HOW DO I KNOW THAT I HAVE ENDOMETRIOSIS?

Symptoms of endometriosis

Depending on the location of the endometriosis, symptoms can vary. But, typically, the pain of discomfort is cyclical. Cyclical pain means that the pain will appear every month, either during menses, before menses or after menses or during mid cycle. Any pain or discomfort that appears on a fixed time during every menstrual cycle is most likely due to endometriosis.

Endometriosis can also cause generalised unwellness like lethargy, headache and tiredness during menses. This is because all the endometriosis in the body causes local inflammation flare during menses and thus causes women to feel sick.

Pressure over any endometriosis can also cause tenderness and pain. This is typically seen with painful sex. Because during sex, there will be pressure placed on the endometriotic spots behind the uterus or at the vagina and that will cause pain.

LOCATION OF ENDOMETRIOSIS	ASSOCIATED CYCLICAL SYMPTOMS
Muscles of the uterus	Period pain or heavy menses or abnormal menses flow
Ovaries	Right or left sided pelvic pain
Rectum	Diarrhoea / loose stools / frequent stools / Constipation / blood in stools
Urinary bladder	Frequent urination / painful urination / blood in urine
Lung diaphragm	Pain under ribcage during breathing
Ureter	Right or left sided backache
Nerves to the legs	Numbness or pain at inner thigh / knee / entire leg

Endometriosis of the rectum

Presents as diarrhoea or constipation. Initial stages, it will present as diarrhoea or soft stools or frequent passing of stools that are cyclical. Most women will notice that these symptoms happen either during menses or before menses. As the endometriosis worsens, it can change into constipation that worsens during menses. In some cases, it can also present as blood in faeces during menses.

Endometriosis of the urinary bladder

Presents as pain during urination or blood in urine. Most of these women will present to the doctor and be diagnosed with a urinary tract infection. But, this urinary pain is cyclical and it happens every month.

The list is exhaustive. This is because endometriosis can spread to any organ in our body and wherever it goes, it causes pain or discomfort at the organ involved. Just remember that any cyclical pain or discomfort, have to suspect endometriosis.

How do I confirm that I have endometriosis?

Imaging is one of the ways to confirm endometriosis. However, endometriosis is an invisible disease in the initial stages. In advanced stages, blood cyst and adenomyosis will form. Blood cyst and adenomyosis can be visualised on routine ultrasound, CT Scan or MRI Scan.

However, for optimum treatment, a woman should start treatment early. In order to do so, we need to confirm the diagnosis at the stage where it is still invisible. In 2016. A group of researchers have found a technique to use ultrasound scanning machines to perform deep endometriosis scans. With this deep endometriosis scan, we can visualise endometriosis involving the rectum, bowel, rectovaginal septum and urinary tract. In our centre, we provide such scans for all cases with endometriosis, fertility cases as well as those with suspicious symptoms.