Endometriosis Specialist Sydney | Treatment for Painful Periods | Gynaecologist
Endometriosis
Dr Jenny Cook | Sydney Gynaecologist & Advanced Laparoscopic Surgeon
Find Relief, Genuine Care, Fertility Expertise
As a Sydney based endometriosis specialist, I have seen many women whose condition was misunderstood or delayed in the diagnosis of endometriosis, leaving them to suffer years of chronic pelvic pain. Endometriosis is a common condition—affecting 1 in 10 women—yet many patients with endometriosis are still underdiagnosed or undertreated.
Others have undergone multiple failed IVF cycles because their condition was not properly recognised by a fertility specialist, despite the fact that endometriosis can cause infertility. My focus is to provide comprehensive, evidence-based endometriosis care through a comprehensive and holistic consultation service for women of all ages.
Dr Jenny Cook on Endometriosis
Understanding how Endometriosis affects Your Body
Endometriosis is a condition where tissue similar to the endometrium (the lining of the uterus) grows outside the uterus, sometimes involving the bladder and ureters, bowel, or ovaries. This condition occurs when endometrial-like tissue implants in the pelvic cavity, leading to inflammation and scar formation.
Endometriosis involves a complex inflammatory response, and endometriosis affects each woman differently. Some women may have no symptoms, while others experience debilitating pain.
Symptoms can include:
- Pelvic pain (a common cause of pelvic pain)
- Painful periods linked to menstruation
- Infertility
- A painful bowel or bladder symptoms
Treatment Overview
– Dr Jenny Cook
Investigations
In most women, routine investigations appear completely normal. The most useful non-invasive test is a Deep Infiltrating Endometriosis ultrasound, which can:
Assess the ovaries for small cysts caused by endometriosis (endometriomas)
Detect deep nodules of endometriosis in the pelvis
Research is also ongoing into the role of pelvic MRI in diagnosis.
Diagnosis and Treatment
The gold standard for both diagnosis and treatment of endometriosis is laparoscopy. During this procedure, endometriosis may appear in several forms:
Red and inflamed tissue
White and scarred areas
Black and pigmented lesions
Subtle powder-burn marks
It may also cause bowel adhesions or nodules around the bowel, as well as disease affecting the bladder. In severe cases, there can be full-thickness involvement of the bowel or bladder.
My Approach
My surgical philosophy is to perform a definitive, wide local excision of all visible disease, including subtle signs that are often overlooked. In some women, endometriosis is present even in normal-appearing tissue. Unfortunately, I frequently see cases where treatment was incomplete, leaving disease behind.
When removing a large endometrioma on the ovary, I take extreme care to excise the disease while preserving normal ovarian tissue. Fertility preservation is always my priority.
When endometriosis is located close to the bowel or bladder, I ensure these structures are carefully identified and preserved. In some cases, consultation with a colorectal or urological surgeon may be required prior to surgery.
Definitive removal (excision) of all endometriosis is known to significantly improve both pain relief and fertility outcomes.
Ongoing Management
For women not planning to conceive, I often recommend placing a Mirena IUCD post-operatively. This device releases progesterone into the pelvic region, helping to suppress the re-growth of endometriosis.
A new medication, Ryeqo, has recently been added to the PBS for the treatment of endometriosis. This provides another valuable option for ongoing suppression following surgical excision.
For women hoping to conceive, fertility is often improved for up to 12 months following surgery. In many cases where endometriosis was the main barrier, I am delighted to receive phone calls within six months from women sharing the news that they are pregnant.
Case Studies
Thoughtful Gynaecological Care for Women of All Ages
Endometriosis can be painful, frustrating, and impact fertility, but you don’t have to face it alone. As a specialist in women’s health, I provide a holistic consultation service for patients across NSW and beyond.
Whether you require diagnosis, surgery, or ongoing support, I am committed to delivering expert care to women of all ages.