Dr Kerryn Phelps, Health Editor, Channel Nine 'Today', with Steve Liebmann

LIEBMANN: …a lot of women.

PHELPS: Yes, it does. It's estimated to affect up to one in ten Australian women in their reproductive years.

LIEBMANN: And we're not just talking middle age and beyond? It can affect teenage women, as well?

PHELPS: Yes, yes. From any time on from when you start getting your periods really through to menopause and sometimes beyond.

LIEBMANN: So, what is it?

PHELPS: Well, it's a very curious disease. It's called endometriosis because it refers to the cells that normally line the uterus, called the endometrium. And if you can see here - and part of the reason for laparoscopy is not only just to diagnose it, but to actually treat it, and you need to go in and locate every single little spot - and there's a spot, coming up there now, of endometriosis - and either using cutting techniques or burning techniques with a laser, try and remove every single little spot of endometriosis.

LIEBMANN: Can you get it again, if you have the treatment?

PHELPS: It can recur, but you can use medical treatments, different types of hormone preparations combined with the surgery and also making sure that there is really good nutrition, that a woman has regular exercise and undertakes some stress management, because that can affect the course of the disease as well.

LIEBMANN: Am I right? The only real signal is really extreme, severe pain?

PHELPS: Period pain would be the main one. Interestingly, you could have really bad endometriosis but not very bad symptoms. And you could have mild endometriosis but quite bad symptoms. But the sorts of symptoms to look out for are painful or heavy periods, painful intercourse, spotting in between your periods, bleeding in between the periods or spotting just before them, pain, sometimes throughout the cycle, back pain, but also bowel and bladder problems. And some people will find that they've got diarrhoea and constipation and they're diagnosed as an irritable bowel syndrome because they don't appear to have any gynaecological symptoms. But, in fact, they might have frequent urination, they might have diahorrea or constipation, or a combination of both, and they're thought to have irritable bowel but, in fact, it's this endometriosis, which is irritating the bowel from the outside.

LIEBMANN: And no clues? I mean, some people suggest it could be hereditary?

PHELPS: There have been suggestions about that, but nobody's been able to pin down a genetic cause. It certainly doesn't seem to specifically run in families, so I think the bottom line is that we need a whole lot more research, and we need women who have these symptoms and don't have a diagnosis to make sure that they see a doctor and have this explored, because it is a possibility for your symptoms.

LIEBMANN: Does a hysterectomy eliminate the problem?

PHELPS: It used to be thought that a hysterectomy would solve the problem but, in fact, it doesn't, unless you get all of the little bits of endometriosis throughout the pelvis, you still will get the cyclic pain. So, it's a very curious disease, these cells appear to respond to the body's normal hormonal cycle as well, in the same way that the endometrium does.

LIEBMANN: And, of course, apart from the impact on the sufferer, it is a disease. Is that right?

PHELPS: Yes. A lot of people say, 'Well, look, it can be so evasive, is it cancerous? Well, no, it's not. It's actually benign. But it can behave quite aggressively. Not in a cancerous fashion, because it won't spread throughout the body elsewhere. But it can certainly be a very debilitating disease and one that causes women to become quite down, quite depressed. And if you can imagine, you've got pain all the time, painful intercourse, it can affect a woman's relationship, and it's something that there is treatment available for, and it can help the symptoms.

LIEBMANN: And, of course, given the fact that it can be so debilitating, you've then got the spin-off effect - the cost to the community…?

PHELPS: Well, that's right. It's been estimated that some millions and millions of dollars are lost to industry every year because women who have endometriosis have to take two or more - I think the average is 2.3 days a month - off work, because their period pain can be so debilitating. So, it is something that has repercussions throughout the system. It has repercussions for people's relationships and, obviously, for the individual woman. And I think one of the big repercussions for women is not knowing what's wrong with them when they have these symptoms. So, if you know what the problem is and you have the laparoscopy and it's diagnosed and then you can make a decision about treatment depending on how severe it is.

LIEBMANN: And, I mean, what's your recommendation, well, it's difficult for you, but recommendation in the first instance, take medication rather than have surgery, or forget the medication and…

PHELPS: I think it really gets down to what the nature of the disease is for that woman. If she has the laparoscopy and says, 'Look, you've got a few spots of endometriosis, and I think this is what's causing the problem', and of course, it can be related to infertility, so sometimes about 30 to 40 per cent of women with endometriosis will have trouble falling pregnant, and it will be in the process of that investigation that it'll be found that they have endometriosis.

LIEBMANN: Alright. Well, there is a hotline.

PHELPS: There's a hotline you can call - 1300 850 108 - to get some information or you can talk to your GP and be referred to a gynaecologist, and then I think it's a matter of discussing what is best for you in your particular circumstances.

LIEBMANN: Okay. See you next week.

PHELPS: Thanks, Steve.

Ends