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Video

Voiceover:
Rebecca is suffering with a gynaecological problem which makes it extremely painful when having sex.

Rebecca:
I just get a burning, stinging sensation, which is really uncomfortable for about an hour, sometimes up to an hour afterwards.

Voiceover:
Dr Pixie swabbed her in order to eliminate any sexually transmitted infections. Our microbiologist Val has the results.

Professor Val:
Well, the good news here is everything’s come back as negative for Rebecca. There’s only normal bacteria in her swabs. So there must be something else causing her problems.

Voiceover:
As she is all clear, Dr Pixie sends Rebecca to see gynaecologist Tyrone Carpenter to get to the bottom of her pain.

Mr Carpenter:
What I’d like to do…I think we need to examine you.

Rebecca:
Yeah.

Mr Carpenter:
And really what I’m trying to tease out is where the pain, I guess, is coming from. So we’re going to start on the outside, and I’m going to use a cotton bud and I’m going to touch various areas, and I’d like you to give me a pain score. So, zero’s no pain, and ten’s the worst pain you could possibly imagine. And then we need to examine you internally, and we’ll use a similar scoring system, um, on the inside.

Mr Carpenter:
Could you give me a number for that?

Rebecca:
About five.

Mr Carpenter:
About five, okay. And I’m just going to stretch the ligaments at the back of the womb now. Could you give me a number for that?

Rebecca:
About seven.

Mr Carpenter:
About seven. And one more thing, I’m just going to put the womb on a stretch one way…sorry, let me do that again, could you give me a number for that?

Rebecca:
About five.

Mr Carpenter:
About five. Okay, that’s fantastic, pop your things back on, come through and we’ll have a chat. Okay?

Rebecca:
Thank you.

Mr Carpenter:
Well, having examined you, I’m beginning to wonder if perhaps, the pain is started from somewhere else, beginning on the inside, and you’ve developed a learnt response to the pain—whereby you anticipate pain, and that causes a superficial pain.

Rebecca:
Okay.

Mr Carpenter:
Now the most common cause for pain deep on the inside with intercourse is endometriosis.

Rebecca:
Okay.

Voiceover:
Endometriosis is thought to affect around two million women in the UK. It’s a condition where cells like the ones lining the womb are found elsewhere in the body. During the monthly cycle, hormones stimulate the endometriosis, causing it to grow, then break down and bleed. This internal bleeding, unlike a period, has no way of leaving the body, and leads to inflammation and pain.

Voiceover:
A week later, and it’s the day of Rebecca’s operation to look for the cause of her pain, and she’s hoping that Mr Carpenter will be able to provide her with some answers. She is undergoing a procedure which is carried out using keyhole, or laparoscopic, surgery. Mr Carpenter begins by inflating Rebecca’s abdomen with carbon dioxide…

Mr Carpenter:
Gas on, please.

Voiceover:
...so he can see her organs more clearly and has space in which to move his instruments. Next, he inserts a camera into the area, and then manipulates his instruments in and around the ovaries and uterus to inspect the tissue.

Mr Carpenter:
What we do is gently lift the ovary and look underneath to see if there’s any disease under there. And that’s all normal. Um, same on the other side, here’s her left ovary here. Ah, and we’re just trying to move it up, and it doesn’t want to move very easily, and we can see there’s some disease there.

Voiceover:
Mr Carpenter has found endometriosis, which is where cells from the womb are found elsewhere. Finally, after five years, Rebecca has an answer for her pain. As well as under her left ovary, Mr Carpenter finds endometriosis in front of and behind Rebecca’s womb.

Mr Carpenter:
Here’s a classic bit of endometriosis here, you can see it’s, it’s pulled in, it’s puckered. And the interesting to note about this, it isn’t just on the surface, you can see it looks like it’s dug in underneath, it’s sort of under the surface. And that’s the thing about endometriosis, it’s an invasive disease, it starts on the surface and it burrows its way in. And that’s why when we treat it, modern treatment involves excising it and chopping all of it out, including the base of it, rather than just cauterising the top, which is traditional old-style treatment. This bulging structure you can see here is her rectum, and we’re just going to the right of the rectum, but we need to be wary, because we’re going to be needing to use heat to remove this. And we don’t want to cause an inadvertent burn to the rectum itself.

Voiceover:
He then carefully cuts away the diseased tissue and removes it from the area. It’s a technique that requires a great deal of skill, but is the best way of resolving the problem.

Mr Carpenter:
For many years endometriosis was simply being treated by people burning the top of the disease in the hope that they would get rid of it. However, by virtue of the fact that the disease invades within the tissues, burning the top is simply like just melting the tip of an iceberg. So nowadays, with advanced laparoscopic surgery and with a high-definition kit, we’re able to go as deep as we need to, and that way we ensure that all the disease’s out. Obviously having had the operation, Rebecca’s going to be rather sore this afternoon, however with radical analgesia, she should be fine to go home later today. Now it’ll take some time to see how well, uh, this operation’s worked, as obviously the areas that we’ve treated on the inside need time to heal out, and these will be more painful initially, rather than less. And she certainly should be back to full normal activity in a couple of weeks’ time. However at two weeks, it’s far too early to assess whether this has been of any benefit with regard to intercourse, we really need around six months for that.

Voiceover:
Six weeks after her op, and Rebecca is back to update Dr Pixie.

Rebecca:
I had it in three places: on my bowel, behind my womb and around one of my ovaries. Um, so he actually managed to cut all that away, while I was under anaesthetic, and managed to remove it all for me.

Dr Pixie:
So, one would hope that because he’s gone in, and done some surgery, that in time…I guess you’re, I guess the whole thing has to sort of settle down first.

Rebecca:
Yeah.

Dr Pixie:
But I think it’s worth giving it a bit of time to see, to see what happens.

Rebecca:
Yeah, I’ve been told, um, that three to six months is kind of a recovery time, when I should start to see a reduction in my symptoms, so I’m just waiting for things to settle down, really.

Dr Pixie:
Are you pleased now that you know what’s going on?

Rebecca:
Yeah, at least now I’ve got something that I can research.

Dr Pixie:
It’s really a case of watchful waiting now, and see what happens.

Rebecca:
Yeah, exactly.

Dr Pixie:
Super, well, thank you very much, and really nice to see you again.

Rebecca:
Thank you. Yeah, thank you.

Dr Pixie:
And yeah, keep us posted.

Voiceover:
Since seeing Dr Pixie, Rebecca has been able to enjoy an active sex life.

Read the video transcript

Rebecca comes to talk to Dr Pixie about the severe pain she gets whenever she tries to insert a tampon or have sex. Dr Pixie performs an examination to check the cervix and ovaries but finds everything to be in order so sends Rebecca to see a gynaecologist. Dr Tyrone Carpenter soon finds Endometriosis around Rebecca’s womb, ovaries and bowel. Subsequently Rebecca undergoes surgery to literally cut the Endometriosis out. 6 weeks later Rebecca returns to Dr Pixie and, although the healing process is a long one, notes a marked improvement in her sex life.

Patient Name: Rebecca Gibbs
Condition: Endometriosis
Specialist: Mr Tyrone Carpenter, Consultant Gynaecologist
Hospital: BMI The Harbour Hospital, Poole
Length of operation: Approx 20 minutes

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Comments and Questions

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I had endometretosis for years had a chocolate cyst removed that had damaged my ovary and my bowel my life was a mess for 20 years pains that never really went I had an ablasion and it helped loads no periods and less pain boobs hurt loads still and I have to take strong pain killers at curtain times in the month but mostly myhell is over if this was a mans complaint it would be cured by now it messed my tthyroid up completely had to have it removed anyone that thinks the two are not coneccted are mistaken the thyroid can't handle the stress it affects every gland in your Body.





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I'm 28 and I have severe endometriosis my niipples have been really sore to the very touch for over a month now what does this mean I know it's not pregnancy what is going on I'm nervous about going to the doctor





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Hi just wanted to ask. I have endometriosis and had a laprascopy to have it removed. Will the endo come back with every period for life now ?





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Unfortunately the answer to your question is yes, the only cures are pregnancy and menopause. Keep in contact with your doctor, there are ways to manage it. Mine is currently managed with a Meraina IUD, but there are other medications, like some birth control pills, that can be used to manage it. The Meraina works because it can hormonally stop your periods, which stops or slows the growth of the endometrial tissue, the none hormonal IUDs won't work. Yes, this is a life long, well until menopause, thing, but they are finding better ways to manage the condition everyday. Don't be embarrassed to ask your doctor for help. This is not a sexual thing, it is not caused by anything you've done or haven't done. It happens because you are female, that's the only causal factor they have been able to nail down.

after dinner last night as soon as i arrived home i had to rush to the bathroom. I had serve pain in the lower stomach i had grueling along my left side under the breast area.I finally had a bowel movement and 2 blood clots that follow.I blamed in the blue cheese dressing,could i be wrong.





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I am older now and all of my reproductive organs are gone ..I had a FULL hysterectomy in 2006 due to many years of battling endometriosis. There were days I wld lay on my couch on a bag of ice for hours GOD I don't miss that ! I had a partial cystectomy in my early 20's where upon my right ovary was removed. The usage of carbon monoxide to blow up my abdomen was a brutal part of surgery in which I was not explained the symptoms of digesting that crap! The surgery was brutal as it was my first and my ob gyn did not know the extent of the size of the cyst or how involved it had become with all my reproductive organs.I used a homeopathic remedy that helped me for many years which was licorice root..it is a godsend for inflammation...in my mid thirties I had my first laprascopy...several follow after that. after my second one I no longer had my cycle which my dr said was fine. I was NEVER so happy when I woke up in that hospital bed hot and not ringing wet from night sweats after my hysterectomy !!! I heard HALLELUAH in my head REPEATEDY! Prob shld of had it done sooner but I waited to make that major womanly sacrifice and have never regretted it. Endometrioses made me a nervous wreck and a hormonal worrier it effects soooo much more than just the physical aspect of a woman . Best of luck to all u ladies who are bearin the cross! I might add my dr (who was/is a miracle dr)put me on hormone therapy for one yr after my hysterectomy ...I had absolutely no menopausal symptoms. Depro Lupron helped too for several yrs before the inevitable decision was made.





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Hi not sure what the problem is but i have very irregular bleeds sometimes lasting 1 day sometimes 4 weeks and sometimes not for 6 months. They are not 'normal' bleeds but are very dark (black) and very lumpy (big sticky clumps the size of 5p). in addition to this i bloat to twice normal size and am in agony. i take a PoP other than that no medication. i was unable to donate blood because my iron level were too low and i was previously having blood tests which showed high testosterone. i get long black hairs on my chest (all over breast not just areola), neck and sometimes my back. previous advice has been 'pluck' however they are multiplying and spreading now. Any ideas?





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has anybody got pressure in their bladder, bloated and pains like cramps or contractions please let me no goin on four mths now, going mad with this, tks





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Hi I recently had protected sex but the next day I was really sore . It's been 5 days now and Im still sore and my pelvis and ovaries have a slight pain. Light twinges. I'm worried I could be pregnant or maybe its a uti? Please help





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Hi I am post menstural, aged 54 and since meeting my husband 9 years ago I am constantly suffering burning sensation and extreme soreness approx 2 days after intercours, which often leads to cystiis. I have tried HRT pills although I came through the menopause absolutely fine, internal cream, have had a biopsy, bladder investigation etc. all to no avail. Im not sure if endometriosis could be the cause after watching the programme last night about Rebecca and her similar problems,any help would be appreciated greatly!!





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Interstitial cystitis and endo are normally together

Unfortunately you can not have endometriosis if you have gone through menopause. Endometriosis is the growth of uterine tissue outside the uterus, it is comprised of exactly the same tissue shed by the body during your monthly cycle. No periods = no endometriosis.

I have recently just had a diagnostic landoscopy as I have constant abdominal pain, I have been told by my gynocologist my womb is badly scared from endomeatriosis but because I now have the ous coil fitted it treats the endomeatriosis but its leaving my womb scared which is giving me constant pain. My doctor said nothing can be done except controlling it with pain relif (tramadol) but I am only 23 with a young son I don't want to end up on tablets forever, I also have ibs, and a condition with my cervix perducing to much mucus which I have freezing treatment for I have my 2nd freezing next month. This is all so stressful and depressing please help me I feel I am the only one.





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