\u201cIt\u2019s really frustrating to be in this cycle of continuous surgery. It makes you feel helpless,\u201d says Natalie Greenwood, of a condition that affects her so badly she is \u201cnon-functioning most of the time because of the constant fatigue\u201d.<\/p>\n
Greenwood, 36, needs to have an operation every few years to limit the impact of the endometriosis<\/a> that gives her chronic pelvic pain, as well as extreme tiredness and brain fog.<\/p>\n She says the trouble with depending on surgery is not just having an invasive procedure and then having to recover afterwards. It\u2019s more that the benefit gained \u2013 the relief from persistent pain \u2013 is brief.<\/p>\n 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\u2019s usual way of treating the condition, does not improve quality of life for female patients.<\/p>\n Greenwood was diagnosed with endometriosis<\/a> 13 years ago, after leaving university. It is a condition in which tissue similar to the lining of the uterus \u2013 the endometrium \u2013 is found outside the uterus, most commonly in the pelvic cavity, and can cause inflammation and pain.<\/p>\n Greenwood, 36, was diagnosed with endometriosis 13 years ago and has a \u2018pain management toolkit\u2019, including a Tens machine, to help with the condition. Photograph: Christopher Thomond\/The Guardian<\/p>\n 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<\/a>, in which the endometriosis is removed using heat or cold. The last procedure involved excision<\/a>, in which the surgeon cuts out the endometriosis.<\/p>\n \u201cThe surgery is effective in that it can keep the pain at bay for a few more years. But I\u2019ve never come out of it feeling better,\u201d she said. \u201cAnd in between surgeries I\u2019ve still had to have hormone treatments, like a hormonal coil, or been put into chemical menopause. 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\u2019s always there in the background.\u201d<\/p>\n Even after surgery, Greenwood has still needed what she calls her \u201cpain management toolkit\u201d \u2013 Tens machines, peppermint teabags, cooling patches, hot-water bottles and CBD oil.<\/p>\n 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<\/a>.<\/p>\n \u201cThe surgery has never been a magic fix for me,\u201d said Greenwood. \u201cI don\u2019t think it\u2019s a magic fix for many people. You don\u2019t just suddenly feel completely better. A life of surgery every five years is just not something you want to do. It\u2019s not sustainable. It\u2019s like a constant rut.\u201d<\/p>\n Greenwood has a boy of five and is keen to have another child. But endometriosis has affected her fertility so much that she will soon start a course of IVF.<\/p>\n Whatever the outcome of that treatment, she is sure of one thing: \u201cI won\u2019t have surgery again. It\u2019s not manageable to keep having surgery every five years. Whatever happens with the IVF, after it I\u2019m going to have a hysterectomy and my ovaries removed because that might give me some relief from endometriosis.\u201d<\/p>\n Dr Jasmine Hearn, a reader in health psychology at Manchester Metropolitan University who co-led the research in the new study, said: \u201cSadly patients are often left struggling due to current pain management strategies not sufficiently alleviating pain.<\/p>\n \u201cChronic pelvic pain is often invisible but its impact can be profound. Our findings highlight that women with pelvic pain report poorer quality of life when they\u2019ve had surgery and hormonal medication for pelvic pain and better quality of life when psychological support is part of treatment.\u201d<\/p>\n The 147 women in the study, who were aged 18 to 66, all reported that their pelvic pain had a major impact on both their physical and psychological quality of life and ability to function normally.<\/p>\n Surgery was found to be associated with lower physical quality of life while painkillers were associated with women having poorer physical, psychological and environmental quality of life.<\/p>\n In contrast, women who received psychological help as part of their treatment to help them manage their pain said their quality of life was better. The evidence for its effectiveness was so great that all those who suffer pelvic pain should be offered it, Hearn added.<\/p>\n Dr Lucy Whitaker, a researcher with the charity Wellbeing of Women and a clinical lecturer in obstetrics and gynaecology at the University of Edinburgh, agreed. She said the same suggestion was made in 2020 by Westminster\u2019s all-party parliamentary group on endometriosis and by a confidential national inquiry<\/a> into the condition in 2024.<\/p>\n Whitaker added: \u201cChronic pelvic pain conditions like endometriosis carry a well-documented psychological burden and integrating psychological support alongside medical management reflects a more holistic approach to a condition that has long been under-resourced.\u201d<\/p>\n A spokesperson for NHS England said: \u201cChronic pelvic pain can have a significant impact on women\u2019s lives and mental health. That\u2019s why psychological professionals provide specialist pain-management support as part of wider physical health services \u2013 including for chronic pelvic pain \u2013 while women can also self-refer to NHS talking therapies for support with long-term physical health conditions.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"\u201cIt\u2019s really frustrating to be in this cycle of continuous surgery. It makes you feel helpless,\u201d says Natalie…\n","protected":false},"author":2,"featured_media":625684,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[10],"tags":[103,61,60],"class_list":["post-625683","post","type-post","status-publish","format-standard","has-post-thumbnail","category-health","tag-health","tag-ie","tag-ireland"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/posts\/625683","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/comments?post=625683"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/posts\/625683\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/media\/625684"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/media?parent=625683"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/categories?post=625683"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/tags?post=625683"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}