Endometriosis And Infertility: How They Are Related?
The human body is a machine, a complex system of interrelated components working together to achieve a common goal- survival. If only a single component moves a little out of place or ceases to function, the entire body will falter. For most of us, the mechanism works so well most of the time that we wouldn’t have to worry about this self-servicing machine we live inside of.
A Word About The Uterus
The uterus is a pear-shaped organ in the female reproductive system. The endometrium is a mucus membrane that lines the uterus. While expecting a pregnancy, this lining thickens to provide a soft and nourishing environment for the embryo. When a fertilized egg is implanted, the uterus holds it until the embryo develops and the baby takes birth. If no egg comes its way, the lining thins and sheds as menses. Things are going well so far.
When The Lining Crosses The Lines
Sometimes this mucus lining grows outside the uterus- most commonly on ovaries, fallopian tubes, and the tissues lining the pelvis. But they still act like the regular endometrial lining. They thin and break in the absence of a fertilized egg. Only this time the discharge has no way to leave the body.
Endometriosis on ovaries may also lead to the development of cysts. They are called endometriomas. These changes may cause irritation to the surrounding tissues and lead to the formation of scar tissue. Another potential result is the formation of a fibrous tissue that sticks the pelvic structures together.
Endometriosis Symptoms: Messages From The Body
Before talking about the potential symptoms, we want to stress the point that Endometriosis is a quality-of-life issue. This means, that if the condition doesn’t progress to a point where it affects your quality of life, you don’t have to do anything about it. Talk to your healthcare provider and get a first-hand expert opinion before making a decision on this matter.
Now that we got that out of the way, the main symptom of Endometriosis is pain. You may feel pain during menstruation, intercourse, bowel movements, or urination. Once again, this is a matter of comfort and quality of life. You may ask, how much pain should be a reason for worry. There is no fixed answer. But your menstrual cycles should not be too painful to make you miss work or school.
People with endometriosis often describe menstrual pain to be unbearable and that it is only getting worse over time. Your lower back or stomach also may hurt. Though feeling pain during intercourse can be normal in the early days, it shouldn’t be too much to make you cry.
If you have endometriosis, your periods may last longer than a week or the flow may get heavy. You may also feel extra tired, bloated, or nauseous. Sometimes the condition shows no symptoms at all. People seeking treatment for infertility are sometimes diagnosed with endometriosis.
Otherwise, if you are diagnosed with endometriosis, you are not a lot more likely to face issues of infertility. It should also be noted that pain is not an indicator of the severity of endometriosis. You may have mild endometriosis with severe pain and vice-versa.
Endometriosis Causes: How We Got Here
The exact cause of endometriosis is still unknown in the medical literature. A range of situations including the flow of menstrual discharge to the pelvic cavity, the effect of hormones, scars left by surgery, and immune system disorders are set out as possible explanations.
However several factors that can place you at a greater risk of developing endometriosis are clearly identified. The following are just a few of them.
- Never giving birth
- Starting periods early
- Hitting menopause late
- Cycles shorter than 27 days
- Periods longer than 7 days
- High estrogen levels in the body
- Low Body Mass Index (BMI)
- Family history of endometriosis
- Obstructed menstrual discharge
- Reproductive tract disorders
Medical science still understands very little about Endometriosis. The condition usually develops a few years after the start of menstruation. The symptoms may temporarily improve during pregnancy and you may completely recover from the condition after menopause.
Endometriosis And Infertility Complications: How Bad Can It Get
Infertility is the major issue endometriosis can create. About 35% to 50% of people with the condition face difficulty getting pregnant. Pregnancy involves the release of eggs from the ovary, moved down through the fallopian tube, fused by a sperm cell, and developed inside the uterus.
As mentioned before, endometriosis may affect the ovaries, fallopian tubes, and the tissue lining the pelvis. Thus, one or more steps of pregnancy can be hampered by this condition. It can block the fallopian tube or damage the sperm or eggs. People in the early stages of endometriosis can still get pregnant and give birth. For the same reason, they are advised to not delay their pregnancy.
Ovarian cancer has a strong correlation with endometriosis. However considering the low overall probability of ovarian cancer, it is not considered a significant reason for worry.
Endometriosis Treatments: The Path Forward
Textbook treatments for endometriosis include medication and surgery. The patient has an important role in making the decision regarding treatment. The approach depends a lot on the severity of the symptoms and whether the patient wishes to get pregnant. Surgery is usually opted only when other treatments fail. If you are experiencing painful menstrual cramps, the doctor will prescribe an over-the-counter pain reliever. If you are not planning to get pregnant, the doctor may combine hormone therapy with the pain medication.
If you are trying to get pregnant, your healthcare provider is likely to opt for a conservative surgery to remove the endometriosis tissues. The surgery is usually less intrusive, done with small incisions, and aimed to preserve the reproductive organs. Traditional abdominal surgery is opted for in more severe cases. If you still have trouble getting pregnant, your doctor may suggest specialized fertility treatments. They may include stimulation of ovaries to produce eggs to in vitro fertilization, depending on the individual.
In case you are worried, no, you don’t have to remove your ovaries if you have endometriosis. Always find a doctor you are comfortable with and get a second and maybe a third opinion before making your treatment decision.
