It makes you feel helpless,” says Natalie Greenwood, of a condition that affects her so badly she is “non-functioning most of the time because of the constant fatigue”. Greenwood, 36, needs to have an operation every few years to limit the impact of the endometriosis that gives her chronic pelvic pain, as well as extreme tiredness and brain fog. She says the trouble with depending on surgery is not just having an invasive procedure and then having to recover afterwards.
It’s more that the benefit gained – the relief from persistent pain – is brief. She is not alone in her lack of belief in surgery and hormonal medication being effective for chronic pelvic pain. A study has found that dual approach, which is the NHS’s usual way of treating the condition, does not improve quality of life for female patients.
Greenwood was diagnosed with endometriosis 13 years ago, after leaving university. It is a condition in which tissue similar to the lining of the uterus – the endometrium – is found outside the uterus, most commonly in the pelvic cavity, and can cause inflammation and pain. Greenwood, who is a languages teacher in West Yorkshire, has already had surgery three times: when she was 23, 28 and 32.
In the first two operations she underwent ablation, in which the endometriosis is removed using heat or cold. The last procedure involved excision, in which the surgeon cuts out the endometriosis. But I’ve never come out of it feeling better,” she said.
That keeps the endometriosis at bay by shutting down the hormones that cause it. But the endometriosis keeps growing. So you might feel better for a while but it’s always there in the background.” Even after surgery, Greenwood has still needed what she calls her “pain management toolkit” – Tens machines, peppermint teabags, cooling patches, hot-water bottles and CBD oil.
Endometriosis is one of the main causes of chronic pelvic pain, a condition that affects between 6% and 27% of women worldwide. Others include vulvodynia and bladder pain syndrome. You don’t just suddenly feel completely better.
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