Endometriosis used to be thought of as an uncommon condition of women in their 30s and 40s. We now know that it is a common problem that usually starts in the teens and twenties.

Even if it is common, that doesn’t make it simple. It’s hard being a woman with endometriosis. Illness is much easier to explain when everyone can see the problem (like a broken leg), when it will reliably get better over time (like the ‘flu), or it affects men too (like asthma or diabetes). You may find it difficult or embarrassing to explain to your friends or workmates that you have a ‘woman’s problem’ that just isn’t getting better.

Your family and friends care for you and want you to be well, but may feel frustrated and powerless to help a pain they don't understand.

This book is for women just like you. To explain your pain, help you manage your pain, and live well. It is also for your family so they can understand. There is so much you can do, both with your doctor and for yourself to become well again. Some women with endometriosis have period pain but others have pain on most days. The pain may have started as bad period pain, but at some stage things changed. Now there may be sharp or stabbing pains, bladder or bowel troubles, pain with intercourse, bloating, a depressed mood, headaches, or pain when you move. These are part of the 'bigger picture of endometriosis'. The best treatment usually involves a mix of surgery, special medications, diet and lifestyle changes.

But won't all my pain go away if I have an operation, or even a hysterectomy?

It is true that for many women, excellent surgery through a telescope (called a laparoscope) can remove all the endometriosis, and make a big difference to their pain. It is an important part of modern endometriosis treatment. However there are many pains you can’t see at a laparoscopy. Surgery won't help pain from the bladder, pelvic muscles, migraines, sharp pains, or most bowel problems. We can help you with all aspects of your pain.

This book fills in the gaps. It explains about surgery, but also covers those other problems that women with endometriosis suffer. We want you to be as well as possible

Susan Evans
Deborah Bush

You can look through the contents of the book to see if our book might help you.

Chapter 1.
What is endometriosis?

Chapter 2.
How is endometriosis diagnosed?
What can a laparoscopy show?
What can an ultrasound show?
What can blood tests show?
What can the lining of the uterus show?

Chapter 3.
How endometriosis is treated?
A history of endometriosis treatment
Modern management of endometriosis and pain
I know I have endometriosis but can't have the laparoscopy I need

Chapter 4.
Different types of pain
How we feel pain and Referred Pain
Period pain
Irritable bowel syndrome, food intolerance, bloating and constipation
Sharp and stabbing pains
Bladder troubles
Painful sex
Migraines and bad headaches
Pains that are worse when I move
Ovulation pain and ovarian cysts
Heavy periods
Pain and auto-immune disorders
Pelvic infections

Chapter 5.
Chronic Pelvic Pain
How did it start?
How can I treat chronic pelvic pain
Be cautious about having more surgery
More ideas for chronic pain

Chapter 6.
Laparoscopy
What is a laparoscopy?
Do I need an operation?
How can I prepare for my laparoscopy?
What complications could there be?

Chapter 7.
Will I be able to have children?
How might endometriosis affect fertility?
Can treatments for endometriosis improve fertility?
When to ask for investigation of fertility
When is the best time of the month to become pregnant?
How can I tell if I am ovulating?

Chapter 8.
Frequently asked questions
What causes endometriosis?
Endometriosis is in our family
Can endometriosis be prevented?
Will my endometriosis come back?
Will I need a hysterectomy?
Should my ovaries be removed?
Will menopause cure my endometriosis?
Will my endometriosis become cancer?

Chapter 9.
Medications and how to use them well
Period pain (anti-prostaglandin) medications
Pain killers (Paracetamol, codeine, tramadol)
Progestogen medications (Mirena ®, norethisterone, dienogest)
GnRH analogues (leuprolide, triptorelin, nafarelin, goserelin)
Other medications for pain (amitriptyline, gabapentin, pregabalin)
Contraceptive pill
Danazol and gestrinone
New treatments for endometriosis

Chapter 10.
You and your gynecologist
How to choose a gynecologist
Preparation for your visit and what to ask
Vaginal examinations

Chapter 11.
Endometriosis - The big picture - Deborah Bush
Have women always had endometriosis?
Getting the best care
Understanding why you are sick and tired of being sick and tired
How bad is your endometriosis?
Teenagers get endometriosis too

Chapter 12.
Journey to Wellness – by Deborah Bush
Step by step
Stress, anxiety and guilt
What to do about painful sex
Fertility – sometimes it’s unfair
PMS and Mood Swings
Pain control ideas

Chapter 13.
Self Care – You will need to be involved – by Deborah Bush
Nutrition
Weight
Exercise
Counselling and life-coaching
How to get a good nights' sleep
The nice things about endometriosis

Conclusion