Endometriosis Management

Understanding Endometriosis

Endometriosis is a condition where tissue similar to the lining of the uterus (endometrium) grows outside the uterus. It can affect the ovaries, fallopian tubes, the tissue lining the pelvis, and occasionally other organs. Endometriosis affects approximately 1 in 9 Australian women and can cause significant pain, menstrual disturbance and fertility difficulties.

Symptoms

Endometriosis symptoms vary widely between individuals. Some women have severe symptoms with minimal disease, while others may have extensive endometriosis with few symptoms. Common presentations include:

• Painful periods — Often progressive and debilitating
• Chronic pelvic pain — Pain that persists throughout the cycle
• Pain with intercourse — Deep pain during or after sex
• Bowel and bladder symptoms — Pain with bowel movements or urination, particularly during periods
• Fertility difficulties — Endometriosis is found in up to 30–50% of women with infertility
• Fatigue and general impact — The condition can significantly affect energy levels and daily life

Diagnosis

Diagnosis may involve:

• Clinical assessment — Detailed history of symptoms and their impact
• Pelvic examination — Physical examination to identify areas of tenderness
• Ultrasound — Transvaginal ultrasound can identify endometriomas (ovarian cysts) and deep endometriosis
• MRI — In selected cases for detailed assessment of deep infiltrating endometriosis

Our Approach

Dr Kirshenbaum provides a thoughtful, individualised approach to endometriosis management:

1. Thorough evaluation — Understanding your symptoms, their severity and their impact on your life
2. Clear diagnosis — Using appropriate investigations to characterise your condition
3. Personalised management — A treatment plan aligned with your symptoms, fertility goals and preferences
4. Medical therapies — Hormonal and non-hormonal options to manage symptoms
5. Fertility planning — If relevant, integrating fertility goals into your management strategy
6. Multidisciplinary coordination — Working with pelvic pain specialists and surgeons when needed
7. Long-term care — Ongoing monitoring and adjustment of your management plan