About endometriosis
Endometriosis is when tissue that’s like the lining of the uterus grows in other places in the body. This includes the ovaries, the fallopian tubes, the bowel and other abdominal organs.
We don’t know what causes endometriosis, but it might be related to the way blood flows from the uterus back through the fallopian tubes. This is more likely to happen when people have heavy periods.
Endometriosis affects people in different ways. Many people with endometriosis have period pain or heavy periods, although endometriosis usually isn’t the cause of these symptoms. The long-term effects of endometriosis might include infertility.
Pre-teens and teenagers sometimes get endometriosis, but it’s rare.
Endometriosis that first appears in the teenage years might continue to get worse, or it might go away by itself.
Symptoms related to endometriosis
There are no symptoms that predict endometriosis. But it’s a good idea for your child to see the GP if they have the following symptoms, and these symptoms mean they’re missing school or other activities:
If your child has these symptoms, it doesn’t necessarily mean they have endometriosis. These symptoms are very common and can happen without a particular cause.
It’s good to talk with your child about periods. This prepares your child and lets them know what to expect. It’s also a good opportunity to encourage your child to tell you if their periods are painful or heavy or worry them in any way.
Diagnosis of endometriosis
It can be hard to diagnose endometriosis in pre-teens and teenagers. But if your child has painful or heavy periods, your GP might suggest tests to diagnose endometriosis or look for other causes for your child’s symptoms.
These tests might include either an ultrasound scan or very rarely an MRI scan. These scans can diagnose severe endometriosis, but this is very uncommon in teenagers. Your GP might also suggest these scans to see whether there’s another cause for the painful periods.
A laparoscopy is another option, although it’s rarely suggested for teenagers. This procedure can diagnose endometriosis, but most teenagers who have a laparoscopy for pain don’t have endometriosis.
If your child has tests and these don’t show endometriosis, ask the GP what else might be causing the painful or heavy periods.
Managing endometriosis
The key to managing endometriosis is managing the symptoms – the painful and heavy periods. If periods are lighter or even stop for a while, endometriosis might go away.
Your child can manage painful and heavy periods by using heat packs and over-the-counter pain relief like ibuprofen or naproxen. This can help with period pain and reduce bleeding a lot.
There are also other options. The GP will talk with your child about which treatment is best for them:
- Tranexamic acid – this is a non-hormonal medicine that your child can use on days of heavy bleeding. It can reduce bleeding a lot.
- Hormonal medicine like the combined oral contraceptive pill, which contains both oestrogen and progesterone, or a progesterone-only pill – these medicines can reduce bleeding or stop periods altogether.
- A hormonal levonorgestrel-releasing intrauterine device (IUD), like Mirena – these devices can reduce bleeding or stop periods altogether.
- Medroxyprogesterone acetate injections every 3 months – this can stop periods.
- Surgery, usually laparoscopy surgery – this can diagnose and remove endometriosis.
These ideas might help your child feel better physically and emotionally:
- Eat a healthy diet.
- Get enough sleep.
- Do some physical activity.
- Take care of mental health.
If a doctor recommends surgery for endometriosis symptoms
Very rarely, the GP or specialist might recommend surgery for your child’s endometriosis symptoms. In this situation, it’s a good idea to ask questions like the following:
- What are the benefits of surgery?
- What are the risks of surgery?
- Can endometriosis come back after surgery? Will more surgery be needed?
- What are the alternatives to surgery?
- Could surgery make the pain worse?
- What happens if you don’t find anything during surgery?