New endometriosis centre at Bronovo Hospital
Period pain is usually regarded as something quite innocent, just something a woman has to learn to live with. Yet there may be a symptom of something far more serious: endometriosis.
So serious that Bronovo Hospital in The Hague has a new Endometriosis in Balance centre to document and address the deeper causes and the physical and mental impact of endometriosis.
Right from their very first period, many women suffer from pain that increases over the years. In the Netherlands, 10 per cent of women in their reproductive years are affected by endometriosis, a condition that sometimes leads to more serious symptoms (see 400.000 women).
"Symptoms may vary widely," explains gynaecologist Maddy Smeets from Bronovo. "Painful periods with heavy blood loss, bladder problems, diarrhoea, lower back pains, pains during sex, fertility disorders.
"One woman with mild endometriosis may have many symptoms, another may never have any symptoms, even though she has extensive endometriosis. Endometriosis does not always give symptoms."
Improved endometriosis diagnostics
Smeets and her colleagues want to improve the diagnostics for endometriosis, because at the moment it can take years before the disease is recognised.
By using a new approach, in which many medical disciplines work together, the disease can be diagnosed more quickly, making very extensive surgery no longer necessary.
As Smeets explains, "After initial discussions with a specialised nurse and an examination by the gynaecologist, we make what’s called a high end ultrasound image, which also shows us the smaller abnormalities."
A patient’s initial examination results are discussed by her gynaecologist, radiologist, psychologist, urologist, pelvic floor physiotherapist and surgeon, after which a treatment plan is set up.
If an operation is necessary, it is carried out using laparoscopic surgery as much as possible, through small incisions in the abdominal wall instead of a large incision. Unfortunately, an operation on its own is not always enough to significantly improve the patient's quality of life.
Life with endometriosis
"We are not satisfied until we have eliminated the endometriosis," says Smeets. "Our objective has only been achieved if the patient has regained control over her life.
"Hence the name Endometriosis in Balance - balance between body and mind. Endometriosis can have a major impact on your life: having to take sick leave from work, a poorer social life and experiencing pain during sex may cause problems with work, friends and within a relationship.
"The first step then is to give each patient a questionnaire about her quality of life. On the basis of the scores we are able to follow this up in supporting consultations with a psychologist."
Women with endometriosis score on average four out of 10, whereas after treatment or an operation the score often rises to six out of 10. "We aim for 8 out of 10," says Smeets. "This is the average score for a Dutch woman."
Regain control of your life
Do you have any symptoms that may be caused by endometriosis? Ask your family doctor to refer you for an examination at the Endometriosis in Balance centre.