Even though endometriosis affects 10% of women globally, there is still often a delay in an accurate diagnosis. Coming under the care of an experienced gynaecologist can help to accelerate your diagnosis, giving you access to timely treatment that can improve your quality of life and reduce the risk of long-term complications.
Endometriosis is a life-long condition involving the abnormal growth of endometrium cells outside of their usual place lining the inside of the uterus. Common areas of this abnormal cell growth include around the reproductive organs, including the ovaries, behind the uterus, and around the fallopian tubes. During your monthly menstrual cycle, these cells continue to respond to the hormones that signal your menstrual period if you haven't conceived that month - breaking down and shedding. As this process occurs in a location other than inside the uterus, it results in pain, inflammation and scarring of the affected body part, and potentially infertility.
The pain from endometriosis can be worse during your menstrual period or at the time of ovulation. Urination and bowel movements may also be uncomfortable.
Having endometriosis does not automatically mean you will have difficulty falling pregnant. Many women with endometriosis are still able to conceive naturally. If you are facing infertility, testing for endometriosis can help to guide your fertility options.
We can deduce a high likelihood that endometriosis is present by a physical pelvic examination and pelvic ultrasound in conjunction with understanding your symptoms. If your diagnosis is still inconclusive, we may refer you to a reputable endometriosis surgeon for a laparoscopy. A laparoscopy is a keyhole surgical procedure that involves visualising the pelvic organs with a laparoscope (a thin telescope), and taking a small sample of abnormal tissue to examine for signs of endometriosis.
If endometriosis is affecting your ability to conceive, we can discuss your options for fertility treatment. Our recommendations are tailored based on the severity of the endometriosis and which areas of your body are affected.
This is actually quite common. 50% of women will undergo a laparoscopy for fertility reasons alone without having troublesome periods. Some symptoms of endometriosis can be subtle such as bloating, fatigue, and headaches.
The data is very encouraging for removal of superficial endometriosis (stage I & II) disease and improved spontaneous pregnancy rates. Data on deep infiltrating endometriosis (stage III & IV) remains more mixed on outcomes.
This is different in each individual and needs to be assessed on a case-by-case basis. Many women will conceive with IVF without needing a laparoscopy and removal of their endometriosis, however, for others it is necessary.
Commonly, women do feel significantly improved after endometriosis excision, with the majority having an improvement in their pelvic pain and other subtle symptoms. However, it is not always the case for everybody.
Dr Danielle Robson, fertility specialist, consults at three locations across Sydney: the CBD, Chatswood, and Manly. A referral from a general practitioner is required for all initial appointments.
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Danielle is a fertility specialist and gynaecologist with an interest in fertility preservation, premature ovarian insufficiency, and menopause management. She is a Fellow of the Royal Australian and New Zealand College of Obstetrics and Gynaecology and a sub-specialist in Reproductive Endocrinology and Infertility.
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