Endometriosis
Written by: Dr. Mohammed Agdi
Endometriosis occurs when endometrial tissue, which normally lines the uterus, is found elsewhere in the body. The most common sites of endometriosis include ovaries, Fallopian tubes and pelvic cavity. This tissue starts to act just like normal uterine tissue. During menstruation the tissue starts to bleed. As this happens, scar tissue starts to form, usually in the pelvic region. The scar tissue and endometriosis can then lead to potential problems and cause infertility.
Endometriosis is a common condition and associated with increased chance of having trouble with conceiving. Common signs and symptoms of endometriosis may include:
• Painful periods. Pelvic pain and cramping may begin before your period and extend several days during your period. You may also have low back and abdominal pain.
• Deep pain in the vagina with deep intercourse.
• Pain with bowel movements or urination.
• Excessive bleeding during periods.
• Infertility. Endometriosis may be first diagnosed in some women who are seeking treatment for infertility.
• Other symptoms. You may also experience fatigue, diarrhea, constipation, bloating or nausea, especially during menstrual periods.
• Some women with endometriosis don’t have such symptoms.
There are other conditions may have similar symptoms but it is not endometriosis. Endometriosis is often confused with these conditions like pelvic inflammatory disease, ovarian cysts and irritable bowel syndrome.
Endometriosis symptoms usually affect women who have never had children. The disease has a strong genetic link. If one of your relatives has endometriosis, then you are six times more likely to have endometriosis, too. Other factors for endometriosis to occur include:
• Menstrual cycles that occur in less than 28 days
• Menstrual bleeding lasting more than 5 days
• Congenital abnormality of the uterus
• Abnormally tight cervical opening
Diagnosis of endometriosis is usually made through careful history taking regarding your period by your physician and diagnostic imaging like ultrasound. However, laparoscopy is considered to be the best diagnostic tool to confirm the diagnosis but not always necessary in each woman.
The main complication of endometriosis is impaired fertility. Endometriosis may obstruct the tube and prevent the egg and sperm to meet. But the condition also affects fertility indirectly like damaging the sperm or egg. The lining of the uterus is also affected indirectly by endometriosis by interfering with embryo implantation.
Although, many women with mild to moderate endometriosis can still conceive and carry a pregnancy to term, fertility physicians advise women with endometriosis not to delay having children because the condition may worsen with time.
One important issue for women who are known to have endometriosis and difficulty in conceiving is consult as early as possible a fertility expert to discuss her management plan and treatment options since her ovarian reserve may worsen faster than usual compared to other women without endometriosis.
