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Week 3: What is Endometriosis?

Endometriosis Awareness Month takes place in March across the world.  In this blog, we will highlight the symptoms and treatments and put focus on the condition to help everyone, regardless of culture, gender identity, age or ability, to become more aware of what it is and how to provide support to those learning to cope with it on a daily basis.

 Keep an eye on this page for links, blogs & information.
For further information on our initiatives and for support, help and advice, please see contact details below.

Endometriosis affects some women very badly, yet some will experience very little discomfort.  It can be a very painful, debilitating condition which affects 190 million women and people assigned female at birth across the world.

Endometriosis is a chronic, inflammatory, gynaecological condition that shows itself by the presence of endometrial-like tissue (clots of blood) outside the uterus. Many women experience exceptionally painful symptoms, and are at risk of infertility, occurrences of fatigue and other associated symptoms. This condition presents in various ways with several differing effects at multiple stages in a woman’s life. A long diagnostic delay after symptoms begin is far too common, and persistence and recurrence of symptoms despite treatment is also common.

The common symptoms of Endometriosis can include pain in your lower tummy or back, known as pelvic pain, which is usually worse during your period. The intense period pain can stop you from doing your ‘normal’ activities. Some women can experience vomiting, nausea, constipation and diarrhoea. Your period flow can be so heavy that you may need to use several or more tampons or pads. You may also experience bloating, poor digestion, anaemia, irregular bleeding, pain-induced vomiting and/or fainting, brain fog, dizzy spells, migraines and insomnia. Due to the wide range of symptoms, it can take up to seven years to get a diagnosis, so prompt action on your part is recommended.

Increased back pain during your period can also be a sign of endometriosis because of muscle irritation from general inflammation or due to the position of the uterus in the pelvis. It is important that you recognise the symptoms and speak with your health professional as soon as possible.

An American study involving 560 women with endometriosis found that over 50% had experienced fatigue during menstruation, but only 22% of women without endometriosis reported fatigue during that process. Fatigue can be one of the most unbearable symptoms of endometriosis.

Endometriosis can affect fertility. Women can have difficulty getting pregnant and even feel depressed or experience ongoing instances of feeling very low in mood.

If you are experiencing any of these symptoms and you’d like to find out more, the Endometriosis UK organisation have a pain and symptoms diary tool that you may find useful. 

 Speak with your partner, parent, doctor or therapist about your feelings and concerns.

Endometriosis UK is an organisation with a focus on this condition and they have a directory of local support groups, a helpline on 0808 808 2227, webchat, and an online community on HealthUnlocked for women affected by this condition.

The Royal College of Obstetricians and Gynaecologists have produced a list of medical terms that you may find useful in helping you understand some of the terminology and language used when reading about or speaking about endometriosis or its associated conditions, or treatments.

What can you do to relieve the discomfort?
Because endometriosis affects every woman differently there isn’t one solution that fits all. 

However, you can speak with your doctor and/or gynaecologist who will have some suggestions for you, which are likely to include simple lifestyle changes, medication and surgery. In addition to those, there are some home remedies and treatments and of course, over-the-counter or prescription medications that can help ease the discomfort. 

Take a moment to work out a schedule for yourself to manage your self-care. Some women find relief in acupuncture, pelvic floor muscle therapy or massage and applying natural progesterone cream. You should try to plan ahead and practice a healthy lifestyle. It’s easier than you may think. Quit smoking, join a local group or ask your GP to sign you up for a programme, and don’t binge on alcohol or any other addictive substances.  

Manage the pain with pain medications like ibuprofen, stay hydrated by drinking water (tepid not chilled), use a hot water bottle, a wireless heat pad and apply it to your lower back or abdomen, alternatively fill a clean sock with uncooked rice and warm it in the microwave for 2mins, then rest it on the area (be sure not to apply it directly against your skin – ensure it is not hot enough to burn!); or take a warm bath as this can relax your muscles and ease cramping pains.

It is important that you visit your GP or health practitioner as soon as you feel any of the symptoms mentioned in this blog, and be prepared to discuss at length your experiences, and ask as many questions as you like.

Watching what you eat – does diet help?
A nutritious diet involving drinking plenty of water and eating green vegetables, avoiding processed foods as much as possible and eating a variety of fibre-rich plant-based foods, healthy fats, nuts and seeds, ghee, coconut oil and organic butters is suggested by health advocates. Hormone support that works by controlling excess oestrogen and toxins can also be good because endometriosis is an oestrogen-dependent condition.  

Foods with a low glycaemic index are broken down at a slower rate and therefore create a gradual rise in blood sugar levels over time, so it’s vital that your food intake is balanced. Articles on this aspect of treatment often suggest avoiding processed foods like tinned or packaged and UHT products and suggest taking up some form of exercise.

Increasing physical activity and bringing some quiet time into your daily routine like meditation or breathing exercises could also be beneficial. Once again we must remind you of the importance of discussing your health changes with your GP or doctor before starting any exercise or health programme.

Diet planning books
The 4-week Endometriosis Diet Plan book
The Anti-Inflammatory Diet for Endometriosis

What support can you expect from your employer?
Endometriosis is not considered a disability under the Equality Act 2010, however, it is a Long Term Health Condition (LTHC) and as such could fall into the category of LTHC which would lay obligation on the employer to provide reasonable adjustments and support to the individual to help them work in more comfort in the workplace.  

If you have been diagnosed with endometriosis you should mention it to your manager and go through the Occupational Health Assessment process to have it recognised. 

Thereafter, several options should be offered including flexible, hybrid working and consideration for attending hospital and GP appointments. 

Organisations, managers and leaders should support engaging flexible working arrangements for someone who has been diagnosed with endometriosis. The person may likely require much more flexible working arrangements that provide assurances that they have access to the type of working conditions they require to work in comfort whilst dealing with the condition.

QUOTE
“The burden of endometriosis on individual patients is substantial both before and after diagnosis. The impact of ongoing pain can cause some patients to lose their jobs or their partners. Fatigue is more common among endometriosis patients than in general, and the financial burden and increased healthcare costs can be significant.” – Frontiers in Global Women’s Health

  “Always remember you are braver than you believe, stronger than you seem, smarter than you think and twice as beautiful as you’ve ever imagined.”  – Dr. Seuss

 

 For further information, please contact:
Helen Choudhury
Head of Diversity, Equality and Inclusion
MPA Champion for Menopause
Mental Health First Aider
[email protected] 

 

Week 2: What is Adenomyosis?

Endometriosis Awareness Month takes place in March across the world. During this month we aim to increase awareness of endometriosis and its associated conditions, highlight the symptoms, causes and treatments; and put a focus on these debilitating conditions to help everyone, regardless of culture, gender identity, age or ability to become more aware of how to provide support to those learning to cope with it on a daily basis.

 Keep an eye on this page for links, blogs & information.
For further information on our initiatives and for support, help and advice, please see contact details below.

There are a number of health issues that women and those assigned female at birth experience. One of them is adenomyosis. This painful, debilitating condition affects around one in ten women of reproductive age, but it is more common in women aged 40-50 and those who have had children. Adenomyosis can have incapacitating effects on a woman’s everyday life, and their wish to have children.

Adenomyosis is a condition of the uterus (womb) where cells similar to the lining on the inside of the uterus are also present in the muscle wall of the uterus. Over the past 30 years, women have been living longer, making conditions affecting the female reproductive system and fertility more prevalent. If left untreated, these conditions could lead to infertility or other pelvic problems. 

Adenomyosis often occurs in the muscle layers on the back wall of the uterus, but if adenomyosis is concentrated in one area, it is known to lead to Adenomyoma (a non-cancerous growth). Although not as well known as endometriosis, those who suffer with adenomyosis make up approximately one-third of the people affected by endometriosis in the UK. Both are chronic conditions that need to be properly managed as early as possible. 

Although women with adenomyosis are likely to have experienced endometriosis, the two conditions are different. With endometriosis, the cells that are similar to those that line the uterus are found on other parts of the body, like on the fallopian tubes, the ovaries or on the tissue lining the pelvis. 

The condition can take years to be diagnosed because of how the symptoms vary from one woman to the next. Typical symptoms of adenomyosis include heavy period flow, painful menstruation, fatigue, pre-menstrual pelvic pain, some have chronic pain during period, difficulty eating, vomiting, headaches, feelings of pelvic heaviness or discomfort, and pains in the bowel area and intimate areas.  

What can you do to help yourself?
It is important that you visit your GP or health practitioner as soon as you feel any of the symptoms mentioned in this article, and be prepared to discuss at length your experiences, and ask as many questions as you like.

https://www.jeanhailes.org.au/health-a-z/vulva-vagina-ovaries-uterus/adenomyosis#what-is-adenomyosis
https://thedietologist.com.au/what-is-the-best-diet-for-adenomyosis/ 

What can you do to relieve the discomfort?
Treatment for adenomyosis can vary from one person to the next.
It really depends on a woman’s symptoms, and takes into account her stage in life and whether she plans to have children.

There are a few non-medical treatment options available. Some are provided under consultation, through your GP or private practice. Others are likely to include a more holistic approach with a tailored exercise plan, meditation or acupuncture treatments, which could also improve symptoms for some women experiencing discomfort.

There is no definitive cure for Adenomyosis other than surgery involving a hysterectomy or the removal of the uterus. These are the common treatments offered to women with significant symptoms, but may not be suitable for most women. Alternative treatments include: Uterine Artery Embolisation (UAE). This is an alternative to the myomectomy or hysterectomy surgery that can sometimes be offered to women with large fibroids. This treatment involves taking a series of scans and x-rays followed by a minimally invasive procedure. Your GP or Gynaecologist will be able to provide you with more information on this process and discuss your options.

In addition, there is also a range of management medications including anti-inflammatory treatments that your GP may suggest could help to control the pain, or you might consider a hormone medication. Your discussions with your healthcare professional will help you to make an informed decision about which way you want to go. After all, your health is your wealth, so please discuss your options with your doctor or gynaecologist as early as possible. 

https://happyhealthyyou.com.au/blogs/articles/11-tips-to-manage-adenomyosis-naturally

Watching what you eat – does diet help?
A nutritious diet with plenty of water and liquid foods like vegetable broth, soups, and infused water (by adding lemon/lime or herbal non-caffeine teas) can be beneficial. Fresh foods contain the highest amount of nutrients for the body to thrive on, like the antioxidant properties in blueberries, and anti-inflammatory properties of aloe vera.

Foods with a low glycaemic index are broken down at a slower rate and therefore create a gradual rise in blood sugar levels over time, so it’s vital that your food intake is balanced. Articles on this aspect of treatment often suggest avoiding processed foods like tinned or packaged and UHT products and suggest taking up some form of exercise.

Increasing physical activity and bringing some quiet time into your daily routine like meditation or breathing exercises could be beneficial. Once again we must remind you of the importance of discussing your health changes with your GP or doctor before starting any exercise or health programme.

https://medhyaherbals.com/adenomyosis-diet-chart/ 

What support can be offered in the workplace?
Neither adenomyosis nor endometriosis are considered a disability under the Equality Act 2010, however, they are Long Term Health Conditions and as such could fall into the category of LTHC which would lay obligation on the employer to provide reasonable adjustments and support to the individual to help them work in more comfort in the workplace.  

If you have been diagnosed with endometriosis or adenomyosis you should mention it to your manager and go through the Occupational Health Assessment process to have it recognised.  

Thereafter, several options should be offered including flexible, hybrid working and consideration for attending hospital and GP appointments. 

Organisations, managers and leaders should support engaging flexible working arrangements for someone who has been diagnosed with endometriosis or adenomyosis. It is likely that the person may require much more flexible working arrangements that provide assurances that they have access to the type of working conditions they require to work in comfort whilst dealing with the condition.

Endometriosis Awareness Month takes place in March across the world. During this month we aim to increase awareness, highlight the symptoms and put focus on this debilitating condition. 

Quote:
“Until recently, doctors treated all cases of endometriosis with the same approach, usually involving surgery. But evidence now shows that the best treatment depends greatly on which of the three kinds of disease [superficial peritoneal endometriosis, cystic ovarian endometriosis (or endometrioma) and deep endometriosis] a patient has. We have found that patients don’t always get better with surgery, and those who do often feel better for a very short time..” – Professor Andrew Horne (The Guardian, July 2021)

 “Instead of diagnosing me, they were like, ‘Oh you have periods that last nine or 10 days and you’re bleeding through overnight pads … perhaps there’s something more there, but every doctor I saw was like, ‘let me put you on birth control.” – Gabriel Union shares her experience of enduring over 11 miscarriages and her difficulties with fertility prior to being diagnosed with Adenomyosis
in 2018 (Insider)

For further information, please contact the DEI Team:

Helen Choudhury
Head of Diversity, Equality and Inclusion
MPA Champion for Menopause
Mental Health First Aider
[email protected] 

For support, help and advice, please contact the following organisations:

Support for Adenomyosis

UCL article
What is Adenomyosis?
Adenomyosis Support
The Standard article
Pelvic Pain Network support
https://www.inclusiveemployers.co.uk/blog/how-to-support-people-with-endometriosis-in-the-workplace/

Diet and nutrition
Can diet and exercise help?
A Happy Healthy You Could Start Here
https://www.miracare.com/blog/endometriosis-diet/

Further support and reading
www.endometriosis-uk.org
The Impact of Ethnicity on Endometriosis
www.nhs.uk/conditions/Endometriosis/Pages/Introduction.aspx

Keep an eye on this page for links, blogs & information.
For further information on our initiatives and for support, help and advice, please see contact details below.

There are a number of health issues that women and those assigned female at birth can experience.
One of them is Endometriosis. This painful, debilitating condition can have incapacitating effects on a woman’s everyday life and their wish to have children.

Endometriosis affects around 176 million women worldwide, and there is currently no cure. The underfunding of women’s health issues over the years means conditions like Endometriosis haven’t always had the attention they deserve. However, there are treatments available. Speaking with your GP or gynaecologist is the first step towards obtaining relief.

Associated Illnesses
Another health-related issue similar to Endometriosis is the lesser-known Adenomyosis, a severe version of Endometriosis (with similar chronic pain and discomfort as the main symptoms). Adenomyosis is a condition where the lining of the womb (the endometrium) lodges in the muscular wall of the womb and brings heavy and prolonged menstrual bleeding. Treatment is similar to that of Endometriosis but there is no known cure. If you feel that you are experiencing symptoms, you should consult your GP immediately. Self-help relief can include a diet and exercise plan and medication.  

Fibroids, PCOS, and Heavy Bleeding are all very uncomfortable, painful conditions that many women go through during the course of their lives. If you feel that you may be experiencing any of the conditions or symptoms in this article, you should contact your GP or speak with your gynaecologist and be prepared to ask as many questions as needed.

Mayo Clinic – Adenomyosis
https://thedietologist.com.au/what-is-the-best-diet-for-adenomyosis/

What can you do to relieve discomfort?
There is a lot of help and support available locally and online to help better diagnose and manage these chronic conditions.
Your gynaecologist will discuss available treatment options with you and outline the risks and benefits. Such treatments are likely to include pain management medication, hormone treatments, surgery and complementary therapies may also help by offering physical and mental relief.

What about self-help to relieve the discomfort?
At home, you can try carefully applying warmth or heat, like taking a warm bath or gently placing a heated pad or hot water bottle on the lower abdomen, to help relax cramping pelvic muscles and reduce pain levels. Pelvic massage can also provide relief. Over-the-counter pain aids like paracetamol or ibuprofen can help – but be sure to mention your need for pain relief to your GP before you start taking any.
Making simple dietary changes is also reported as helping, like eating more green leafy vegetables, less sugar and alcohol, and reducing your dairy and wheat intake. Rest is also very important, so take time to sleep or rest when feeling drained, tired or sluggish. Some herbal supplements are said to also be helpful, as well as Omega-3 fatty acids. 

You should always consult your GP before taking any supplements or medications.

https://www.healthline.com/search?q1=relief%20for%20endometriosis 

Quote:
“Until recently, doctors treated all cases of Endometriosis with the same approach, usually involving surgery.
But evidence now shows that the best treatment depends greatly on which of the three kinds of disease
[superficial peritoneal Endometriosis, cystic ovarian Endometriosis (or Endometrioma)and deep Endometriosis] a patient has.
We have found that patients don’t always get better with surgery, and those who do often feel better for a very short time..”
– Professor Andrew Horne (The Guardian, July 2021)

“Since her teenage years, the actress Emma Roberts has been dealing with the symptoms of Endometriosis
because she wasn’t diagnosed until she reached her late 20s.
By then the condition had advanced and was already affecting her fertility levels.
Emma took the prudent decision to freeze her eggs and make that step in preparation for motherhood.
– Article courtesy of Women’s Health

For further information, please contact the DEI Team:
Helen Choudhury
Head of Diversity, Equality and Inclusion
MPA Champion for Menopause
Mental Health First Aider
[email protected]

For support, help and advice, please contact the following articles and organisations:

Support for Endometriosis and Adenomyosis
UCL article
https://www.pelvicpain.org.uk/conditions/adenomyosis/
Andenomyosis support
Pelvic Pain Network support

Helplines in the UK
Endometriosis support organisation
https://www.healthline.com/search?q1=relief%20for%20endometriosis

Diet and nutrition
Can diet and exercise help?
https://www.nutritionist-resource.org.uk/articles/endometriosis.html
https://www.miracare.com/blog/endometriosis-diet/