and menopause

Endometriosis can complicate hormone replacement therapy (HRT) administration, especially for those using a hormonal coil or those needing a hysterectomy, as oestrogen-only HRT is normally prescribed. However, women with endometriosis benefit from adding body-identical progesterone to their regime.

Other common symptoms

Some experience pain while urinating, during bowel movements or having sex; pain in the pelvic region, back or legs; bloating, unexplained fatigue, anxiety and depression. Pain can be cyclical or constant and mild to severe.

Diagnosis and treatment

A definitive diagnosis is only possible with a laparoscopy. As this is a surgical procedure performed under general anaesthesia, it is not the first line of treatment, and this delays diagnosis. GPs will usually try hormonal treatment and pain medication first to suppress symptoms. However, many require an onward referral.

Treatment with excision surgery is considered more effective than ablation, and further onward referral may be required for example if the skill of a colorectal surgeon is required rather than a gynaecologist. For anyone who suspects they might have endometriosis, we recommend keeping a journal of symptoms to ensure you get the support you need.

More must be done to properly understand the extent of the disease and to ensure people will have access to the care they need.