March is Endometriosis Awareness Month however despite nearly two millions of people suffering from the condition, it’s very misunderstood. Doctor Bhavini Shah, GP at LloydsPharmacy Online Doctor, has warned people that there are many ways to ease your pain, but notes there is no cure.
Symptoms and pain levels vary widely from person to person. While some may experience mild discomfort, others endure debilitating pain that can leave them bedridden for days. But what exactly is endometriosis, and how can you find relief?
What is endometriosis?
Dr Shah explains: “Endometriosis is where cells similar to those in the uterus grow in other parts of the body. It affects reproductive-age women and girls and can cause chronic pain during periods, sex and urination, and also causes bloating.
“There is no known cure, and treatment is focused on managing pain symptoms. The main symptoms of endometriosis can include painful periods that interfere with daily life, heavy menstrual bleeding, pelvic pain, irregular periods and pain during or after intercourse.”
Other symptoms include:
- Irregular or heavy periods
- pelvic pain when either passing urine or opening the bowel
- fatigue
- difficulty getting pregnant
7 ways to relieve endometriosis symptoms
1. Heat
Endometriosis UK suggests that using a hot water bottle or heated wheat bag can help relieve pain – even a warm bath may help. This can work by relaxing pelvic muscles, improving blood circulation and boosting nerve function. However, it’s important not to apply heat directly to the skin, as advised by the doctor.
2. Physiotherapy
Physiotherapists can create a tailored program of exercises and relaxation techniques to help strengthen or relax pelvic floor muscles. This can help to ease pain both during and outwith your period.
3. Painkillers
Whilst painkillers like paracetamol or ibuprofen may help, it’s not for everyone. The doctor notes that if you find these don’t help, stronger medications such as codeine may help but it comes with side effects for some.
4. TENS machines
A TENS machine – which stands for transcutaneous electrical nerve stimulation – eases aches and pains – including back and shoulder pain which can occur with endo. As a drug-free option, TENS machines can be used alongside medication to relieve muscular pain and aching joints.
A TENS machine uses electrodes that are attached to the skin and emit vibrations that help to relax the muscles. Whilst not painful, people with heart conditions or who are pregnant should not use TENS machines. A discussion with a GP must be had before using this option.
5. Amitriptyline
Amitriptyline, a pain-modifying medication commonly used to treat depression, can also help manage pain by altering how the body perceives it, preventing pain signals from reaching the brain. For endometriosis, the prescribed doses are lower than those used for depression and are available in both tablet and liquid form. However, it’s important to consult your GP before starting this treatment.
6. Hormonal treatments
The pill, coil, and implant can be effective options for managing endometriosis symptoms. In some cases, these methods stop periods altogether, which may help reduce pain and alleviate certain symptoms. However, it’s important to discuss the best approach with your GP to determine what works for you.
7. Surgery
Several surgical procedures can help ease endometriosis symptoms, making it crucial to consult a doctor to determine the best approach. The choice of treatment depends on various factors, such as age, future fertility plans, and any existing complications.
Laparoscopic (keyhole) surgery can be used to remove endometriosis tissue, potentially providing symptom relief. However, there is a chance that symptoms may return over time.
However in some cases, “if endometriosis is severe, surgery could be more complex”, the doctor says. “If it involves either the bladder or the bowel. This surgery will be the same as a laparoscopy, but it will involve more surgeons, such as a colorectal surgeon.
“A hysterectomy is a surgery that removes the womb, with or without removing the ovaries. If the ovaries are left, there is a chance that endometriosis might return.
“A hysterectomy isn’t the right option for everyone, and it’s not a decision to take lightly. It’s important to explore all other options first and discuss them with a GP or gynaecologist.
“An oophorectomy surgery is the removal of one or both ovaries. If both ovaries are removed, this is called a bilateral oophorectomy, which causes irreversible menopause.
“These procedures may be considered for various personal reasons. Since they are irreversible, it’s important to discuss the benefits and risks in detail with a consultant before making a decision.”