Endometriosis can occur in women of childbearing potential and is characterized by the growth of endometria outside of your uterus. Tissue that normally lines your uterus, is deposited into different locations inside of your body – which primarily constitute the lower abdominal region. Generally, this causes significant and chronic pelvis pain, and has a profound impact on a patient’s wellbeing. But besides a lot of discomfort and an increased risk of further disorders, did you know that endometriosis can also affect your fertility and dictate your family plans?
Statistics and Research
According to Endometriosis World, roughly 1 in 10 women of reproductive age suffer from endometriosis. While this is a significant percentage, research into this disease has been limited and is mainly focused on treating emerging symptoms. Many current studies solely focus on pain management.
Little is known about the triggers and the causes of the disease are poorly understood. Nevertheless, a genetic component seems likely as endometriosis tends to occur in multiple members of one family. However, clinical trials have yet to address the source of endometriosis and fail to provide a solution to its root cause.
Life with Endometriosis
Many women that suffer from endometriosis undergo quite a journey before doctors are even able to diagnose the illness. Endometriosis symptoms may start out very generic making it difficult to pin down the underlying illness. Many women experience heavy periods, significant cramping (primarily around the time they have their periods), and pain during sexual intercourse and/or urination.
Depending on the location of the growing endometria in your body, the pain may not be restricted to your pelvis region. This can be very misleading when trying to address the cause of the pain. For instance, endometrial tissue can grow within your urinary tract system and cause flank pain around your kidneys. It can also lead to increased blood in your urine, making it appear to be a kidney disorder rather than one of gynecological nature.
Chronic pain and discomfort can take a significant toll on you and impact your mental health over time. Women with endometriosis are therefore at a higher risk for depression and anxiety. With endometriosis being a hormonal illness and being commonly treated by hormonal means, mood swings and fatigue further occur frequently in patients.
Patients with endometriosis also show an increased potential to develop auto-immune disorders as the endometriosis may adversely impact your immune system. Auto-immune disorders such as rheumatoid arthritis and lupus appear to occur more frequently in women suffering from endometriosis.
Diagnosis and Challenges Faced
One of the main challenges in treating endometriosis is that a vast number of women go undiagnosed for years. Despite best attempts, endometriosis can only be diagnosed and fully confirmed through surgical means. During a laparoscopy the endometria can then be removed and the extent of the illness can be determined.
Stages are classified by the amount and locations of the growing endometria. Frequently, endometriosis affects your lower pelvis area, i.e. ovaries, fallopian tubes and urinary tract system. Only in rare cases, endometrial tissue spreads to the upper abdomen and can grow in your lungs and even extend to as far as your brain.
With limited research into endometriosis, the sad truth is that treatment is very limited as well. Oral birth control may be used for slight relief in symptoms, as they can lead to lighter periods. Sometimes the implantation of an intrauterine device (IUD), such as the Mirena, may also lessen the strength of your period and/or lead to a cease in your menstrual cycle altogether. Furthermore, hormonal therapy including Lupron treatment can help contain the spread of the endometria when injected for at least six months.
Endometriosis is further considered an inflammatory illness; the pain can therefore be treated with anti-inflammatory medications such as Ibuprofen. For more natural remedies, a heating pad and limited exercise can help reduce the pain. Unfortunately, more often than not, treatment only yields very temporary relief and comfort.
While a laparoscopy may be the last resort, it may also be the most effective as endometria can be removed from your body. Nevertheless, even with surgery, microscopic lesions cannot be identified and removed and may continue to cause pain after surgery.
Endometriosis and Fertility
While many women with endometriosis are able to conceive on their own, endometriosis is still a leading cause in female infertility. According to the American College of Obstetricians and Gynecologists, around 40% of women suffering from infertility have been diagnosed with endometriosis.
In many cases, women with endometriosis have less of a chance to get pregnant the more severe the progression of the disease. In general, women with stage I or II endometriosis are much more likely to conceive on their own or with limited intervention. However, stage III and IV endometriosis more severely affects the ovaries and the reproductive system overall, making it more difficult to conceive.
When endometrial tissue grows in the ovaries, it can develop endometrial cysts that can negatively impact ovulation. It can interfere with a woman’s menstrual cycle and change the regularity and/or pattern of her period. With a profound history of endometriosis, patients can also develop significant scar tissue in the ovaries, hence reducing their functionality and effectiveness. Scar tissue can also build up in other parts of the reproductive system and block the path of the egg in the fallopian tubes.
Surgical means seem the most productive in assisting to remove endometrial tissue, as well as scar tissues from the female reproductive system. Many women are therefore most likely to conceive within a few months of laparoscopic surgery. If still unable to conceive, excision surgery can be performed alongside further fertility treatments, such as IVF (in vitro fertilization). During the IVF process, a woman’s own egg is extracted and fertilized in a lab environment. It is implanted directly into the uterus after fertilization has been completed.
Endometriosis during Pregnancy
The good news is that once you get over the hurdle of getting pregnant, women with endometriosis can have unremarkable pregnancies. However, depending on the disease stage, some studies suggest that endometriosis may increase your risk of miscarriage in early pregnancy.
While a lack in menstrual activity during pregnancy will generally reduce the growth of endometrial lesions, scar tissue can cause continuous pain along the journey. As the pregnancy unfolds, your growing bump and expanding uterus will cause the scar tissue to stretch further. This can cause notably increased pressure in your pelvis area and bring about pain and discomfort.
Overall, hormone levels will dictate the course of your endometriosis symptoms. While progesterone levels can help relieve endometriosis, a rise in estrogen can trigger the growth of more endometrial tissue.
Endometriosis after Pregnancy
As a pregnancy changes your hormonal system quite a bit, it will also affect the severity of your endometriosis. However, if the pregnancy helped relieve some of your symptoms, endometriosis can still reoccur after child birth. Yet, breastfeeding can be an additional factor that may be able to at least delay this recurrence. Studies indicate that pregnancy has a good chance in making positive changes in regards to your pain levels. Generally, physicians recommend some type of hormonal treatment shortly after giving birth, to preserve reduced symptom levels as much as possible.
Endometriosis is for sure a very complex illness, but further research into the disease can hopefully help clarify some pressing questions and bring forward more treatment options. While women may suffer from a series of painful symptoms and face challenges with just their daily activities, the good news is that endometriosis does not necessarily have to affect your fertility. Even if things don’t work out right away, there are options to help reduce the occurrence of endometrial tissue in your body and hopefully make pregnancy a soon-to-be reality.
Author bio – Kady Stoll is a copywriter with a background in clinical research, specializing in the medical and health niche. See kadystoll.com