Endometriosis - A GP's Perspective
By Dr Ayodhya Jaysinghe, Dr Fiona Raciti and Dr Maria Boulton, Family Doctors Plus, Windsor
As GPs with more than 20 years combined experience we have come across many patients who have undiagnosed endometriosis and have been living with painful periods and/or heavy bleeding for years. The delay in diagnosis can sometimes be as long as 7 years or more. Patients will sometimes say that they have felt let down in the past by other doctors who did not take their symptoms seriously. Unfortunately it is very common to see patients who have spent years trying to find and answer for their symptoms. Sometimes this can involve seeing many different practitioners or specialists or having invasive, expensive testing.
We believe that a diagnosis of endometriosis should be considered in any woman who has symptoms such as painful periods, heavy bleeding, severe pelvic pain or other pelvic symptoms. Women can also present with infertility, fatigue and even irritable bowel syndrome type symptoms. Sometimes women are reassured when they have an ultrasound that is normal and continue to have symptoms. In fact, ultrasounds may not show endometriosis. The best way to diagnose endometriosis is to have a laparoscopy. A laparoscopy is when a small camera is inserted through your abdomen into your pelvis making it easier to see what is going inside of your body. This is performed by a gynaecologist. If endometriosis is found your gynaecologist will explain the management options to improve your symptoms and quality of life.
It is important to seek advice early if you think you may have endometriosis. The longer it goes undiagnosed the more severe the effects of the disease. In general practice we often see women who have been treating heavy, painful periods for many years with over the counter medication. Not all these women have endometriosis however it is important that it is investigated. We often see patients who have clear endometriosis that affects their ability to go to work, school or can even affect their relationships. If you have any concerns, speak to a trusted health professional. This can be tricky, and we often hear from patients that sometimes they don’t feel that their doctor is listening, or taking their pain seriously. Don’t be afraid of getting a second opinion if you feel you are not being listened to. Remember there is an experienced and caring GP who is always willing to listen and work with you to develop a plan that suits your individual needs. Groups such as QENDO are valuable sources of support and can recommend GPs who are experienced in women’s health. An experienced and caring GP is essential not only for diagnosing endometriosis but also as an integral part of your treatment team. They can also recommend a gynaecologist who is experienced in the treatment of endometriosis. Some patients also need the help of a physiotherapist and psychologist. Your GP can co-ordinate and lead this team and provide you with ongoing support.
Our patients sometimes feels isolated and find groups such as QENDO a valuables source of information and support. Thank you to QENDO for increasing awareness of this important issue affecting many women.
By Dr Ayodhya Jaysinghe, Dr Fiona Raciti and Dr Maria Boulton
GPs at Family Doctors Plus, Windsor, Brisbane, QLD
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