Roughly 1 in 10 women have endometriosis, and while the condition is not life threatening, it can have implications for women in later life around their reproduction, fertility and ability to get pregnant.
Roughly 1 in 10 women have endometriosis, and while the condition is
not life threatening, it can have implications for women in later life around
their reproduction, fertility and ability to get pregnant.
What is Endometriosis?
Endometriosis is a chronic condition that affects the reproductive
organs in women. It’s caused when the cells that line the womb – called the endometrium – move and grow in other
parts of the body, outside of the womb.
experience your menstrual cycle, your body releases hormones that send signals
to the womb and cause the lining of the uterus to thicken ready for a
fertilised egg. When no egg is fertilised, the lining of the uterus then breaks
down which is what causes women to experience their period. No matter where
endometrial cells are in your body, they will still respond to the hormones
sent out by your body and breakdown. Outside of the womb, when these cells
breakdown, the bleeding that is a result has nowhere to go and can cause
further problems around the reproductive organs, such as ovarian cysts, called endometriomas, or lesions around the
womb and pelvic area that can ‘leak’ in response to the bodies hormones.
What causes endometriosis?
There is no defined cause for endometriosis – it affects many different
women, from all different backgrounds, cultures and lifestyles. It is not an
infectious condition and cannot be passed on through sexual activity. It is a
chronic condition that can be managed when properly diagnosed.
Some suggested causes for the condition include:
Your Family History – you
are more likely to be diagnosed with endometriosis if you have close female
relatives, such as your mother or grandmother, who have experienced or been
diagnosed with endometriosis.
Your Menstrual Cycle – some
women experience a form of menstruation called retrograde menstruation – this
is where the blood can flow back into your uterus during your cycle, towards
the fallopian tubes and pelvis.
Immune Dysfunction – there
is currently research into whether changes in immune cells are a cause for
Lifestyle Choices –there is
also research currently looking into whether different lifestyle factors are a
cause for endometriosis including body weight, diet and alcohol consumption.
How does it affect fertility?
Because endometriosis affects the reproductive organs it is estimated
that about 30% of women who have endometriosis will have difficulty falling
pregnant. There a number of different reasons for this including:
Scarring caused by
endometriosis on the fallopian tubes and ovaries
Damage caused by
endometriosis to the lining of the womb, resulting in a fertilised egg having
difficulty in implanting into the wall of the uterus in order to develop
Blocked fallopian tubes
caused by damage and lesions from endometriosis
Damage to the unfertilised
eggs in the ovaries caused by endometriosis
Although these are some of the reasons thought to affect the fertility
of women with endometriosis, they are not conclusive and it is important to
remember that even if you have been diagnosed with endometriosis, you will not
definitely experience all of these symptoms and have issues with fertility.
Endometriosis does mean that you are infertile, and many women have
successful pregnancies with no complications, during conception or birth.
How do I know if I have endometriosis?
Endometriosis can be difficult to detect but it can cause a wide range
of symptoms, so it’s worth knowing what to look out for and keeping a note of
prolonged and reoccurring symptoms that you can report to your doctor if you
think you might have endometriosis.
Some of the symptoms to look out for
1. Uterus and Ovulation Pain –
you may experience strong period pains – both during your period and
pre-menstrual pain, and pain during sex.
2. Abnormal bleeding – you may
experience bleeding and spotting in between your menstrual cycle or after sex,
as well as heavier periods than normal that might contain thickened clots of
blood. You may also experience blood in your urine or bowel movements.
3. Pelvic pain – you may
experience pain around your pelvic area, which might get worse in the lead up
to your period.
4. Irritable Bowel Syndrome
symptoms – these include constipation, diarrhoea, bloating and tiredness.
5. Emotional Symptoms – you
might experience emotional symptoms such as depression, anxiety, irritability
and mood swings as a result of the imbalance of hormones in your body.
6. Difficulty falling pregnant – you
may find that it is taking you longer to fall pregnant than expected.
The severity of the symptoms of endometriosis may not match the
severity of the condition so many women do not realise they have the it, and it
can take up until they start trying to fall pregnant for them to be diagnosed
by a doctor. Diagnosing endometriosis can be difficult, but it is worth
speaking with your doctor especially if you are having trouble falling pregnant
so they can carry out tests and provide supportive medical advice on managing
and dealing with the condition.
What if I am diagnosed with endometriosis
and want a baby?
Your doctor will be able to diagnose you with endometriosis by carrying
out an operation called a laparoscopy.
This is where a small incision is made near your belly button, and a small
telescope is inserted into your pelvis so your doctor can see what is happening
around your pelvic area and reproductive organs. From this your doctor will be
able to diagnose for sure if you have the condition, and provide support and
While there is no cure for endometriosis there are a few ways of
managing the condition, both through surgical and non-surgical means that can
help you to improve your chances of falling pregnant. These include:
1. Laparoscopic Surgery – as
well as using this surgery for diagnosis, it can also be used to help reduce
the symptoms of endometriosis. This is done through removing any of the
lesions, cysts, patches or nodules that have occurred as a result of the
2. Freezing your eggs– as
endometriosis can cause damage to your ovaries, and so also cause damage to
your eggs, your doctor may recommend this as an option if you are thinking of
having a baby in the future.
3. Hormonal Treatments – your
doctor might recommend different fertility treatments that are hormone based,
such as clomiphene, which aid the production of your eggs.
4. In Vitro Fertilization (IVF)–if your endometriosis is particularly severe, and you have struggled to get
pregnant for a while, your doctor may recommend IVF as an alternative. This is
where an unfertilized egg is extracted from your ovary, fertilized outside the
body with your partner’s sperm, and then re-implanted into the uterus at the
optimal time. IVF usually comes along with a number of hormonal treatments as
well and is not an option to be undertaken lightly,
Your doctor will make a diagnosis on the severity of your condition and
then discuss with you the best option based on this and other factors, such as
your age, lifestyle and individual circumstances (including how soon you want
to have children). Your doctor will usually work with a range of other health
professionals, including counsellors to ensure you are provided with the right
treatment. You may try a few different treatments before finding the one that
works the best.
How does endometriosis affect my
body during pregnancy?
Many women have perfectly normal pregnancies and births, even if they
have been diagnosed with endometriosis. That said it is important that you do
not stop receiving medical care when you fall pregnant for the condition and to
make sure you make your doctor and midwife aware of your diagnosis when you
fall pregnant. Recent studies have shown that there may be a link between
Abnormal bleeding – you may
experience bleeding after week 24 of your pregnancy
High blood pressure
Caesarean Delivery – you may
be more at risk and require a delivery by caesarean.
What else can I do to help my
fertility if I have endometriosis?
If you are diagnosed with endometriosis, whether you are trying to get
pregnant or not, it is important to maintain a healthy lifestyle to help your
body manage and deal with the symptoms of the condition. Other ways to stay
healthy, manage your condition and improve fertility include:
Physiotherapy – pelvic floor
physiotherapy can help deal with pelvic pain, bloating and other abdominal
symptoms caused by endometriosis
Regular Exercise – regular
light exercise will always help you keep healthy and improve your fertility. But
try to avoid exercise such as Pilates which focuses on your abdominals and your
core as it can cause tightness in your muscles which could make the pain caused
by endometriosis worse.
Nutrition – eating the right
foods and getting plenty of fresh water is very important for your entire
wellbeing. Eating healthy can also help you pinpoint any foods that irritate
your bowl, and so help you eliminate foods that could aggravate any of these
symptoms caused by endometriosis.
Alternative Therapies –
relaxing, health focused therapies such as meditation, yoga, acupuncture and
natural herbal medicines can also help with some of your symptoms – especially
around the emotional symptoms. This can help alleviate the stress associated
with your condition, and so also help improve your fertility.
It’s especially important to know that if you are diagnosed with
endometriosis, you are not alone. Thousands of women are diagnosed each year
and there are many websites, support groups and communities for women to
support each other and provide advice and tips on managing the condition.
A diagnosis does not mean you will not be able to conceive, and if you
are at all concerned, speak with your doctor who can put in place the right
advice, support and treatment for now and your future.
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