Unfortunately, a majority of doctors do not suspect endometriosis when a differential diagnosis seemingly confirms pelvic inflammatory disease (PID) or, in some cases, gonorrhea. Cramps, back pain, abdominal tenderness, and other symptoms tend to indicate pelvic inflammatory disease; additionally, gonorrhea left untreated creates a few symptoms that can resemble endometriosis, including abnormal bleeding and severe pelvic pain. However, there is often accompanying fever with advanced gonorrhea (pus from resulting tubal or ovarian abscesses may cause pelvic inflammation), which does not occur in cases of endometriosis. We emphasize this contusion in diagnosis because a majority of doctors suggest the possibility of infection first. Antibiotics, as previously noted, do not help sufferers of endometriosis.

Cysts are a common ovarian abnormality. They vary in content and can be benign or malignant. A simple cyst, which is a fluid-filled sac, can grow on an ovary anytime during the menstrual cycle. A dermoid cyst contains types of skin tissue, is mote solid in character, and grows less frequently. Most ovarian cysts will disappear spontaneously after one or two menstrual cycles and are therefore not much cause for alarm. This is the type of cyst doctors thought Annie had, but such cysts tend not to cause much pain. In Annie’s case, pain was severe.

Endometrial cysts, called endometriomas, grow faster than either simple cysts or dermoids and can cause more pain—the kind of pain Annie was feeling. Endometriomas are also called chocolate cysts or blood cysts, since they are filled with old blood and endometrial cells, and they are deep brown in color. An endometriotic cyst can be very large, even bigger than a grapefruit, or smaller than a pea. Interestingly, smaller cysts can cause more pain than larger ones and may make diagnosis more difficult.

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For years endometriosis was tagged the ‘career woman’s disease’. This was based on the unfounded idea that women who delay having children are more at risk of developing endometriosis. Women are made to feel guilty that delaying marriage and having children until after they have established a career has been the cause. You ask yourself if you had started your family earlier would you have developed the disease? Would infertility have been a problem?

What must be remembered is that it is not known if delaying childbirth has any connection with the development of endometriosis. Also remember that many women actually get endometriosis after they have had children.

Other women complain that they feel guilty because they may not have been assertive enough in getting a diagnosis. Having been told by one doctor that nothing was wrong they simply suffered in silence and put up with their pain and symptoms.

Sometimes the assumption is made that stress causes the disease. This may make some women think that if they did not have such a stressful job, did not work so hard or didn’t have a difficult family life, they may not have developed the disease.

It does appear that the symptoms of endometriosis may be aggravated when a person is suffering from stress, but it does not mean that it actually develops because of stress.

Women may feel guilty because they cannot cope in certain situations whereas others cope well.

For those who have had an abortion, used contraception such as the Pill or an IUD, used tampons or had sexual intercourse at an early age, there can be the mistaken belief that this has contributed to them getting the disease.

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In order to make the best decision you need to consider your lifestyle, goals, values and feelings, as well as the severity of your disease and its symptoms, and the purpose of the treatment. You also need to weigh up all the potential advantages and disadvantages of each of the treatments against the possible relief that it will bring.

Get as much information as you can. Make an appointment with your gynaecologist to ask any questions that you may have.

Do not hesitate to get a second opinion if you have any concerns or doubts.

It helps if you discuss the issues with your partner, a friend or another woman with endometriosis.

How effective are the different treatments

No treatment offers a magical or permanent cure for endometriosis.

It is not possible to give reliable figures for the success rates of the different types of treatment because few large-scale studies have been carried out. Gynaecologists believe that, overall, success is related to the severity of your condition: the milder your disease the more likely that your treatment will be successful. Nevertheless, there is a wide variation in the way women respond to treatment and it is not possible to predict how you will respond.

Women react differently to each treatment and you may find that you need to try two or three treatments before you find one that works for you.

Regardless of the type of treatment used, some women will have a recurrence of their symptoms. It seems that approximately 20% of women will have a recurrence within 12 months and as many as 50% will have a recurrence within five years.

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Fruit and Vegetables

Buying organic produce will enable you to avoid pesticides, DDT and Kepone. These contain xenoestrogens which are oestrogen-like compounds that can upset the delicate male and female hormone balance. Although DDT is banned in the UK, it is still used in some developing countries and can therefore enter our food chain through imported produce. Organic food also contains more of the valuable nutrients which are essential for fertility. You should include plenty of organic fresh fruit and vegetables in your diet. Fruit is very versatile and can be enjoyed at any time of the day.

Dried fruits make a nice change, but you should avoid any that contain the preserving agent sulphur dioxide which is also used as a bleaching agent in flour. Sulphur dioxide occurs naturally but is produced chemically for commercial use. It is suspected of being a factor in genetic mutations and also of irritating the alimentary canal.

Supermarket dried fruits, such as mixed fruit, raisins and sultanas, often have mineral oil added to them to give them a shiny appearance and keep them separate. Try to avoid this kind of oil, as it can interfere with your absorption of calcium and phosphorus. As it passes through your body, mineral oil can pick up and excrete the oil-soluble vitamins (A, D, E and K) which you really want to retain.

Grains

If you only have a limited amount to spend on organic produce, then buy organic grains if nothing else. This is because grains are very small and can absorb more pesticides than other foods.

Breakfast Cereals

Shredded Wheat and Puffed Wheat (and supermarket own brands of these) are sugar-free. There are also a number of good no-added sugar mueslis and cereals available from health food shops and supermarkets now.

Muesli contains raw flakes of various grains and should be soaked for a minimum of ten minutes before eating, but soaking overnight is definitely best. Soaking enables the phytates (which can block the uptake of minerals from food) to be broken down properly.

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