Category: Reproductive Health Issues & Conditions

Period poo. What is it and why does it happen? In this article, we take a look at why our bowel movements seem to wreak havoc during our periods and some tips for managing any symptoms. Quick facts: What is period poo? Period poo is basically any changes to your bowel movements during your period. This can be loose stools, diarrhoea, more frequent bowel movements, constipation, or more wind.  Although period poo might not be the most hotly debated dinner party conversation, it’s actually really common—with one study citing that up to 73% of people who menstruate experience period poo.  What causes period poo? Throughout our menstrual cycles, our hormones cause a whole host of changes, some of which can affect our digestion and gastrointestinal tract. Here are some of the changes that occur in the lead-up to our periods specifically, which can lead to changes in bowel movements.  Prostaglandins and muscle contractions Prostaglandins are chemical messengers that your uterus (womb) produces around your period. They act on the uterine smooth muscles to help them contract and shed their lining each month. This means you have prostaglandins to thank for your period cramps.  Sometimes, excess prostaglandins can act on smooth muscles elsewhere in the body, including the bowels. This causes an increase in muscle contractions in the intestines and bowel, leading to loose stools or diarrhoea.  On the flip side, too little prostaglandins can have the opposite effect, causing things to slow down in the gastrointestinal tract. This is one theory of why some people experience constipation at the time of their period (3).  Increased progesterone levels Although the exact relationship is not well understood, your gut – as well as your uterus – also has receptors for sex hormones like progesterone and oestrogen. This means your gut is sensitive to the changes in hormones that come about at the time of your period. Just before your period, progesterone levels are high, which can cause gut sensitivity, including bloating, diarrhoea or constipation, in some people.  For people who already suffer from Irritable Bowel Syndrome, this can be exacerbated at this time of the month. If you’re experiencing flare-ups, stick to your prescribed symptom management plan and if you think you need more relief, speak to your doctor about alternative ways to manage your IBS during your period.  Diet changes and cravings An increase in progesterone levels just before our periods can cause cravings for certain foods. Changing your diet, for example eating more, consuming more carbs and processed foods, consuming less fibre and not drinking enough water can all affect digestion and lead to changes in stools.  Increased stress or anxiety A common symptom of Premenstrual Syndrome (PMS) that is often experienced just before or during our periods is increased levels of anxiety, overwhelm or stress. Each of these symptoms can lead to a change in bowel movements, as our guts are intimately linked to our stress levels (think the nervous poos).  How to manage period poo symptoms There are certain lifestyle changes you can adopt to help alleviate any gastrointestinal symptoms you notice around your menstrual cycle. Try some of the following tips to help make that time of the month a little less crappy. Eat lots of natural fibre  Fibre is like your bowel’s best friend—it helps to move things through and keep your digestion and bowel movements regular. Make sure you’re getting lots of high-fibre foods like fruit, vegetables and whole grains in the run-up to and during your period. Try not to overeat processed foods and carbs as these often have the opposite effect.  Limit caffeine If you’re experiencing loose stools and diarrhoea, try cutting down on your caffeinated drinks and foods (like dark chocolate). This is because caffeine stimulates the gut, resulting in you needing to go more frequently.  Coffee in particular (even decaf) can stimulate the gut, so best to skip the morning coffee at your time of the month and opt for another way to energise yourself, like a morning walk or some yoga. If you do experience diarrhoea, be sure to increase your water intake to prevent dehydration.  Get moving  Movement and exercise are great for the gut and bowels. They help keep things moving through your digestive tract and can reduce the instances of bloating as well as helping to alleviate period cramps. If you’re not feeling up for your usual fitness routine, some yoga or simple stretching and walking are all great options.   Stay hydrated If you’re experiencing either constipation or diarrhoea, then drinking plenty of water is essential. Being adequately hydrated is very important for a healthy functioning gut and if you have diarrhoea you are at risk of becoming dehydrated quickly if you aren’t replacing lost fluids.  Painkillers and stool softeners It’s not unusual to mistake period cramps for bowel urges and vice versa during your period. Pain and cramps associated with either gut problems or your period can be eased with exercise, heat pads, or painkillers. You can also try stool softeners if you’re experiencing bad constipation. Resources:

Premature Ovarian Insufficiency (POI) is when the ovaries stop working normally before the age of 40. Getting a diagnosis can be worrying at first, but there are options available. Let’s take a look at what you need to know about POI including symptoms and treatments.  Quick facts: What is Premature Ovarian Insufficiency? In short, Premature Ovarian Insufficiency (POI) is when the ovaries stop functioning properly before the age of 40. It can significantly reduce your fertility.  This doesn’t always mean that you don’t have any eggs left in your ovaries or that you couldn’t carry a baby. It means your body is failing to mature eggs or to ovulate each month.You may have heard of Premature Ovarian Insufficiency (POI) being referred to as premature ovarian failure. It is also referred to as Primary Ovarian Insufficiency, gonadal dysgenesis, and hypergonadotropic hypogonadism. Premature Menopause Premature Menopause is when someone before the age of 40 experiences menopause. This means they will not have any more periods and are permanently no longer able to become pregnant.  This is different to POI, where although fertility becomes significantly reduced, there is a chance of spontaneous ovulation, and hence a period might still occur. Some people are still able to conceive spontaneously after their diagnosis. However, POI and Premature Menopause do share many of the same symptoms. What are the symptoms of POI ? POI symptoms are similar to menopause and low oestrogen. You’re likely to experience: Other than menopausal symptoms, loss of skin pigmentation caused by vitiligo or hyperpigmentation can accompany POI. As can hair loss caused by alopecia.  Fatigue, anxiety, and depression can also be common symptoms as a result of other symptoms or a diagnosis (3). If you’re missing your period for three or more months, it’s important to get your hormones tested to try and decipher what’s going on.  You can miss your periods for a number of reasons, including increased stress, changes to your diet or exercise routine. Some people might even like the idea of not getting a period every month, but sudden changes should always be investigated to check the cause of the change and rule out POI or something more serious. What causes POI ? Roughly 1 in 100 people will experience POI and it can affect people up to the age of 40, with some affected as early as their teens (4). But despite its prevalence, the causes, like for many female-reproductive health conditions, are still relatively unknown (2).  POI can happen spontaneously. However, there are a few known risk factors that may increase your risk of developing POI. These include: How is POI diagnosed? To receive a POI diagnosis, you’ll need to get a hormone test. High FSH (greater than 25) and low oestrogen levels, also seen at the onset of menopause, are indicators of POI. This is accompanied by absent, unpredictable or irregular periods for at least two consecutive months.  If POI is suspected, you might also be sent for an internal ultrasound to check your antral follicle count (AFC). Antral follicles are small fluid-filled sacs in your ovaries containing immature eggs. An AFC count is an indicator of the number of eggs you have left in your ovaries, also known as your ovarian reserve. What does POI mean for my overall health? POI can increase the risk of other illnesses or health problems if left untreated. People with untreated POI have an increased risk of developing heart disease and stroke.  Also, because oestrogen plays such an important role in bone health, low oestrogen seen in POI is known to lead to lower bone density, increased risk of bone fractures, and osteoporosis.  There is also evidence that lower oestrogen levels earlier in life can increase the risk of developing Alzheimer’s disease or dementia (3,4). If you have received a POI diagnosis, your doctor will likely recommend hormone therapy to you. This could be in the form of HRT or taking some form of hormonal contraception.  Hormone therapy can help to alleviate symptoms and reduce the risk of developing the associated conditions mentioned above. Does POI affect fertility? Often, yes, POI can reduce your fertility significantly. This can mean getting a diagnosis can be stressful and upsetting, particularly if you want to start or grow your family.  Although POI means your ovaries aren’t functioning properly, as many as 25% of people with POI do spontaneously ovulate. Another 10% do conceive and deliver after their diagnosis (5). If you are looking to get pregnant, there are treatment options available if you have POI—including In Vitro Fertilisation (IVF).  Egg donation is also an option for some people. POI is a condition that affects the ovaries, not the uterus. This means egg implantation and your ability to carry a pregnancy are not greatly affected by a POI. Think you might be experiencing POI symptoms? If you suspect POI symptoms, like irregular or absent periods, it’s important to get checked. Our at-home advanced hormone and fertility test can give you a better insight into your hormones and any symptoms you might be experiencing.  Our team of experts will help you understand whether your symptoms are related to POI or other underlying health conditions. We can also support you with follow-up fertility treatments and fast-track you to specialists for tailored care plans. References:

After a 9 year battle with pain, Abbie finally got a diagnosis for endometriosis. This is Abbie’s story, detailing the ordeal she went through to finally get treatment for her pain.  Quick facts: Meet Abbie My name is Abbie (@cheerfullylive) and in May 2019 I was finally diagnosed with endometriosis after a 9-year battle with pain.  If you aren’t aware, endometriosis is a chronic and debilitating condition where cells similar to the ones in the lining of the womb are found elsewhere in the body like the ovaries and fallopian tubes.  In response to your hormones, these cells break down and bleed, similar to the lining of your womb. This can cause inflammation and symptoms like painful periods, as well as possible infertility, fatigue, bowel and bladder problems, as well as many other symptoms. This is my story with endometriosis, from pain to diagnosis and treatment. I hope it can help you if you suspect you may have endo symptoms, or just want to learn more about this condition. Living in pain I can remember distinctly the first time I had severe pain. It was about a year before I had my first period. It was absolutely terrifying and things only got worse from there. My periods started when I was 15 and month by month the pain gradually became more debilitating. It got to the point where I could no longer get out of bed or do normal activities.  I would miss school, university and even work, but my pain and symptoms were deemed ‘normal’ period pain. I was told repeatedly that ‘I just had a bad period’, ‘I had a low pain threshold and ‘it was just something I would have to endure as a woman’.  This was even when I was having fainting episodes and vomiting due to the excruciating pain I was getting between periods. Because it was doctors telling me this, I genuinely believed it was just ‘normal’ and put up for it for many years of my life. Years to diagnosis It was only when my pain became chronic in December 2018, that my health was investigated fully. After going back and forth to my GP, A&E, urology and gynaecology, I was sent for an MRI in April 2019.  After so many years of believing this pain was normal, I didn’t expect my MRI to come back with severe endometriosis adhesions all over, but it did.  I was immediately booked in for an appointment with an endometriosis specialist. He told me I had extensive endometriosis on the left side of my pelvis, my left ovary and my bowel (sigmoid colon). I was also told that it was highly likely I had endometriosis growing on my bladder, my kidneys and on the right side of my pelvis. But only this wouldn’t be known until I had surgery. Managing my endometriosis It’s been over a year since I was diagnosed and I’ve tried so many different things to help with managing endometriosis. I’ve gone from being on the combined pill to the mini pill to extra hormones on top of that.  I’ve come off those extra hormones, gone on the waiting list for excision surgery, have taken different painkillers, tried yoga, hot water bottles, a TENS machine and trialled sacral steroid injections!  It’s been a long, hard journey and there are still many difficult days, but I seem to have found a few things that have personally helped me along the road. Deciding to have an expert excision of my endometriosis I’m still waiting for a surgery date, but just being able to make this informed decision with my consultant made me feel empowered. It made me feel like I was able to have some control over my endometriosis and how much it affected my life.  Being on the mini pill This is something that has helped me, as I no longer have periods anymore, which reduces the debilitating monthly pain and anxiety that comes with it. However, I understand that hormones are a very personal choice and you have to do what’s right for YOUR body. Pain management  Investing in a decent hot water bottle and a heat pad, as well as a TENS machine has really helped me manage my everyday chronic pain. Looking ahead Despite the struggles I’ve faced and the pain I’ve had to endure whilst living with endometriosis, I’m very grateful for all the positive experiences that have come out of this journey.  I started up my own blog, enjoyed being creative on Instagram and found an incredible community of #EndoWarriors! A fellow Endo warrior and I wrote a powerful blog post on “What Endo Means To Me”. Thank you to Hertility for having me on their blog to share my journey with endometriosis! If you feel you may have endometriosis or are concerned about your symptoms, please reach out to someone and don’t suffer in silence. Whether that’s your GP, sexual health clinic, hospital or a company like Hertility who can help you get answers on your reproductive or gynaecological health. You can find me over on my blog at www.cheerfullylive.com or on Instagram at @cheerfullylive www.instagram.com/cheerfullylive. I’m always open to having a conversation around women’s/period health, pelvic pain or endometriosis! Let’s break down the stigma and have more of these conversations!

We’re all sold the ideal of perfect skin by skin care companies. But sometimes the cause of our breakouts is more than skin deep. So how do we know if our skin troubles are hormone-related? Read on to find out. Quick facts: What is hormonal acne? Hormonal acne is acne or breakouts that are related to hormonal fluctuations or imbalances.  Typically hormonal acne is found on the lower face, cheeks and jawline chest, neck, shoulders and back. Hormonal acne can affect people of all ages. Whilst it’s common during puberty when lots of hormonal changes are occurring, it can also be common as an adult, especially for women and people who menstruate, due to hormonal fluctuations throughout the menstrual cycle. What causes hormonal acne? Your skin has many small glands, called sebaceous glands, that produce an oily substance called sebum. Sebum helps keep your skin supple, smooth and healthy.  These glands also have receptors for our sex hormones, particularly androgens like testosterone, and oestrogen. Both of these hormones stimulate the production of sebum. When excess sebum is produced, this buildup causes visibly oilier skin and can clog the pores, resulting in inflammation and acne breakouts. Hormonal acne and androgens When our bodies produce excess amounts of androgens, it can cause hormonal acne and other skin problems. If androgen levels are higher than normal, there is more androgen binding to the sebaceous gland receptors, promoting more sebum production.  There can be lots of reasons for elevated androgens. A common cause is Polyendocrine Metabolic Ovary Syndrome (PMOS, formerly known as PCOS). Those who experience PMOS are more likely to experience excess androgen-related symptoms like acne, excessive facial and body hair growth (hirsutism) and skin darkening.  Trans and non-binary people who begin taking testosterone as part of their transition journey may also notice acne breakouts because of raised androgen levels. Hormonal acne and oestrogen Sebum production is also influenced by the menstrual cycle, specifically by the hormone oestrogen.  Oestrogen fluctuates throughout the menstrual cycle. It’s at its lowest level during your period and gradually rises to a peak at ovulation, around the mid-point in your cycle. Although the impact of oestrogen on the sebaceous glands is not fully known, it has been shown to suppress sebum production at high levels. Therefore when your oestrogen levels are higher, generally your skin will be clearer. This is why lots of people experience hormonal acne flare-ups just before or during their periods when oestrogen levels are low.  Oestrogen is also associated with increased collagen production, skin thickness, skin hydration and wound healing—which all contribute to clear-looking, healthy skin. After menopause, your oestrogen drops. Some people find that this drop causes hormonal acne and may also leave their skin dry, itchy and saggy. For some individuals, HRT to reduce the symptoms of menopause can also cause hormonal acne. How to treat hormonal acne? If you think you suspect you’re suffering from hormonal acne, there a number of treatments you can explore.  Firstly, if you’re not already, begin tracking when you have flare-ups and your periods. You can do this with a period tracking app or just using a calendar. This will help you to understand when in your cycle you’re getting flare-ups and whether it could be due to hormonal fluctuations during your cycle.  Testing your hormones will be able to give you answers as to whether you have raised androgen levels. Our advanced hormone and fertility test can help you identify any hormonal imbalances.  There are topical treatments available that can help with flare-ups, as well as some contraceptives like the combined pill that has anti-androgenic properties. Lifestyle changes like diet, exercise, stress and alcohol reduction can also have a significant impact.  If you’re struggling with your skin, don’t suffer in silence. Reach out to us and get on a plan to find the root cause of your skin issues. References:  

Annie Coleridge, CEO of Alva Health, shares her story of getting a PMOS (formerly PCOS) and dermoid cyst diagnosis. Erratic periods I’ve always had a feeling something wasn’t quite right with my hormones. Nothing major, but something a little skew-whiff.  Since I was a teenager I’ve had erratic periods. They’re on the light side, making me one of the lucky ones, but sometimes they won’t come for months.  Once, just after my final exams at university, my period didn’t come for about 9 months. I’ve always been a normal weight and was eating ok (albeit a bit stressed about exams) but 9 months seemed excessive…  So did the endless doctor’s appointments checking that I wasn’t pregnant or having a flare of an autoimmune condition I had previously. That was my early 20s. My mid-twenties passed with little change to that pattern, to be honest. Months and months without a period, then they’d just restart again.  I tried to track my periods, but I didn’t have the monthly reminders to help me remember. So I just put up with a mild, low-level, background kind of anxiety about my reproductive health.  Weirdly, although I understand contraception pretty well, it made me reluctant to go on any hormonal birth control. I just didn’t want to mess with these hormones which seemed in such fine balance. And anyway, it didn’t bother me that much. Testing my hormones Then I started working at a health tech company, which really highlighted to me that knowledge is power when it comes to your body. Finally, it clicked – I really should check if my hormones are balanced.  I knew that wouldn’t hold all the answers to my period woes… but it seemed like a very interesting place to start.  When I got my first test back I had high testosterone and low oestrogen – which was not what I expected… I knew that raised testosterone suggested PMOS but I also knew I didn’t have the typical symptoms. Beyond the messed up periods and the raised testosterone, I just didn’t have much else that was typical for PMOS. Or at least I thought I didn’t.  What I knew about PMOS was that it usually causes heavy periods, excessive hair growth, insulin sensitivity and weight gain. I didn’t struggle with those. I had light, irregular periods and bad mood swings. But that was it.  So… I ignored my first few sets of results, for about a year. I’d had abnormally high cortisol results at the same time, so as ever I just sort of put it all down to stress. Maybe my periods were just super super super sensitive to stress. A sudden change Then my periods suddenly got incredibly heavy. I thought it might be a sign of something really serious so I went to a doctor. I don’t hate the doctors at all, but I do find the process often quite inconvenient. It just doesn’t fit in with my life. Despite having recent blood tests, the doctors made me take another test and told me I had PMOS. That was it. A single phone call. Just the test results and a simple conclusion. Nothing else on the matter,  no follow-up information.  Doctor Google and my mum (an actual doctor) helped me learn that there are loads of different types of PMOS. Turns out whilst some people get the more ‘classic’ PMOS symptoms it’s actually a hugely varied condition. PMOS diagnosis – what else? But this new diagnosis didn’t explain the sudden changes in my periods. Or at least I didn’t think it did. I was pretty confused to be honest. So I went back to my GP and they said I could have an ultrasound.  The process of finding out I had a dermoid cyst involved an initially inconclusive scan – where the sonographer simply told me that I had ‘some sort of mass.  Four weeks later, another scan followed. This time they told me that the mass was probably a ‘ benign cyst’. The probably in that sentence didn’t fill me with confidence. So I went to my GP to ask what next? What next was a very long wait to see an NHS gynaecologist.  Now, let me say that although I felt pretty horrific after my various appointments I am staunchly pro the NHS. They gave me a certain first diagnosis – PMOS – and a probable second one – a benign cyst.  I did feel a little lost though. Suddenly my fertility (not something I’d thought about being 28 years old at the time and in a very new relationship) felt uncertain. I’m not even sure I want kids but that feeling was very unsettling. Knowledge is power To get a quicker second diagnosis I went and got a private scan. I’m very lucky they could confirm it was a dermoid cyst that was not cancer.  They could also see the characteristic ‘string of pearls’ appearance around my ovaries that suggested PMOS. It was a relief to be able to see what was going on in my ovaries, although they didn’t look in the best shape I must say.  I feel so fortunate to have been able to quickly access answers but it took me years to take control of my reproductive health. Even though it’s not perfect – nothing ever is and it’s much better to know Written by Annie Coleridge, CEO Alva Health If like Annie, you’re experiencing irregular and erratic periods, it could be a sign of a hormonal imbalance. Our at-home hormone tests can help you get to the root of your period problems. Our team of experts include PMOS (formerly PCOS) specialists that can help you to manage your PMOS (formerly PCOS) symptoms.

Endometriosis is a common reproductive health condition that affects 1 in 10 in the UK. It’s characterised by painful, heavy periods as well as other, often debilitating symptoms. Here we go through each of the main symptoms in detail, so you know what to look out for and when to get checked.  Quick facts: Endometriosis in the UK In the UK, endometriosis affects around 1.5 million women and people assigned female-at-birth (AFAB). That’s 1 in 10 who are currently living with the condition, regardless of race or ethnicity (1). People with endometriosis often experience very painful periods as well as a host of other symptoms. Many people live with endometriosis for a long time before getting diagnosed. Sometimes up to 7 years or more.  This is often the result of a general lack of awareness about the condition, dismissal of women’s pain and symptoms having a lot of crossover with other conditions. So what are the main symptoms of endometriosis? Here’s what to look out for if you suspect you, or someone close to you, may have the condition. What is endometriosis? Endometriosis is a chronic reproductive health condition where cells similar to those lining the uterus grow in other parts of the body. Endometrial tissues and lesions are found in the ovaries and Fallopian tubes.  They can sometimes also grow in the vagina, cervix, vulva, bowel, bladder and rectum. Rarely, do they appear in other parts of the body, like the lungs, brain, and skin (2). Just like the lining of the uterus, these cells build up and eventually shed. But unlike your period which drains through the vagina, this blood and tissue has nowhere to go. This can cause inflammation, crippling pain and a long list of other symptoms. Endometriosis can affect women of any age, including teenagers. What are the main symptoms of endometriosis? Here are the most common symptoms of endometriosis (3):  Severe period pain  Severe period and pelvic pain are often reported to be the most debilitating symptoms of endometriosis. This pain is often described as ‘a razor blade pain’.  During your menstrual cycle, the lining of your uterus (endometrium) is built up to support a potential pregnancy. If its baby-making dreams are not fulfilled, your body releases chemicals called prostaglandins.  Prostaglandins cause the uterus to contract and your endometrium sheds. Cue, your period. These contractions are what cause period pain. With endometriosis, the endometrial-like cells that have grown outside of the uterus also build up and shed. This internal bleeding leads to inflammation, intense pain and a buildup of scar tissue and adhesions (a type of tissue that can bind your organs together).  Usually, the first or second day of your period is the most painful. But in cases of endometriosis, the crippling pain usually kicks in a few days before your period’s arrival. It can also make an unwelcome return during ovulation or even throughout the month.  People can also experience chronic pain, increased lower back and pain around their legs which increases around their periods. “Endo belly” is a common term used to refer to the uncomfortable abdominal symptoms associated with endometriosis. Heavy periods Another common endometriosis symptom is heavy periods. Heavy periods are defined as: If your periods are painful or heavy it’s important to seek medical advice. Monthly heavy bleeding can increase the risk of anaemia (iron deficiency) which can result in symptoms of fatigue, feeling cold often and hair thinning. Pain during or after sex Another common symptom of endometriosis is pain during or after vaginal penetration. This can be caused by endometrial lesions growing in the pelvic region and becoming inflamed during or after sex. This pain is called dyspareunia. It has been reported to feel like a stabbing shooting pain, usually felt deep inside the pelvis. Any unwanted pain during sex is not normal. If you experience any pain during or after sex or any bleeding, get it checked out. There is also mental health support available if you feel your intimacy is being affected by pain during sex. Bowel and urination pain Endometrial lesions can sometimes find their way to the surface of the bowel or even penetrate its wall. This can cause uncomfortable symptoms such as pain when urinating or passing bowel movements or noticing blood in your urine or poo. Pain during urination can sometimes be misdiagnosed as a UTI. If you’re in pain when passing urine or poo or if you notice any blood in either, get it checked out to understand what might be the cause. Bloating and gastrointestinal issues People with endometriosis can also experience bloating and gastrointestinal issues. These symptoms are similar to those of irritable bowel syndrome (IBS). Including diarrhoea, constipation and bloating. These symptoms are often affected by your cycle and can worsen in the days before your period. Fertility problems Unfortunately, endometriosis can affect your fertility. Infertility affects about 30-50% of those with endometriosis, but there are no definitive answers (yet) as to why—only theories.   However, this does not mean that if you have endometriosis you can’t conceive. Even in cases of severe endometriosis, natural conception is possible.  Mental health impacts Living with a chronic condition can be tough and often isolating. Endometriosis can affect various aspects of life from personal to professional relationships, which can impact your mental health.  If you feel like endometriosis is impacting your mental health, there are online support communities like Endometriosis UK. You can also talk to our Fertility Counsellors for any mental health concerns relating to your fertility.  Getting to the bottom of symptoms Just like any reproductive health condition, endometriosis varies from person to person. Not everyone with endometriosis will experience all of these symptoms to the same severity. Some people may not experience any of these symptoms at all.  Having severe pain or very heavy periods is not necessarily a sign of more severe endometriosis. It’s also important to remember that each of these symptoms can also be caused by other conditions.  If you’re experiencing any of the […]

Have you been diagnosed with endometriosis? Discover our top tips for managing endometriosis pain and the treatment options available to you. From painkillers to surgery.  Quick facts: Living with endometriosis If you live with endometriosis, you probably know that one of the biggest symptoms of endometriosis is pain… a lot of it. Experiencing chronic pain amongst other, often equally debilitating symptoms, can have big physical and emotional consequences.  Sadly, there is currently no cure for endometriosis. And with limited research and understanding of the condition, it can be difficult for both doctors and endo warriors to get a handle on managing endometriosis symptoms.   But you don’t have to put up with pain. There are several treatments available to manage symptoms and help improve your quality of life. Lots of people report huge improvements with these treatments—it’s just about finding what works for you. Medication for managing symptoms The first step in managing pain is usually exploring the use of painkillers. Your doctor may recommend taking nonsteroidal anti-inflammatory drugs (NSAIDs) (aspirin, ibuprofen) or paracetamol as a first line of treatment to manage any pain.  However, there are lots of different types of painkillers and your doctor can help you to find ones that work for you and your pain level.  Depending on the severity of your endometriosis pain, you may try a course of painkillers for a few months until you assess whether or not they are working for you.  But if you’re finding that these aren’t making the cut and you’re unable to go to work, uni, school, work or other plans, don’t suffer in silence! This is just the first option for managing endometriosis, so push your doctor for alternatives. Tips for endometriosis pain management Endometriosis UK suggests some extra tips for pain management: Heat and comfort Hot water bottles, heated wheat bags or special heat pads can really help to soothe pain, cramping and inflammation.  Remember to never put them directly onto the skin and always have a layer in between. Partnered with your comfies, hopefully, this can help you to feel more comfortable. Physiotherapy Physiotherapists can develop a programme of exercise and relaxation techniques designed to help strengthen pelvic floor muscles, reduce pain, and manage stress and anxiety. TENS machines Transcutaneous Electrical Nerve Stimulator (TENS) machines are small devices with electrodes that send electrical pulses into the body. This can block the pain messages as they travel through your nerves. Pain clinics Your doctor can refer you to your nearest pain clinic to see chronic pain specialists. Push for your doctor to get you the expert advice you deserve to manage your endometriosis pain. Hormone treatment for endometriosis When you’re diagnosed with endometriosis, hormone treatment is another common avenue to explore. You should discuss hormone treatment with your doctor or specialist to decide if it’s right for you. For those with endometriosis, similar cells to those lining the womb exist outside of the womb (usually in the abdomen).  These cells also respond to your sex hormones, particularly oestrogen and progesterone, in the same way as your womb lining. They thicken, break down and bleed during your period. This bleeding causes inflammation and scarring, leading to chronic pain.  Hormone treatment is commonly used to reduce the growth of this endometrial tissue.  How does hormone treatment help endometriosis? Hormone treatment aims to maintain low levels of oestrogen in the body, as oestrogen has been found to encourage the growth of endometrial tissue. Hormone therapy can help reduce heavy flow or even stop periods and therefore improve symptoms.  Whilst most endo warriors find that hormonal treatment reduces their symptoms, it is not a permanent fix to manage endometriosis. Types of hormonal treatment used to manage endometriosis? There are lots of different types of hormone treatment available. Some of the most common are also used as contraceptive methods including: Unfortunately, not everyone gets on with hormonal contraception and side effects can be common. It’s important to consider which hormone treatment is right for you. Surgery for endometriosis A last resort if the above treatments aren’t keeping your symptoms at bay, is endometriosis surgery. This aims to remove or destroy areas of endometrial tissue.  This can include laparoscopic surgery or a hysterectomy. The kind of surgery you have will depend on where the endometriosis is and how much of it there is. Laparoscopic surgery for endometriosis Initial surgery will almost always involve gynaecological laparoscopy for both diagnosis and excision. In laparoscopic surgery, also known as keyhole surgery, your surgeon inserts a small tube with a light source and a camera, through a small incision near your belly button.  They use this to be able to look inside your tummy or pelvis and then use fine tools to remove endometrial tissue (excision) or use intense heat to destroy the tissues (ablation). They can also remove any scar tissue that has built up in the area.  This form of surgery can be difficult, as many of the lesions are below the surface and not visible, so a highly skilled practitioner is required to remove them.  It might be the most long-lasting treatment, and people do notice relief in symptoms, but many who undergo surgery find their endometriosis grows back over time. This is why endo warriors may have to undergo surgeries multiple times. Hormone treatment might be used after surgery to help get better, longer-lasting results. Hysterectomy for endometriosis Sometimes healthcare professionals will also suggest undergoing a hysterectomy, a surgery where the womb is removed. This can be a very big decision as post-surgery, you will no longer be able to become pregnant or carry a pregnancy.  If you want children, you can discuss egg freezing before this procedure with your doctor. This means that you will then have the option of trying to have a baby using fertility treatments such as in vitro fertilisation (IVF) with the help of a surrogate. In some cases, someone might still experience symptoms after getting a hysterectomy done as a form of endometriosis management. If the ovaries […]