Could it be endometriosis?

What is endometriosis?

Endometriosis occurs when cells similar to the tissue lining of the uterus grow in other parts of the body. This most commonly occurs in the reproductive organs, but cells have also been found in bones, muscle, the lungs, and the brain. Each month as hormones fluctuate during the menstrual cycle, these cells respond, meaning they shed and bleed at the same time as you get your period. Because there is no way for this tissue to leave your body it becomes trapped and can cause inflammation and scar tissue, which in turn can become very painful.

Signs and symptoms to look out for

Endometriosis can present with a range of symptoms that are not always consistent. This, understandably, makes recognising the condition difficult, and contributes to the average diagnosis time of 6.5 years.² Some common symptoms of endometriosis include:

• Heavy or irregular periods
• Abdominal or pelvic pain before and during a period, during or after sex, or when going to the toilet
• Changes to urination or bowel movements, including bleeding
• Bloating
• Feeling tired or moody
• Difficulty conceiving

Symptoms can appear anytime from puberty and some people may experience no notable symptoms at all. If you are experiencing any of the symptoms above it is important to speak with your doctor. Some of these symptoms also relate to other serious conditions.

Endometriosis symptoms can be treated with:

• Pain relief medications such as paracetamol
• Hormonal therapy, such as the oral contraceptive pill, intrauterine devices, implants and injections. These are all used to suppress the growth of endometriosis
• Lifestyle changes such as improving your diet, reducing and managing stress, exercising regularly and getting enough sleep

What is the link between endometriosis and fertility?

Around 1 in 3 people with endometriosis will experience difficulty with fertility.³ This can happen if scarring occurs on the fallopian tubes and ovaries, if there is pelvic inflammation, or if blockages form in the fallopian tubes. Endometriosis can also affect ovulation. Because endometriosis affects people in different ways, treatment to improve fertility will vary between individuals. In some cases, medication and the medical insertion of sperm directly into the uterus, or IVF, will be recommended.

How is endometriosis treated?

There is no cure for endometriosis, but there are treatments for the problems and symptoms it causes.

A laparoscopy is the only way to positively confirm a diagnosis of endometriosis. Taking place under a general anaesthetic, this procedure is when a thin tube (a laparoscope) is inserted through a small incision made near the belly button. A camera is used to look at the tissue and see if it is endometrial. During this procedure, the endometriosis may be fully removed, partially removed, or it may not be treated at all, depending on the extent of the endometriosis and the skill of the surgeon. A small tissue sample is also taken for lab testing to confirm the diagnosis.

In severe, recurrent cases, a hysterectomy is sometimes needed to treat the condition.

A laparoscopy is generally an in-patient procedure and may require an overnight stay in hospital. Doctor’s fees for the laparoscopy itself typically are around $2,800⁴ with a portion of this covered by Medicare. In addition to payments for doctors’ fees, hospital costs like accommodation, theatre and medical device fees can also occur. Depending on your level of Private Health Insurance, your insurer may pay a portion of these fees. When medical out-of-pocket expenses occur it may be from charges relating to the surgeon, anaesthetist, assistants or medical imaging.

It is a myth that pregnancy can cure endometriosis – in some cases it may relieve symptoms (similar to the use of hormonal therapies), but they tend to return after childbirth.⁵

Ongoing care and treatment

Because there is no cure for endometriosis, there is a chance that the condition can recur after surgery. Recurrence can depend on factors like the extent of the endometriosis, how much was removed during the surgery, and whether suppressive hormonal therapy is used post-surgery.⁶

When to see your doctor

If you are experiencing pelvic or period pain that causes disruption to your day or any of the symptoms listed above, visit your doctor to discuss your options and find out what can be done to help you relieve your symptoms.

1 Endometriosis Australia (2024), Endometriosis Australia, https://endometriosisaustralia.org/about-endometriosis/.

2 Ibid.

3 Australian Government Department of Health and Aged Care (2023), National Action Plan for Endometriosis, https://www.health.gov.au/resources/publications/national-action-plan-for-endometriosis.

4 Australian Government Department of Health and Aged Care (2024), Medical Costs Finder, Laproscopy – keyhole surgery to abdomen or pelvis, including for endometriosis, Australia, https://www.health.gov.au/resources/apps-and-tools/medical-costs-finder.

5 Endometriosis.org (2016), Myths and misconceptions in endometriosis, https://endometriosis.org/resources/articles/myths/.

6 Cleveland Clinic (2022), Endometriosis Surgery, https://my.clevelandclinic.org/health/treatments/4620-endometriosis-surgery