Latest news with #LondonGynaecology
Daily Record
5 days ago
- Health
- Daily Record
Common signs of Endometriosis as pop star Ella Henderson opens up about 'devastating' diagnosis
The singer said the news was "devastating" but finally getting an official diagnosis has also been "empowering" UK singer-songwriter Ella Henderson has revealed to her fans on social media that she was officially diagnosed with endometriosis in January. The artist, who was an X Factor contestant in 2019, said the news had been "devastating". The 29-year-old said receiving an official diagnosis, however, has also been "validating and empowering". The musician, known for hits such as 'Ghost' and 'Crazy What Love Can Do,' shared her health update on Instagram. In a video, she explained: "The last few years have been a little bit of a rollercoaster to say the least behind the scenes. I have really, really been struggling not only with stomach bloating and physical pain, but also with my mental health on the basis that I thought at one point that this was just all in my head and I wasn't really believed. "Although it has kind of been devastating news... I can finally take control of my own body. I feel very, very fortunate that I was able to have a laparoscopy earlier this year to find out what I do have. "Speaking to other women who have endometriosis and learning about it and understanding it more, and about how to live with it, has been so so crucial to me feeling like I am not alone." Endometriosis affects one in 10 women in the UK, according to Endometriosis UK, however, it remains a widely misunderstood condition. Here we take a look at what endometriosis is, common symptoms, and how to get help. What is endometriosis? "Endometriosis is an oestrogen driven, chronic inflammatory condition where tissue similar to the lining inside the uterus (endometrium) grows outside the uterus, leading to various symptoms, including painful periods," explained Mr Hemant Vakharia, consultant gynaecologist, specialising in endometriosis at London Gynaecology. Endometriosis is often categorised into four main types – which refer to the location, amount and depth of endometrial lesions – and it's possible to have more than one type, according to Endometriosis UK. Here are some explanations of the different types which are listed on Endometriosis UK's website: Peritoneal (superficial) endometriosis – is found mainly on the pelvic peritoneum – a thin film that lines the inner surface of the pelvis and surrounds the pelvic organs. Ovarian endometriosis (endometrioma) – is when endometriosis cysts are found in the ovaries. Deep endometriosis – is found in locations such as the bladder, bowel and recto-vaginal septum (tissue separating the vagina and the rectum). The lesions of endometriosis are at a deeper level than peritoneal (superficial) endometriosis. Extra-pelvic endometriosis – is when endometriosis is found outside of the pelvis, such as the thorax (chest) and caesarean scars. What are the common symptoms? "Painful periods, known as dysmenorrhoea, is a common sign of endometriosis," highlights Vakharia. "Endometriotic cells are stimulated by hormones in your natural cycle which causes inflammation and pain." Another typical sign is dyspareunia, the medical term for painful intercourse. "The inflammation can lead to structures in the pelvis sticking together and also lead to thickening of tissues developing," says Vakharia. "As a result of the inflammation and thickening, patients with endometriosis can have pain with intercourse.' It can also impact your bowels. The endometriosis specialist went on: "In patients who have endometriotic deposits on the bowel, or in those where the inflammation has caused their bowel to stick to other structures, it can be painful to open their bowels. This can occur with their periods or all the time." Other issues include chest pain when on your period, difficulty conceiving and ovarian cysts, Vakharia added. How is endometriosis diagnosed? "It is a good idea to speak to your GP in the first instance who will take a history from you and examine you," Vakharia advised. "Often, they will request an ultrasound of the pelvis and discuss the results with you." However, endometriosis does not always show up on standard imaging, such as ultrasounds or MRIs. "This is especially true in superficial endometriosis, where the signs can be very subtle or when the disease affects areas not easily visualised," Vakharia noted. "If you have been told your scan is normal but have persistent symptoms, such as chronic pelvic pain, heavy periods, or pain during sex, it's essential to advocate for yourself and seek a specialist for further evaluation." When should women seek medical help? "It can be difficult to differentiate between 'normal' periods and 'heavy or painful' periods, as there is often no objective way of comparing," Mr Narendra Pisal, consultant gynaecologist at London Gynaecology, said. "A lot of women just put up with that 'time of the month' and are told to get on with it. However, if you have to put your life on hold for those few days or if your sex life is affected by pain during sex, it is time to take note and ask for some tests." Pisal acknowledges that it can be challenging for a GP to identify the root cause during a 10-minute appointment, so suggests keeping a diary to track when your symptoms occur and how intense the pain is. "Have a diary of your menstrual cycle with particular emphasis on heaviness, pain and any other symptoms with a system for indicating severity," suggests Pisal. "Also note down if you have to take painkillers and how many. If the symptoms are affecting your life and you have to take time off work, that is also a significant factor." Join the Daily Record WhatsApp community! Get the latest news sent straight to your messages by joining our WhatsApp community today. You'll receive daily updates on breaking news as well as the top headlines across Scotland. No one will be able to see who is signed up and no one can send messages except the Daily Record team. All you have to do is click here if you're on mobile, select 'Join Community' and you're in! If you're on a desktop, simply scan the QR code above with your phone and click 'Join Community'. We also treat our community members to special offers, promotions, and adverts from us and our partners. If you don't like our community, you can check out any time you like. To leave our community click on the name at the top of your screen and choose 'exit group'. If you're curious, you can read our Privacy Notice. What treatment options are available for endometriosis? "Patients can be treated with the combined pill, progesterone-only pill, progesterone intrauterine device or surgery," Vakharia said. "Sometimes, we also use medications that induce a temporary menopause by blocking hormonal signals to the ovary which reduces stimulation of the endometriotic tissue. "This option is often used before surgery for severe disease. A laparoscopy will allow diagnosis and excision of disease which can improve symptoms. In patients with severe disease, they may need a two-stage procedure."
Yahoo
6 days ago
- Health
- Yahoo
Endometriosis affects one in 10 women. These are the signs to look for
British singer and songwriter Ella Henderson has revealed that she was officially diagnosed with endometriosis in January. Endometriosis affects one in 10 women and those assigned female at birth in the UK, according to Endometriosis UK; however, it remains a widely misunderstood condition. In a video posted on Instagram, the 29-year-old singer said: 'The last few years have been a little bit of a roller coaster to say the least behind the scenes. I have really, really been struggling not only with stomach bloating and physical pain, but also with my mental health on the basis that I thought at one point that this was just all in my head and I wasn't really believed.' Henderson said that although it had been 'devastating news', it 'has been the most validating and empowering feeling because I can finally take control of my own body'. 'I feel very, very fortunate that I was able to have a laparoscopy earlier this year to find out what I do have. Speaking to other women who have endometriosis and learning about it and understanding it more, and about how to live with it, has been so so crucial to me feeling like I am not alone.' Emma Cox, CEO for Endometriosis UK, said she applauds Ella for 'sharing her experience of endometriosis in such an open and frank way, highlighting the significant and detrimental impact the condition can have on all aspects of someone's life'. 'Ella's willingness to share her story will no doubt help others in their diagnosis journey; helping them access the care they need.' Experts at London Gynaecology have shared exactly what endometriosis is and what some of the common symptoms to look out for are. What is endometriosis? 'Endometriosis is an oestrogen-driven, chronic inflammatory condition where tissue similar to the lining inside the uterus (endometrium) grows outside the uterus, leading to various symptoms, including painful periods,' explains Mr Hemant Vakharia, consultant gynaecologist, specialising in endometriosis and advanced minimal access surgery at London Gynaecology. Endometriosis is often categorised into four main types – which refer to the location, amount and depth of endometrial lesions – and it's possible to have more than one type, according to Endometriosis UK. Here are some explanations of the different types, which are listed on Endometriosis UK's website: Peritoneal (superficial) endometriosis – is found mainly on the pelvic peritoneum – a thin film that lines the inner surface of the pelvis and surrounds the pelvic organs. Ovarian endometriosis (endometrioma) – is when endometriosis cysts are found in the ovaries. Deep endometriosis – is found in locations such as the bladder, bowel and recto-vaginal septum (tissue separating the vagina and the rectum). The lesions of endometriosis are at a deeper level than peritoneal (superficial) endometriosis. Extra-pelvic endometriosis – is when endometriosis is found outside of the pelvis, such as the thorax (chest) and caesarean scars. What are the common symptoms, and how do they differ from typical menstrual cramps? 'Painful periods, known as dysmenorrhoea, is a common sign of endometriosis,' highlights Vakharia. 'Endometriotic cells are stimulated by hormones in your natural cycle which causes inflammation and pain.' Another typical sign is dyspareunia, the medical term for painful intercourse. 'The inflammation can lead to structures in the pelvis sticking together and also lead to thickening of tissues developing,' says Vakharia. 'As a result of the inflammation and thickening, patients with endometriosis can have pain with intercourse.' It can also impact your bowels. 'In patients who have endometriotic deposits on the bowel, or in those where the inflammation has caused their bowel to stick to other structures, it can be painful to open their bowels,' notes the endometriosis specialist. 'This can occur with their periods or all the time.' Other issues include chest pain when on your period, difficulty conceiving and ovarian cysts, adds Vakharia. How is endometriosis diagnosed? 'If you suspect you have endometriosis, it is a good idea to speak to your GP in the first instance, who will take a history from you and examine you,' advises Vakharia. 'Often, they will request an ultrasound of the pelvis and discuss the results with you.' However, endometriosis does not always show up on standard imaging, such as ultrasounds or MRIs. 'This is especially true in superficial endometriosis, where the signs can be very subtle or when the disease affects areas not easily visualised,' highlights Vakharia. 'If you have been told your scan is normal but have persistent symptoms, such as chronic pelvic pain, heavy periods, or pain during sex, it's essential to advocate for yourself and seek a specialist for further evaluation.' When should women seek medical help? 'It can be difficult to differentiate between 'normal' periods and 'heavy or painful' periods, as there is often no objective way of comparing,' says Mr Narendra Pisal, consultant gynaecologist at London Gynaecology. 'A lot of women just put up with that 'time of the month' and are told to get on with it. 'However, if you have to put your life on hold for those few days or if your sex life is affected by pain during sex, it is time to take note and ask for some tests.' Pisal acknowledges that it can be challenging for a GP to identify the root cause during a 10-minute appointment, so she suggests keeping a diary to track when your symptoms occur and how intense the pain is. 'Have a diary of your menstrual cycle with particular emphasis on heaviness, pain and any other symptoms with a system for indicating severity,' suggests Pisal. 'Also note down if you have to take painkillers and how many. If the symptoms are affecting your life and you have to take time off work, that is also a significant factor. ' What treatment options are available for endometriosis? 'Patients can be treated with the combined pill, progesterone-only pill, progesterone intrauterine device or surgery,' says Vakharia. 'Sometimes, we also use medications that induce a temporary menopause by blocking hormonal signals to the ovary which reduces stimulation of the endometriotic tissue. This option is often used before surgery for severe disease. 'A laparoscopy will allow diagnosis and excision of disease which can improve symptoms. In patients with severe disease, they may need a two-stage procedure.'
The Irish Sun
10-05-2025
- Health
- The Irish Sun
When I broke out in an agonising rash that left me bleeding docs blamed scabies – but 3 common foods were to blame
I COULDN'T sleep, I couldn't concentrate at work and I was cancelling social plans. I felt like my body was covered in ants due to a persistent itch - but I was completely unaware of a little-known allergy to foods in my daily diet. Advertisement 6 Lucy couldn't stop scratching an itch that presented all over her body Credit: Supplied-Lucy Gornall 6 "It was persistent and impossible to ignore," Lucy said Credit: Supplied-Lucy Gornall It was January 2022 when I suddenly developed the most This wasn't just a little tickle. It was persistent and impossible to ignore. And when I did ignore it, the itchiness would grow and grow. A specialist mentioned that it might be I did two rounds of scabies treatments, but still the itchiness persisted. Advertisement On a trip to Austria in March 2022, I broke down in tears as my incessant scratching was causing my skin to bleed. It took a (very expensive!) trip to an Austrian dermatologist to discover I had urticaria (the medical term for hives). My body was covered in these hives. And I was then told it caused by a histamine Advertisement Most read in Health Ever wondered why you don't quite feel right after eating certain foods such as cheese or chocolate? Or, feel as though your skin is itchier than normal after drinking red wine? Megan McKenna blasted the Prime Minister today for 'abandoning' a vow to create an 'allergies tsar' Perhaps yoghurt, beer and champagne - which are fermented foods - have left you bloated and struggling with Or, like me, you have never even connected the dots. Histamine tolerance can also cause a runny nose, brain fog and fatigue. Advertisement "It can even impact mental health, with reported symptoms such as Some foods act as histamine liberators, meaning they trigger the body to release more histamine, even if they don't contain much themselves. Laura Southern nutritional therapist at London Gynaecology The little-known problem primarily impacts women and tends to occur more frequently with age, often in the 40s and 50s but anytime from the age of 30. 'Histamines are chemicals that your immune system makes," explains Dr Najja. "They are released by white blood cells during an immune response, helping to respond to allergy triggers (such as pollen or certain foods)." Advertisement 6 Chocolate is a trigger for histamine tolerance Credit: Alamy 6 Aged cheese, such as blue or parmesan, are no-gos Credit: Alamy 6 Lucy did two rounds of scabies treatment before a dermatologist finally diagnosed her with histamine intolerance Credit: Supplied-Lucy Gornall Histamine intolerance, he says, refers to an excess of histamine in the body. The body struggles to process or eliminate excess histamine. It can lead to a range of symptoms that may mimic allergies. Advertisement But while allergies involve your immune system response, releasing histamines to get rid of whatever it sees as a threat (even if it's harmless), histamine intolerance, in contrast, is a problem with the body's ability to process histamine. "When histamine is released then the blood flow to the area increases, causing inflammation such as redness, swelling and itchiness," he says. The symptoms of histamine intolerance Symptoms of histamine intolerance can vary from one person to another. However, Dr Najjar says that common symptoms include: Advertisement Abdominal pain and Changes of bowel movement, which could include Skin rashes, flushing or hives Dizziness Fatigue Brain fog Runny nose or nasal congestion Shortness of breath or wheezing Heart palpiations Mental health effects A 2019 study in the journal Intestinal Research found participants suffering from histamine intolerance experienced an average of 11 symptoms. What foods trigger symptoms or antihistamine intolerance? When I got dianogsed, I had to laugh at the fact I was consuming foods and drinks daily that trigger histamine intolerance daily. At the time, I was shotting apple cider vinegar in the morning, drinking a fair bit of champagne and was eating spinach, tomatoes and chocolate every day. High histamine foods include aged cheeses such as parmesan and blue cheese and cured or smoked meats, such as salami and smoked salmon. Fermented foods such as soy sauce and miso also don't help. Advertisement Aged, fermented and processed foods contain high levels of histamine because histamine forms during bacterial fermentation or food decay. Alcohol, especially red wine, champagne and beer, pickled or canned foods, beans and pulses, salty snacks and chocolate are all no-gos. 6 Wine was triggering Lucy's hives, she says Credit: Getty Laura Southern, nutritional therapist at Advertisement The list of histamine liberators are often 'healthy' foods. They include vinegar, tomatoes, citrus fruits, spinach, strawberries, and nuts, especially walnuts, cashews and peanuts. 'Some foods block DAO, the enzyme that breaks histamine down," says Laura. "These include energy drinks, black and green tea and alcohol.' A high dose vitamin C supplement can break down histamine. Tara Ghosh a certified Hormone and Women's Health Coach Laura adds: 'Histamine levels in food can vary based on storage time and processing. 'Histamine is often a Advertisement "These foods are UPFs, sugar, fried foods, processed meats, alcohol and sweeteners.' Hormones, particularly oestrogen, play a big role in the development of histamine intolerance, according to Therefore, she says, a lot of women may notice that menopause and perimenopause can make histamine issues worse. 'Having too much oestrogen in relation to progesterone leads to something called oestrogen dominance which can cause our allergies to be way worse or indeed appear out of nowhere for the first time," she says. Advertisement Generally, oestrogen is on a downward slope during perimenopause, but with unpredictable peaks. 'While oestrogen is on a rollercoaster as we age, progesterone plummets,' Tara says. Foods that trigger histamine intolerance Foods that have been reported to have higher levels of histamine: Alcohol Pickled or canned foods – sauerkrauts Matured cheeses - blue, parmesan, camembert Smoked/cured meat products – salami, ham, sausages Shellfish Fresh or canned tuna, sardines, mackerel, salmon, herring Beans and pulses – chickpeas, soy flour Long-stored nuts – e.g peanuts, cashew nuts, almonds, pistachio Chocolates and other cocoa based products Seitan Rice vinegar Ready meals Salty snacks, sweets with preservatives and artificial colourings Aubergine Spinach Tomatoes Broad beans Foods that have been reported to have released histamine (histamine releasers): Most citrus fruits – lemon, lime, oranges Cocoa and chocolate Walnuts, peanuts Papaya, pineapples, plums, kiwi and bananas Legumes Wheat germ Most vinegars Additives – benzoate, sulphites, nitrites, glutamate, food dyes Foods that have been reported to block the diamine oxidase (DAO) enzyme: Alcohol Black tea Energy drinks Mate tea Source: Tara explains that oestrogen increases histamine and is linked to slowing down the production of the DAO enzyme which clears histamine from our body. As well as hormones, some medications and gastrointestinal issues such as irritable bowel disorder can actually get in the way of DAO working properly. Advertisement How to treat histamine intolerance The NHS doesn't offer a histamine intolerance test, but you can buy them online. However, Dr Najjar advises against doing them without the support and expertise of a qualified medical practitioner. You may take antihistamines when your body is reacting to histamines - and, after being put on strong ones, I was given a long list of foods that I had to remove from my diet. Although you can take antihistamines, Tara claims: 'Most antihistamine treatments are just a band-aid, blocking your histamine receptors. 'What we need to think is, 'why is my allergy bucket so full and causing me this hell?' Advertisement 'Reduce dairy, gluten, sugar and alcohol as these are inflammatory and limit fermented food (such as kombucha and sauerkraut), avocados, spinach, tomatoes, chocolate and citrus fruit as these stimulate histamine.' Tara adds: 'High levels of the stress hormone cortisol correlate with high histamine so find ways to calm your nervous system every day and prioritise your sleep. "A high dose vitamin C supplement can also break down histamine.' A process of eliminating potential histamine-rich trigger foods and then slowly reintroducing them, can help you discover where your tolerance lies. Advertisement In a matter of days, my skin calmed. The itching ceased and I felt like a free woman! Still to this day, I am strict on what I eat and if I know I'll be drinking champagne or wine, or eating smoked salmon or anything fermented, I will take an antihistamine to prepare myself. My histamine intolerance dictates what I eat and drink and every day I have to stop and think before I put anything in my mouth. Honestly, the itchiness isn't worth it. So what can you eat? Laura says that low-histamine staples include fresh meat and poultry (not processed or leftover), freshly cooked fish and eggs (especially the yolks). Advertisement Gluten-free grains like rice and quinoa, most fresh vegetables (like courgette, carrots and broccoli) and leafy greens (except spinach) are all okay. 'Vitamin C and B6 are crucial for DAO activity," says Laura. "I often suggest foods such as parsley, fresh greens, peppers, blueberries, chicken, turkey and sunflower seeds.' Read more on the Irish Sun She adds: 'The gut plays a huge role in histamine regulation so I also encourage anti-inflammatory and gut-supportive foods such as freshly cooked root vegetables, herbs such as ginger, turmeric and thyme and omega-3-rich oils from flax or chia seeds." Advertisement Laura adds that the freshness of your foods plays a part - even food that's been left in the fridge for a day could trigger symptoms.
The Independent
21-02-2025
- Health
- The Independent
Could you have endometriosis? These are the key symptoms
Heavy periods or pain in the pelvis is part of life for many. But these symptoms could point to something else going on within the body - endometriosis. March is Endometriosis Awareness Month - so there is no better time to tune into your body and question whether there is actually something going on. Understanding how the condition impacts your body and learning about potential treatments will boost quality of life. We've spoken to leading gynaecologists who have explained when it's time to request a doctor's appointment, starting with an overview of endometriosis and its key symptoms. What is endometriosis? 'Endometriosis is an oestrogen driven, chronic inflammatory condition where tissue similar to the lining inside the uterus (endometrium) grows outside the uterus, leading to various symptoms, including painful periods,' says Mr Hemant Vakharia, consultant gynaecologist, specialising in endometriosis and advanced minimal access surgery at London Gynaecology. What are the common symptoms, and how do they differ from typical menstrual cramps? Common symptoms of endometriosis include painful periods, known as dysmenorrhoea, which differ from typical menstrual cramps. 'Endometriotic cells are stimulated by hormones in your natural cycle which causes inflammation and pain,' explains Vakharia. Another typical sign is dyspareunia, the medical term for painful intercourse. 'The inflammation can lead to structures in the pelvis sticking together and also lead to thickening of tissues developing,' says Vakharia. 'As a result of the inflammation and thickening, patients with endometriosis can have pain with intercourse.' It can also impact your bowels. 'In patients who have endometriotic deposits on the bowel, or in those where the inflammation has caused their bowel to stick to other structures, it can be painful to open their bowels,' notes the endometriosis specialist. 'This can occur with their periods or all the time.' Other issues include chest pain when on your period, difficulty conceiving and ovarian cysts, adds Vakharia. 'If you suspect you have endometriosis it is a good idea to speak to your GP in the first instance who will take a history from you and examine you,' advises Vakharia. 'Often, they will request an ultrasound of the pelvis and discuss the results with you.' However, endometriosis does not always show up on standard imaging, such as ultrasounds or MRIs. 'This is especially true in superficial endometriosis where the signs can be very subtle or when the disease affects areas not easily visualised,' highlights Vakharia. 'If you have been told your scan is normal but have persistent symptoms, such as chronic pelvic pain, heavy periods, or pain during sex, it's essential to advocate for yourself and seek a specialist for further evaluation.' How can women differentiate between mild, moderate, and severe menstrual pain, and when should they seek medical help? 'It can be difficult to differentiate between 'normal' periods and 'heavy or painful' periods as there is often no objective way of comparing,' says Mr Narendra Pisal, consultant gynaecologist at London Gynaecology. 'A lot of women just put up with that 'time of the month' and are told to get on with it. 'However, if you have to put your life on hold for those few days or if your sex life is affected by pain during sex, it is time to take note and ask for some tests.' Pisal acknowledges that it can be challenging for a GP to identify the root cause during a 10-minute appointment, so suggests keeping a diary to track when your symptoms occur and how intense the pain is. 'Have a diary of your menstrual cycle with particular emphasis on heaviness, pain and any other symptoms with a system for indicating severity,' suggests Pisal. 'Also note down if you have to take painkillers and how many. If the symptoms are affecting your life and you have to take time off work, that is also a significant factor. ' But, it's also important to remember that not all patients who have painful, heavy periods and pain with intercourse will have endometriosis. 'Other conditions such as fibroids and adenomyosis can also cause this and in some patients, no cause is identified,' says Vakharia. ' Patients can be treated with the combined pill, progesterone-only pill, progesterone intrauterine device or surgery,' says Vakharia. 'Sometimes, we also use medications that induce a temporary menopause by blocking hormonal signals to the ovary which reduces stimulation of the endometriotic tissue. This option is often used before surgery for severe disease. 'A laparoscopy will allow diagnosis and excision of disease which can improve symptoms. In patients with severe disease, they may need a two-stage procedure.'
The Independent
20-02-2025
- Health
- The Independent
Could your painful periods be endometriosis?
For many, the discomfort of heavy periods or pelvic pain is simply part of life, but it could also indicate endometriosis. With Endometriosis Awareness Month approaching in March, now is the perfect time to tune in to your body and learn more about this often misunderstood condition. Understanding how endometriosis affects your body and exploring treatment options can make a significant difference in managing symptoms and improving overall quality of life. We've spoken to leading gynaecologists who have explained when it's time to request a doctor's appointment, starting with an overview of endometriosis and its key symptoms. What is endometriosis? 'Endometriosis is an oestrogen driven, chronic inflammatory condition where tissue similar to the lining inside the uterus (endometrium) grows outside the uterus, leading to various symptoms, including painful periods,' says Mr Hemant Vakharia, consultant gynaecologist, specialising in endometriosis and advanced minimal access surgery at London Gynaecology. What are the common symptoms, and how do they differ from typical menstrual cramps? Common symptoms of endometriosis include painful periods, known as dysmenorrhoea, which differ from typical menstrual cramps. 'Endometriotic cells are stimulated by hormones in your natural cycle which causes inflammation and pain,' explains Vakharia. Another typical sign is dyspareunia, the medical term for painful intercourse. 'The inflammation can lead to structures in the pelvis sticking together and also lead to thickening of tissues developing,' says Vakharia. 'As a result of the inflammation and thickening, patients with endometriosis can have pain with intercourse.' It can also impact your bowels. 'In patients who have endometriotic deposits on the bowel, or in those where the inflammation has caused their bowel to stick to other structures, it can be painful to open their bowels,' notes the endometriosis specialist. 'This can occur with their periods or all the time.' Other issues include chest pain when on your period, difficulty conceiving and ovarian cysts, adds Vakharia. How is endometriosis diagnosed? 'If you suspect you have endometriosis it is a good idea to speak to your GP in the first instance who will take a history from you and examine you,' advises Vakharia. 'Often, they will request an ultrasound of the pelvis and discuss the results with you.' However, endometriosis does not always show up on standard imaging, such as ultrasounds or MRIs. 'This is especially true in superficial endometriosis where the signs can be very subtle or when the disease affects areas not easily visualised,' highlights Vakharia. 'If you have been told your scan is normal but have persistent symptoms, such as chronic pelvic pain, heavy periods, or pain during sex, it's essential to advocate for yourself and seek a specialist for further evaluation.' How can women differentiate between mild, moderate, and severe menstrual pain, and when should they seek medical help? 'It can be difficult to differentiate between 'normal' periods and 'heavy or painful' periods as there is often no objective way of comparing,' says Mr Narendra Pisal, consultant gynaecologist at London Gynaecology. 'A lot of women just put up with that 'time of the month' and are told to get on with it. 'However, if you have to put your life on hold for those few days or if your sex life is affected by pain during sex, it is time to take note and ask for some tests.' Pisal acknowledges that it can be challenging for a GP to identify the root cause during a 10-minute appointment, so suggests keeping a diary to track when your symptoms occur and how intense the pain is. 'Have a diary of your menstrual cycle with particular emphasis on heaviness, pain and any other symptoms with a system for indicating severity,' suggests Pisal. 'Also note down if you have to take painkillers and how many. If the symptoms are affecting your life and you have to take time off work, that is also a significant factor. ' But, it's also important to remember that not all patients who have painful, heavy periods and pain with intercourse will have endometriosis. 'Other conditions such as fibroids and adenomyosis can also cause this and in some patients, no cause is identified,' says Vakharia. ' Patients can be treated with the combined pill, progesterone-only pill, progesterone intrauterine device or surgery,' says Vakharia. 'Sometimes, we also use medications that induce a temporary menopause by blocking hormonal signals to the ovary which reduces stimulation of the endometriotic tissue. This option is often used before surgery for severe disease. 'A laparoscopy will allow diagnosis and excision of disease which can improve symptoms. In patients with severe disease, they may need a two-stage procedure.'
