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By Margaret Mielczarek. Endo what? National ‘not-for-profit’ organisation Jean Hailes for Women’s Health describes endometriosis as “a condition that occurs when cells similar to those that line the uterus are found in other parts of the body”. (Jean Hailes, 2020.) Most commonly occurring in the pelvis, endometriosis “can affect a woman’s reproductive organs” and may cause pain, heavy bleeding, irregular menstrual bleeds, bleeding longer than normal, bladder and bowel problems, bloating, fatigue, mood swings (anxiety and depression), reduced quality of life, and vaginal discomfort. (Jean Hailes, 2020.) “Endometriosis is a condition where cells that normally line the uterus and that thicken up and produce a period each month are found elsewhere in the pelvis,” said Dr Tal Jacobson from Eve Health and Mater Hospital in Brisbane, a gynaecologist with an interest in the condition. “They’re typically found behind the ovaries, sometimes on the outside of the uterus, sometimes on the bladder, sometimes on the bowel. “These same cells undergo the same hormonal changes that the cells on the lining of the uterus undergo. They develop and undergo degeneration and bleeding, and can cause inflammation and pain when they’re in the wrong place.” Telling signs Feeling a little more irritable than normal? Has exhaustion got you beat? What about bloating – is your belly more extended than usual? These symptoms combined with heavy, painful periods and significant pain could be signs that something is up. “I’ll get the occasional stabbing pain here and there – it kind of feels like somebody is stabbing me in the belly,” said Ellie Angel-Mobbs, Ambassador for Endometriosis Australia, who was diagnosed with the condition at age 25. “Given that it’s such a difficult illness to diagnose, I wasn’t officially told that I had it until 25 years old, when I had my first laparoscopy, which was the operation where they discovered that I had stage four endometriosis.” While, according to Dr Jacobson, the “most common symptoms \[of endometriosis\] are heavy, painful periods”, other symptoms include “pain with intercourse, pain on opening your bowels, fatigue, bloating, infertility or difficulty with conceiving”, and rarer symptoms such as “bladder pain or bladder irritability”. “The more mild and moderate signs of endometriosis are few and far between until you do a laparoscopy, which is when you can do a diagnosis,” he said. Ms Ciccia points out that because “symptoms are variable, this may contribute to \[a potential\] seven- to 12-year delay in diagnosis”. “Common symptoms include pelvic pain that puts life on hold around or during a woman’s period,” she said. “It can damage fertility. While endometriosis most often affects the reproductive organs, it’s frequently found in the bowel and bladder, and has been found in muscle, joints, the lungs and the brain. Ms Angel-Mobbs said: “I have a friend who has it on her lungs, so she has trouble breathing sometimes. I know people who had it in their heart and even in their brain as well. There’s lots of weird and wonderful places where endometriosis can grow, and I suppose, depending on where it is in your body, it’s going to cause complications for that particular organ.” CONTRACEPTION VS FERTILITY PART 1 27 Ah, the dreaded monthly red dragon: not fun at the best of times but a lot worse when things go wrong. This month, Retail Pharmacy Assistants magazine explores the often crippling condition of endometriosis. Ms Ciccia elaborates on the common symptoms of endometriosis, which include: • Fatigue. • Pain that stops you, on or around your period. • Pain during or around ovulation. • Pain during or after sex. • Pain with bowel movements. • Pain when you urinate. • Pain in your pelvic region, lower back or legs. • Trouble holding on when you have a full bladder, or having to urinate frequently. • Heavy bleeding or irregular bleeding. RETAIL PHARMACY ASSISTANTS • MAY 2020 TO PAGE 28