Let’s Talk About Endometriosis

So this article is, shall we say, a little off-piste for #TeamCoco yet we feel it’s most definitely worth publishing. It doesn’t contain enviable travel snaps or lust-worthy beauty products or even inspirational entrepreneurs. It does however contain a little glimpse into my recent discovery and some crucial info and advice from leading UK doctors.

With that said, this is definitely worth a read for those who suffer from endometriosis, those who think they may be and even those who know someone with the condition.

So, let’s go. After 11 years of suffering badly at the time of the month (being sick, passing out, countless days off school, university and work) and with a history of endometriosis in the family, my mum was convinced I had it; me, not so much. Despite having all the symptoms listed, my experiences were so different to those in my family, I was pretty much adamant, I did not have endometriosis, I thought I just suffered badly at that time of the month.In December last year  my mum finally convinced me to see our local GP and ask for a referral to a specialist. Within no time I was in the Gynaecology department being informed that the most effective option is a laparoscopy (key-hole surgery) to see if I did have endometriosis and if I did, they would remove it.

Eight months later and I’m being sedated by pills to calm me down enough to just have an injection in my tummy to thin out my blood, I’m having the child’s numbing cream applied to my hands for cannulas and I’m pretty much ready to run out of the hospital, (I’m a wimp FYI) after all why was I putting myself through this if I knew I didn’t have endometriosis.

After coming around in the recovery room after 2 and a half hours in surgery, being sick a lot and speaking to my surgeon, I am very glad I went through with it. It turns out I do have endometriosis, mainly on my left pelvic wall, side of my womb and near my bowel, I also had many adhesions in these areas too.

Luckily for me, none within my uterus or fallopian tubes, meaning my chances of getting pregnant may be hard but not as hard as the could be. The present endometriosis and adhesions were removed and I am now recovering.

So, why am I telling you all this, it’s quite personal right? It’s about something intimate isn’t it? Well the reason I’m talking about this so openly is that 1 in 10 women in the UK have endometriosis, that’s around 10% of women worldwide, yet the topic is still quite taboo, people usually haven’t heard of it and more often than not, people just dismiss it. Endometriosis can be debilitating, it can leave you infertile or with major problems when trying to conceive, it can leave you feeling like a hypochondriac when what you’re experiencing is severe pain that you are just expected to get on with.

So, in the hope’s of helping someone else with the condition, I have spoken to some medical professionals about when to seek help, how to ‘control’ symptoms, contraception options and the treatment available.

Let’s begin with speaking to Dr Venkat from the Harley Street Fertility Clinic to understand what endometriosis is and how it can affect fertility.

What is endometriosis?

Endometriosis is where pieces of tissue, similar to those found in the inner lining of the womb, grow outside of the womb in the bowel, bladder, ovaries fallopian tubes or in the lining of the abdomen. This causes symptoms including painful, heavy or irregular periods as well as pain in the lower abdomen, pelvis or lower back at any point throughout the cycle but especially during ovulation and can affect mental well-being too. It can also cause pain during, or after sex and can lead to difficulty in getting pregnant which is why it is linked to infertility.

How can having endometriosis affect fertility?

Endometriosis can reduce the egg number in the ovaries, if it is present in the ovaries. This leads to a low AMH and los ovarian reserve.If you have endometriosis and are trying to get pregnant without success, it is important to speak to your doctor about being referred to a gynaecologist or a fertility specialist, especially if you’ve been trying for over six months and are over 35.

What options are available to endo suffers to help with fertility?

There are surgical treatments to remove tissue that can help improve symptoms and give you a better chance of not only conceiving, but having better health. Removed tissue can grow back so surgery isn’t a guaranteed fix, but it can help improve the situation and the chances of having a baby. Even if you are not trying to get pregnant, you should check your ovarian reserve. If it is borderline or low, you should consider freezing your eggs. Again, speak to your GP as a first port of call and consider seeing a fertility specialist so you know what your options are – it’s always best to know what is happening with your body and fertility, especially if time is of the essence.

Next up is Dr Larisa Corda is an Obstetrician and Gynaecologist and is one of the UK’s leading Fertility experts. (www.drlarisacorda.com) with who we discuss diagnosis and contraception options.

For women who think they may be suffering from endometriosis, what steps would you recommend for them to take?

I would always advise anyone who is suffering from painful or heavy menstruation, pain during sex or unexplained abdominal aches, changes in bowel habit or urination, to go and see their GP in the first instance. Endometriosis can often take a long time to diagnose, even up to 10 years, so presenting early is vital. Not everyone will need an operation to diagnose the condition, but sometimes other causes need to be ruled out first. There can also be some cross over in symptoms. For example, IBS can often co exist with endometriosis.

Once endometriosis has been diagnosed through a laparoscopy, how do you know how severe it is?

The first thing to say is that not everyone needs an operation to diagnose endometriosis. Sometimes we can suspect it through symptoms, an examination and an ultrasound scan. If a laparoscopy is done, the surgeon will stage the endometriosis according to its size, depth and location, and whether it’s affecting any other organs in your pelvis, like your bladder or bowel.

Through surgery, endometriosis and adhesions are often discovered, can you help clarify the difference?

Endometriosis is essentially tissue that belongs to the inside of the womb found elsewhere where it doesn’t naturally grow, such as the ovaries or fallopian tubes. In response to changing hormone levels in the menstrual cycle, this tissue will thicken then break down and bleed but because it can’t leave the body like a period, it starts to irritate the tissue around it, forming scars. These are called adhesions and can cause a problem because they can distort certain organs, cause obstruction, pain and possible problems with fertility.

Are there any contraception options would you recommend?

This really depends on several factors such as your age, personal medical history and also what you prefer to take, but a range of hormonal contraceptives, such as the Mirena coil, and progesterone injection and implant are very effective at preventing pregnancy, and also help to reduce the symptoms of endometriosis at the same time, so you get the benefits of both.

For women who suffer from endometriosis, what advice would you give them to help reduce monthly symptoms?

Endometriosis is a condition that involves inflammation, which is when the body’s defence mechanisms go into over drive, and so reducing symptoms starts off with alleviating inflammation through lifestyle measures, such as diet, exercise, stress management and reducing your exposure to toxins in any products you may be using, as well as through smoking and alcohol.

Finally, we spoke to Laura Southern, nutritional consultant at www.london-gynaecology.com about how diet can affect the symptoms of endometriosis.

Can diet affect the symptoms of endometriosis? 

Yes, nutritional support can play a role in helping the endometriosis sufferer by supporting the immune system and inflammation as well as detoxification pathways. Because endometriosis is thought to be an oestrogen dominant condition, liver and digestive support through food is paramount.

So what should the diet of an endometriosis sufferer be?

High in brightly coloured, fresh vegetables to support both immunity and detoxification. Favour the green ‘brassica’ family, such as broccoli, Brussel Sprouts and kale, and add lots of deep red and purple vegetables; beetroots, purple ‘heritage’ carrots, red onions, red cabbage. Stir fries and soups can be utlitised to maximize vegetable intake. Include lots of foods rich in ‘essential fat’ for their anti-inflammatory benefit. Eat oily fish (salmon, mackerel, trout, herring, sardines) 2-3 times a week, and consume a handful of raw nuts and seeds daily. Try almonds, pumpkin seeds, pine nuts, walnuts, chia seeds and use a good quality olive oil or flax oil on salads. Additionally reduce reliance on caffeine, tobacco and alcohol which all place strain on the liver.

Does eating red meat and dairy worsen symptoms or is this a myth?

There is some evidence which shows that consuming red meat can increase risk of endometriosis, but it’s not conclusive. In some women consuming red meat can increase inflammation in the body – inflammation is what can cause pain and swelling which is a component of endometriosis. For those with a dairy intolerance, consuming dairy foods, e.g. milk and cheese, can also increase inflammation and therefore exacerbate symptoms of endometriosis.

The science is not definitive on this, however if you’re suffering, and seeking some relief, it might be worth seeing if a vegetarian, or vegan month improves symptoms. It is also thought that high levels of red meat and dairy consumption can increase oestrogen levels in the body. Including lots of fresh vegetables, pulses, beans, nuts and seeds will increase fibre. High levels of fibre can support the microbiome (good gut bacteria) to help denature old circulating oestrogen and excrete it effectively. This is important for endometriosis sufferers as endometriosis is an oestrogen dominant condition.

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