What is Endometriosis & How Can it Impact Fertility?

June 2023 (4 min read)

Endometriosis is a condition in which tissue that normally lines the uterus (the endometrium) grows outside of the uterus. This tissue can then implant itself in other areas of the body, such as the ovaries, fallopian tubes, bladder, and bowel.

According to Endometriosis UK (source), an estimated 1.5 million women in the UK have endometriosis. This means that around 1 in 10 women of reproductive age in the UK have the condition.

Endometriosis can impact fertility in a number of ways.

  1. Endometriosis can cause inflammation and scarring in the pelvic area. This can damage the fallopian tubes, making it difficult for eggs to travel from the ovaries to the uterus.
  2. Endometriosis can also cause adhesions, which are bands of tissue that can block the fallopian tubes or attach the ovaries to other organs in the pelvis.
  3. Endometriosis can also disrupt ovulation, which is the process of releasing an egg from the ovary each month.

The severity of the impact of endometriosis on fertility will vary from woman to woman. Some women with endometriosis are able to get pregnant without any difficulty, while others may need fertility treatments. If you have endometriosis and are having trouble getting pregnant, it is important to see a doctor to discuss your treatment options.

The best way to diagnose and treat endometriosis will vary depending on the individual woman’s symptoms and medical history. However, there are a few general steps that are typically involved in the diagnosis and treatment of endometriosis.

Diagnosis

The diagnosis of endometriosis can be challenging, as there is no single test that can definitively confirm the condition. However, there are a number of tests that can be used to help diagnose endometriosis, including:

  • Pelvic exam: A pelvic exam can help your doctor to look for signs of endometriosis, such as painful nodules or cysts on the ovaries.
  • Blood tests: Blood tests can be used to check for certain substances that are produced by endometriosis, such as CA-125.
  • Ultrasound: An ultrasound can be used to look for signs of endometriosis, such as fluid-filled cysts on the ovaries.
  • Laparoscopy: A laparoscopy is a surgical procedure in which a small incision is made in the abdomen and a camera is inserted to look for signs of endometriosis. This is the most accurate way to diagnose endometriosis.

Treatment

There is no cure for endometriosis, but there are a number of treatments that can help.

Hormonal therapy: 

This type of treatment uses hormones to prevent ovulation and reduce the growth of endometrial tissue. Hormonal therapy can be used in a number of ways, including:

Oral contraceptives:

These pills contain a combination of oestrogen and progestin hormones. They can be used to prevent ovulation and reduce menstrual flow.

Progestin-only therapy:

This type of therapy uses progestin hormones to prevent ovulation and reduce the growth of endometrial tissue. Progestin-only therapy can be used in a number of ways, including:

  • Injectable progestin: This medication is injected into the muscle once a month.
  • Implantable progestin: This small rod is inserted under the skin of the arm and releases progestin hormones over a period of three years.
  • Intrauterine device (IUD) with levonorgestrel: This IUD releases progestin hormones directly into the uterus.

Gonadotropin-releasing hormone (GnRH) agonists:

These medications stop the production of oestrogen and progesterone hormones, which can lead to a temporary menopause. GnRH agonists are usually used for short-term treatment of endometriosis.

Pain relievers:

Over-the-counter and prescription pain relievers can be used to manage pain caused by endometriosis. Some common pain relievers include:

  • Acetaminophen (Tylenol): This medication can be used to relieve mild to moderate pain.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs): These medications can be used to relieve pain and inflammation. Some common NSAIDs include ibuprofen and naproxen.
  • Opioid pain relievers: These medications are more powerful than over-the-counter painkillers. They should only be used for severe pain that is not relieved by other medications.

There are a number of other treatments that may be helpful for endometriosis, including:

Acupuncture:

This ancient Chinese medicine technique involves inserting thin needles into the skin at specific points. Acupuncture may help to reduce pain and improve other symptoms of endometriosis.

Yoga:

Yoga is a mind-body practice that combines physical poses, controlled breathing, and meditation. Yoga may help to reduce pain and improve other symptoms of endometriosis.

Diet and nutrition: Eating a healthy diet and getting regular exercise may help to reduce pain and improve other symptoms of endometriosis.

Surgery: Surgery may be an option for women with endometriosis who do not respond to other treatments. There are a number of different surgical procedures that can be used to treat endometriosis, including:

  • Laparoscopy: This minimally invasive surgery is used to remove endometrial implants and scar tissue.
  • Hysterectomy: This surgery removes the uterus. It may be an option for women who have severe endometriosis and do not want to have children.
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