Endometriosis (also fondly known as Endo)
Did you know that one in 10 women around the world are thought to have endometriosis? So, if you know you have it, or suspect you do, then you’re not alone.
Endometriosis is a condition in which the same cells which form the endometrium (lining of the womb) grow outside of the womb, most commonly in the pelvis in places such as on the ovaries, bowel, bladder, cervix, vagina and fallopian tubes.
Symptoms of endometriosis
If you have endometriosis, you might experience all of these symptoms, you might experience some of them or you might not have any of these signs of endometriosis (sorry, that wasn’t really helpful was it):
- Pelvic pain
- Painful intercourse (dyspareunia)
- Constipation, bloating, bowel discomfort, diarrhoea
- Heavy and/or irregular periods
- Lack of energy
- Back pain
- Rectal pain and/or rectal bleeding
- Pain on passing urine, blood in the urine
So, by now you’re probably madly googling “how do I know if I have endometriosis?”. If your doctor finds a particular type of ovarian cyst called an endometrioma on your ultrasound they might suspect you have endometriosis. Ultrasound can also sometimes detect endometriosis growths or scar tissue. But often the only way to accurately diagnose endometriosis is by an operation called a laparoscopy.
A laparoscopy requires a general anaesthetic and keyhole surgery through two to four small incisions in the abdomen – your belly. The endometriosis can often be removed surgically at the same time as the diagnosis is made. The surgeon will be very careful to remove the endometriosis and not damage the normal ovarian tissue or other tissue, particularly where future eggs will mature.
Doctors are not 100% sure what causes endometriosis, but one theory is that the endometrial cells move from the womb down the fallopian tubes and out into the abdomen where they adhere and grow outside of the uterus.
Endometriosis and fertility
Your next question is probably “how is endometriosis going to affect my chance of getting pregnant?”
While doctors and scientists have many theories about the effect of endometriosis on fertility. There’s no one single outcome for women with the condition. People diagnosed with endometriosis are still likely to conceive but it is a common cause of infertility. For some, endometriosis can distort the ovaries and fallopian tubes and can cause the body to resist or reject foreign material – such as sperm. Endometriosis growth also produces a whole series of chemical substances (called cytokines or interleukins) that are thought to contribute to infertility. Under the influence of these chemicals, ovulation and egg quality may be impaired, sperm may not function so well in the environment and embryos can find it harder to implant.
If you know or suspect that you have endometriosis, consulting a doctor for review before trying to conceive is highly recommended.
Treatments for endometriosis
In addition to surgically removing the endometriosis during a laparoscopy, hormonal treatments can be used to suppress endometriosis. The problem with the hormonal treatments is that they stop ovulation and therefore a woman cannot become pregnant whilst taking them. Not really helpful if having a baby is your aim. However, if you are struggling to get pregnant and believe endometriosis is part of the problem, there are a range of fertility treatments that can support conception. So, get in touch to see how we can help. A number of our Fertility Specialists specialise in endometriosis.
It’s really important that your medical team is honest with you. Despite what you might read on the forums, pregnancy is unfortunately not a cure for endometriosis and about 50% of women have recurring symptoms of the condition after giving birth.