Endometriosis

Endometriosis is a condition where tissue like your uterine lining grows outside the womb: on the ovaries, fallopian tubes, pelvic tissues, or more rarely, in other parts of the body. If this tissue grows on the muscular wall of the uterus, it’s called adenomyosis.
This tissue acts like your uterine lining during the menstrual cycle: it thickens, breaks down, and then bleeds. But it doesn’t drain out of your body like period blood and instead gets stuck, which can cause cysts, scarring, and adhesions (bands of scar-like tissue). Around 10% of women of reproductive age around the world have endometriosis.

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Impact of endometriosis on fertility

Up to 50% of women with endometriosis experience difficulty getting pregnant. This condition affects fertility because tissue growth or scarring can damage the ovaries or fallopian tubes, blocking the movement of sperm or eggs. Endometriosis can also harm egg quality and distort pelvic anatomy.

Potential causes of endometriosis

There’s not a clear cause for endometriosis, but experts believe it to be due to one or a combination of the following factors:

• Retrograde menstruation: When period blood with endometrial cells flows back through the fallopian tubes and into the pelvis rather than leaving the body through menstruation.
• Cellular transformation: When hormones or immune factors cause cells outside the uterus to change form. 
• Endometrial cell movement: When blood vessels move cells from the uterine lining around the body. 
• Immune system disorder: When the body can’t get rid of the endometrial-like tissue growing in other places.
• Surgery: After an operation in the pelvic area (such as a C-section), endometrial-like cells may grow at the location of the incision.

Genetics and environmental toxins could also play a role.

Symptoms of endometriosis

Women experience this condition differently and symptoms can vary from very mild to severe. The most common sign is chronic pelvic pain. Other symptoms include:

• Period pain that gets in the way of daily life
• Pain during or after sex
• Uncomfortable bowel movements and painful urination
• Fatigue
• Heavy periods or bleeding between periods
• Bloating and nausea

Diagnosis of endometriosis

Based on your symptoms, LEVY makes a suspected diagnosis for endometriosis. We recommend you visit an OB-GYN for a physical exam to confirm if you have this condition. Endometriosis can be diagnosed through the following methods:

• Pelvic exam: Your doctor inserts their fingers into your vagina and places the other hand on top of your tummy to check for cysts, scarring, or enlarged ovaries.
• Laparoscopy: A surgeon makes a tiny cut on your belly and inserts a small instrument that lets them see inside your abdomen. Any abnormal tissue found during the exam can also be removed with this method.
• Imaging techniques: Your doctor may do an ultrasound, magnetic resonance imaging (MRI), or a computerized tomography (CT) scan to look at your pelvic area.

When diagnosed, endometriosis gets classified into four stages (I-IV), ranging from minimal to severe.

Treatment to improve fertility

Although there’s, unfortunately, no definitive cure for endometriosis just yet, treatments exist that can ease symptoms and improve fertility. Your age, how long you’ve been trying to conceive, and level of pelvic pain are all important factors to consider when deciding on the right path for treatment.
Surgical operations, including surgical ablation and laparoscopy, can destroy or remove endometrial tissue, scarring, and ovarian cysts to reduce pelvic pain and improve the chances of conceiving. Studies have found that surgery helps almost 40% of infertile women with endometriosis get pregnant within 2 years. Assisted reproduction treatments like intrauterine insemination (IUI) and in vitro fertilization (IVF) may also be recommended to help you conceive.
It’s possible for the endometrial tissue to grow back after surgery and pain to return, so many women need other treatments over the long-term. For instance, birth control pills can lessen period cramping and pain from endometriosis.
Lifestyle changes like adopting an endometriosis-friendly diet, exercising more, and practicing meditation can also help to manage symptoms and improve quality of life. Add more foods rich in antioxidants, fiber, iron, and healthy fats to your plate as they may help reduce inflammation and pain from this condition.
The good news is that lots of women with endometriosis are able to have a baby, either naturally or with medical assistance.

This article has been verified by a medical professional

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