Endometriosis is a little understood, but relatively prevalent female reproductive disease. In this post, we explore what endometriosis is, what the symptoms can be, what the treatment options are and if you can get pregnant with endometriosis.
What is endometriosis?
Endometriosis is a female disorder that affects the reproductive system and surrounding organs. The word itself comes from the root “endometrium”, which is the tissue that lines the uterus and that sheds during a menstrual period. In women with endometriosis, endometrial tissues grow in areas beyond the uterus. The bladder, bowel, ovaries and other surrounding organs can be affected by this growth, and the presence of endometrial tissue in these areas can lead to adhesions, scarring, and nodules.
An estimated 176 million women suffer from endometriosis worldwide, with around 8.5 in North America. The cause of endometriosis is still, unfortunately, unknown. Many factors can play a role in the development of the disease, however. They include genetic factors, environmental triggers, immune system response, and stem cells. The Edometriosis Foundation of America points out that a woman whose mother has/had endometriosis has a seven times higher risk of developing the condition herself.
There is a perhaps surprising lack of awareness about endometriosis, especially considering that the condition is so prevalent. Endometriosis can come with a significant amount of symptoms, or it can be symptomless. Even for women who do have symptoms, it can take as long as a decade to receive the proper diagnosis, among other reasons because they may see their symptoms as normal and do not seek help.
Endometriosis comes in several stages, determined on the basis of the amount, depth, and locations of the endometrial tissues or implants. Healthcare providers will look at whether there are blocked fallopian tubes, and to what extent the patient has adhesions as well. The stages are:
- Stage I — minimal
- Stage II — mild
- Stage III — moderate
- Stage IV — severe
What are the symptoms?
The symptoms do not always correspond to the patient’s stage of endometriosis, contrary to popular belief and perhaps contrary to common sense as well. A woman with mild endometriosis may experience significant symptoms, while one with severe endometriosis may not have any noticeable symptoms whatsoever. Where symptoms do occur, they also come in a broad range of severity.
Some of the symptoms that are associated with endometriosis are:
- Pelvic pain
- Severe menstrual pain
- Pain during intercourse and bowel movements
- Rectal pain
- Back pain, especially before a period id due
- Irregular vaginal bleeding — between periods or after sex
- Blood in bowel movements
- Nausea and vomiting
- Infertility, ectopic pregnancy, and miscarriage
Treatment and getting pregnant
Treatment of endometriosis depends on a wide variety of factors. When a woman is diagnosed with the disease, she will have a detailed discussion about the possibilities with her healthcare provider. The symptoms a woman has and the extent of her endometriosis are important factors that need to be considered. Other things you and your doctor would examine after an endometriosis diagnosis include your own opinions and preferences, and particularly whether you would like to get pregnant.
To manage the pain that is often associated with endometriosis, you may be offered pain killers such as ibuprofen, which also act as anti-inflammatory medications. There are many hormonal treatment options available for those women who do not wish to get pregnant. These include combined oral contraceptives or other hormone-based contraceptives, which prevent ovulation and alter the menstrual cycle. A “hormonal menopause” can also be induced. Women who don’t want to get pregnant also sometimes opt to have a hysterectomy.
For those women who would like to have a baby, surgery is sometimes recommended to remove endometrial implants. Endometrial implants will usually return following such a procedure, but the woman’s chances of getting pregnant go up greatly within the first year of having the surgery.
Between 20 and 40 percent of women who have endometriosis are infertile. This depends on the extent of the endometrial implants and adhesions, and surgery can — as mentioned — increase a woman’s chances of conceiving naturally. Though endometriosis has been shown to have a negative impact on IVF success chances, most women who have IVF due to endometriosis-related infertility will still be able to conceive. This is one option you may like to discuss with an infertility doctor.