02 March 2011

Endometriosis FAQs

Heavy periods, abdominal or pelvic pain, irregular periods can all be symptoms of endometriosis. Here are the questions most frequently asked about endometriosis.


The tissue lining the inside of the uterus is called the endometrium, and endometriosis occurs when fragments of that tissue implant outside of the uterus in other areas of the body. 

These tissue growths respond to menstrual cycle hormones just the same way as the lining of the uterus:  building up, breaking down and shedding.  But, while blood from the uterus can leave the body via the cervix and vagina, the blood from endometriotic implants becomes trapped, forming cysts and causing scarring.


Q:  What are the symptoms of endometriosis?

What are the signs / symptoms of Endometriosis and what exactly does is mean?

A:  Endometriosis is the presence and growth of endometrial tissue external to the uterus. Common sites are the bladder, bowel and liver. The symptoms are abnormal uteran bleeding/abnormal menstrual cycle. This is usually associated with severe abdominal cramps and pain. Usually people who have endometriosis, struggle to conceive.

Q:  Endometriosis after a hysterectomy

I had a hysterectomy (only uterus removed) because of endometriosis. Can the endometriosis come back if I still have my ovaries?

A:  Endometriosis is caused by external uterine lining tissue. So if the uterus was removed, but the spots of endometriosis are still there, you may still have symptoms. Gyne's usually check with laporoscopy if any signs of endometriosis are visible and burn it or remove it.

Q:  Diagnosed with endometriosis

Yesterday I went for my first gynae visit.  The doctor did an internal scan and said I may have endometriosis.   He asked me to go for blood tests so he can get more results, but he said I could go for a laparoscopy which will cost about R10000 TO R15000.  Can I ask him to put me on treatment first?

The doctor said I can fall pregnant easily after a laparoscopy.  Does endometriosis make it difficult for a woman to fall pregnant?

A:  Endometriosis can only really be diagnosed with a laparoscopy as you can’t see it on sonar or x/rays. The doctors usually come to that diagnosis if they can’t find anything else that could be an obvious cause of pain or infertility.

You can ask him to put you on a “therapeutic test” of treatment for endometriosis if you can’t afford the laparoscopy, but you may need to have it anyway if this does not help. You can bargain with your gynae and the anaesthetist to see if they will reduce the fee for you. You can also ask them if you pay it off over a few months.

Q:  Treatment for endometriosis

I've just come out of hospital where I had a laparoscopy done, and I have been diagnosed with endometriosis.   What I want to know is what can be done to cure or take away this condition?

A:  They can treat this with physically removing the lesions ( laser or cauterizing them) or with hormonal medication to shrink them.

Q:  Period and bleeding belly button?

During the past few months I've noticed that my belly button bleeds on the first day of my period. I never see the actual bleeding, but I find the dried blood in there the next morning. I have endometriosis and PCOS and am on Ovral. Should I be worried or is there a logical explanation?

A:  It is most likely endometriosis in your belly button. If there is bleeding at the time of your period, it means that the endometriosis in your abdomen is not under control.

Q:  Extremely painful periods

I’ m 29 and healthy as far as I know, but I've been having problems with my period:
I was on the pill on and off since I was 16, until 2 years ago when I stopped taking it and my period didn’ t come for four months.

When it did come back, it was very heavy and painful. After that month when it came back, it’s been every 30 to 34 days, and not too heavy, but the pain has become unbearable. The pain will start anything up to a week before my period actually starts and it will continue throughout the duration of it. Sometimes it gets worse around the 5th or 6th day - the flow gets heavier instead of lighter, and contains a lot of blood clots.  I had a smear test at the beginning of the year which came back as normal. The doctor prescribed Ponstan, which I’ve been taking, but most months it doesn’t work and I have to take at least one day off work and spend it in bed, crying in agony. I don’t think this is normal.

Please can you give me some advice? My husband and I want to start trying for a baby this year and I’m really worried that there is something terribly wrong and I won't be able to fall pregnant!

A:  Endometriosis is a possible cause for severe period pains. This can only be diagnosed with laparoscopy, and it's important to discuss this with your gynaecologist.

More information:

Endometriosis:  surgery

(Joanne Hart, Health24, February 2011)


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