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Endometriosis

Overview

What is Endometriosis?

Endometriosis is a chronic gynaecological condition where tissue similar to the lining of the womb grows outside the uterus, most commonly in the pelvic cavity. This misplaced tissue can be found on the ovaries, fallopian tubes, the outer surface of the uterus, the bowel and the bladder. Responding to the monthly hormonal cycle, this tissue behaves as it would inside the womb - it thickens, breaks down and bleeds. However, unlike a normal period, this blood and tissue have no way to leave the body. This trapped material is known as endometriomas, causing inflammation, chronic pain, scarring, adhesions and ovarian cysts down the line.

Endometriosis remains poorly recognised and often mismanaged, affecting an estimated 1 in 10 women. The impact it has on quality of life, fertility and overall wellbeing can be profound. Providing the specialised multidisciplinary expertise, dedicated endometriosis can effectively diagnose and manage this complex disease.

Types of Endometrioses

Endometriosis is classified by certain factors like the location and depth of tissue growth. Superficial peritoneal endometriosis is the most common form and develops when small implants are found on the peritoneum lining the pelvic cavity.

Ovarian endometriomas are another form, which are sometimes called 'chocolate cysts,' and are fluid-filled cysts forming on the ovaries that can cause significant pain.

The most severe form is deep infiltrating endometriosis (DIE), where tissue invades more than 5mm beneath the peritoneal surface, affecting vital structures like the bowel, bladder or ureters. DIE is the most difficult to manage and often requires complex, multi-disciplinary surgical treatment.

Many women live with debilitating symptoms for years, often being told their severe pain is normal. It is not. Patients should consider consulting a specialist if they find themselves experiencing severe period pain that stops daily activities or worsens over time.

Chronic pelvic pain not limited to periods. Pain during or after intercourse and pain when opening bowels or passing urine, especially during period times, are all key signs. Endometriosis could be a contributing factor in women who have been trying to conceive for a year without success. Important indicators as well would be heavy or irregular bleeding and overwhelming fatigue that accompanies period cycles. It would be time to seek guidance from a knowledgeable endometriosis doctor if women find themselves experiencing any of the mentioned symptoms.

Diagnosing endometriosis begins with a detailed discussion of symptoms, their impact and family history, as first-degree relatives of women with the condition have a significantly higher risk. A pelvic examination may be performed by our specialists, to check for cysts or tender areas with imaging following this process, if required. A high-resolution pelvic ultrasound can identify ovarian endometriomas and, in skilled hands, signs of deep disease. An MRI scan may be recommended to map the extent of disease on the bowel, bladder or ureters before surgery, for complex cases. The gold standard for definitive diagnosis is a laparoscopy where this minimally invasive procedure uses a thin camera inserted through a small incision, allowing the surgeon to view the pelvic cavity, identify all lesions and take a biopsy. For an expert, the same procedure is often the first step in treatment.

  • Superficial Peritoneal Endometriosis
  • Ovarian Endometriomas (Chocolate Cysts)
  • Deep Infiltrating Endometriosis (DIE) affecting the bowel, bladder, or ureters
  • Adenomyosis
  • Endometriosis-Related Infertility
  • Chronic Pelvic Pain Syndromes
  • Painful Periods (Dysmenorrhoea)
  • Painful Intercourse (Dyspareunia)
  • Associated bowel and bladder dysfunction related to the menstrual cycle

The understanding that endometriosis is a chronic, often recurrent condition requiring long-term management is the foundation of our approach. We recognise it affects not just a woman's physical health, but her emotional wellbeing and life plans. We follow the three core principles of endometriosis care which are to alleviate pain, improve fertility and prevent recurrence. We tailor all endometriosis treatment to a patient's symptoms, the extent of disease and the desire for future fertility.

For many, the journey begins with medical management. Hormonal treatments like the combined oral contraceptive pill, progestogens or GnRH agonists to suppress the hormonal cycle and slow tissue growth are an option. Pain management strategies are also available.

Medical management is often of limited value when endometriotic cysts are present. Endometriosis surgery is frequently the most effective path for severe pain, deep disease or fertility concerns. Our expert surgeons are highly skilled in advanced laparoscopic surgery. They all work toward the goal of achieving complete excision of all visible implants, draining cysts and dividing adhesions all while preserving healthy tissue and organs. Complete laparoscopic excision, as evidence shows, is associated with a better quality of life and a lower risk of recurrence.

We adopt a multidisciplinary team approach for complex cases of deep infiltrating endometriosis which involve the bowel or bladder, working collaboratively with colorectal and urology surgeons. Recommended by international bodies, this integrated method ensures comprehensive care, minimises complications and reduces the need for repeated surgery. Our team across Abu Dhabi, Dubai, Sharjah, Ajman, Ras Al Khaimah and Al Ain offers endometriosis treatment and is equipped to support all phases of the journey, whether patients are seeking initial diagnosis, medical management or a surgical opinion.

Our team consists of consultant gynaecologists who have a background and specialised training in minimally invasive surgery. They are experts in the management of complex endometriosis, including deep infiltrating disease. Supported by dedicated nurses, fertility specialists, physiotherapists, pain consultants and counsellors, every member is integral in our goal of delivering holistic, patient-centred care.

Our consultants, taking time with each patient, listen to their story, explain complex conditions in clear terms and discuss all options. This allows for confident, informed decisions to be made. They are here to help those in search of a trusted endometriosis doctor across Abu Dhabi, Dubai, Sharjah, Ajman, Ras Al Khaimah and Al Ain and are passionate about guiding them from pain and uncertainty towards relief and a better quality of life.

FAQs

Find the Answer to Your Medical Questions

Frequently Asked Questions

No, endometriosis is not cancer. Research does suggest however, that women with endometriomas have an increased risk of developing ovarian cancer. This is why laparoscopic excision is often recommended, especially for women over 40.
There is currently no permanent cure but it’s a highly manageable condition. A combination of medical management and complete laparoscopic excision surgery can provide significant, long-lasting relief and a good quality of life for many women.
Endometriosis is a common cause of infertility. It affects about 30-40% of women with the condition. Expert laparoscopic surgery used to excise endometriotic tissue can significantly improve fertility outcomes. Its important fertility wishes are discussed with your doctor, in order for a personalised treatment plan to be developed for you.
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