What Is Endometriosis And How It Affects Your Fertility?

What is Endometriosis?

Endometriosis is a chronic gynecologic condition in which the tissue that lines the uterus, the endometrium,  grows outside of it, usually in the pelvic area but can also be found in other places in the body. The misplaced tissue responds to the hormonal changes during the menstrual cycle in the same way that the tissue lining the uterus does.  Each month the tissue may build up, break down and shed. Unlike menstrual blood that flows out of the body through the vagina, the blood and tissue from endometriosis remain in the body. This results in inflammation and sometimes scarring (adhesions) leading to pain and infertility. This painful and often debilitating condition affects approximately 10% of women in reproductive age. The condition is often overlooked and dismissed as “just” painful menstrual cramps.

Common Symptoms of Endometriosis:

– Painful periods (dysmenorrhea)

Intense pelvic pain that typically begins before the menstrual bleeding starts and may last a few days longer than your period.

– Menstrual cramping that increases over time.

– Heavy menstrual bleeding which increases over time.

– Bleeding between periods.

– Pain during or after sex.

– Pain with bowel movements or urination

– Difficulty in getting pregnant.

– Other symptoms – fatigue, diarrhea, constipation, bloating or nausea, especially during menstrual periods.

The severity of the pain can range from minimal to severe. The pain is not an indicator of the severity of the condition.  Some women with mild pain will have severe endometriosis and vice versa.

Endometriosis and Infertility:

One of the common complications of Endometriosis is infertility. Almost 50% of women with endometriosis will struggle with infertility, which is usually how women find out about their condition.

Being diagnosed with Endometriosis doesn’t mean you will never have children. It may require some more time and some help of assisted reproductive technologies.

How is Endometriosis diagnosed?

If you are experiencing any of the above signs and symptoms, you should consult with your healthcare provider. Initially, the doctor may conduct a physical examination, order blood tests, imaging studies and at times require a Laparoscopy to validate the diagnosis. Laparoscopy is a surgical procedure using a fibre optic cable system which allows the doctor to examine the inside of the abdominal cavity in search of endometriosis implants.  

What are the causes of Endometriosis?

The exact cause of endometriosis hasn’t been identified. However, several theories offer possible explanations for what causes Endometriosis. Scientists believe that one possible cause is that in some cases menstrual blood flows backward through the fallopian tubes into the pelvis and then the endometrial glands reimplant in the pelvis. Another possible explanation is a that other types of cells transform to become endometrial cells. This may explain distant endometrial implants to areas with no direct communication with the uterus. There might be a genetic component to Endometriosis as women with family history of endometriosis are more likely to develop endometriosis. The immune system also plays a potential role in the development of the disease. A dysfunctional immune system will fail to efficiently remove the extrauterine endometrial tissue, giving it the time needed for implantation. Lastly, hormones such as estrogen allow the development of Endometriosis while pregnancy and progesterone inhibit its growth.

What is the treatment?

There is no known cure for endometriosis. However, there are treatments which will relieve some of the symptoms and improve the quality of life. The treatment plan to Endometriosis depends on different factors such as severity of the disease, its location, the woman’s age and presence of other symptoms and medical conditions. For optimal outcome, the specialist will build a treatment plan based on your individual profile.

  1. Drug Therapy: While the exact cause of Endometriosis is unknown, scientists identified that estrogen contributes to the progression of the disease and its symptoms. The principles of the hormonal therapy are either to lower estrogen production, provide a high dose of progesterone or combine both. In addition to the hormonal therapy, the doctor may prescribe anti-inflammatory pain medications
  2. Surgical: If the drugs are not helpful, the doctor may offer a  surgery to remove only the diseased tissue such as lesions, implants, cysts, and adhesions. Surgery is very effective for pain management but of limited value for treatment of infertility.
  3. Endometriosis-related infertility is best treated with IVF that removes the creation of the embryo away from the toxic environment induced by the endometriosis.
  4. Complementary treatment and lifestyle changes: Many women report relief when supplementing the medical treatment with dietary changes and alternative therapies such as acupuncture, meditation, and other relaxation techniques. These alternative methods may offer relief from the symptoms of endometriosis.

Endometriosis can be a challenging condition to manage. However, with the right treatment plan, support and lifestyle change the quality of life can be restored. You should not suffer alone, reach out and get the support and treatment you need! 


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