Many things affect your fertility, one of which is endometriosis. It’s a medical condition in which the endometrial tissues or the tissues found in the inner lining of the uterus grow outside the uterus. These tissues can grow in the pelvic region, chest, abdomen, and other parts.
Endometriosis is more common than one might think. Around 190 million women of childbearing age are diagnosed with endometriosis worldwide. It’s more common in women in their 30s and 40s, although any woman who menstruates can develop it. Early diagnosis is crucial, as endometriosis can affect your quality of life and the ability to conceive. Besides, the condition can cause painful menstruation, excessive bleeding, and periods that last longer than normal.
Endometriosis Symptoms
Endometriosis is linked to symptoms like pain, bleeding, and infertility. But, not every woman with endometriosis reports these symptoms. Some might not know they have this condition until it’s diagnosed in a fertility test or during other pelvic screenings. Here are a few common signs and symptoms of endometriosis.
Painful Periods
Pain in the pelvic area during menstruation is the most common symptom of endometriosis. However, pain during periods is quite common among women. If you are diagnosed with endometriosis, the pain might be worse than what a typical woman experiences during her menstrual cycle.
Painful Intercourse
Endometrial tissue growing outside your uterus can get inflamed and irritated, causing painful intercourse.
Infertility
Around 30% to 50% of women with endometriosis experience difficulty getting pregnant. Endometrial tissue growth within the fallopian tubes can block them, preventing egg fertilization. Sometimes, inflammation caused by endometriosis in your uterus and other reproductive organs can create an unfavorable environment for the embryo to develop normally.
Excessive Bleeding
Endometrial tissues bleed during your menstrual cycle. If these tissues form outside your uterus, they might act the same way as normal endometrial tissues. They thicken and bleed during your periods, causing excessive bleeding. Some women with endometriosis experience bleeding between their menstrual cycles.
Other Symptoms
Women with endometriosis report diarrhea, constipation, painful bowel movements, back pain, fatigue, nausea, and bloating.
Psychological Symptoms
Apart from these physical symptoms, endometriosis patients are likely to experience psychological issues like depression and anxiety. Mood disorders occur because of painful periods, heavy bleeding, and infertility. It also impacts your social life, as you may have to cancel your plans or get-togethers because of the painful symptoms. This can add to frustration and mood swings.
Hormonal imbalance is the biggest culprit here. Research shows that endometriosis can increase your estrogen levels, which is linked to mood disorders. That said, not every woman diagnosed with endometriosis suffers from mental health disorders. It mostly depends on your symptoms and how it affects your lifestyle.
Endometriosis Causes
Scientists do not know the exact cause of endometriosis, although they have linked the condition to these factors:
- Retrograde Menstruation: One possible cause is retrograde menstruation, in which the menstrual blood (that’s supposed to leave your body through the vagina) travels back to your pelvic cavity through the fallopian tubes. This blood contains endometrial cells, which tend to attach to different pelvic organs. These cells then bleed during your menstrual cycles.
- Immune System Disorders: Ideally, your immune system should destroy these cells. However, a weak or diseased immune system might not identify endometrial tissue growth in the wrong places.
- Hormonal Imbalance: A spike in estrogen production in your body can increase your risk of developing endometriosis. Endometrial tissues depend on estrogen, so if they grow outside your uterus, they will more likely thrive if your estrogen levels are high.
- Surgical Scar Implantation: Although rare, surgical scar implantation can cause endometriosis. It happens in women who have had uterine surgery, like a C-section or hysterectomy. The endometrial cells might attach themselves to the surgical scars during the surgery and form lesions.
Diagnosis and Staging
Identifying endometriosis is the challenging part, as there’s no particular test that can confirm the condition. Your symptoms alone might not be enough, as endometriosis symptoms resemble the symptoms of pelvic inflammatory disease, adenomyosis, and other medical conditions. Here are the common diagnosis procedures that can confirm it:
Pelvic Exam: Your healthcare provider will check your pelvic organs to identify scars, lesions, cysts, and unusual growth in your pelvic area.
Ultrasounds: An ultrasound report provides a clear picture of your pelvic organs and can detect the presence of lesions and endometrial tissues in your pelvic cavity.
Laparoscopic Procedure: A laparoscopic procedure is the only way to determine whether you have endometriosis and its severity. It’s a minimally invasive surgical procedure in which the surgeon makes a small incision on your abdomen and inserts a camera to evaluate your internal organs. The doctor extracts a small tissue sample and sends it to the lab to confirm the diagnosis.
Stages of Endometriosis
The stage of endometriosis in each case depends on its severity, where it’s spread, and its effect on your life. Here are the four endometriosis stages you should know.
Stage 1: No scar tissue is found, and the growth of endometrial tissue is limited to the pelvic or abdominal lining.
Stage 2: There might be some scar tissue. The endometrial tissue in this stage grows deeper into your tissues and is found in larger numbers than in the first stage.
Stage 3: At this stage, the patient develops scar tissues and cysts in the ovaries. Endometrial tissues might also spread outside your pelvic cavity.
Stage 4: Scars, adhesions, cysts in the ovaries, and deep implants are the signs of stage four endometriosis.
Treatment Options for Endometriosis
Endometriosis doesn’t have a permanent cure, but with the proper treatment, managing the symptoms and living with the condition is possible. Your healthcare provider will discuss the treatment options based on your health, pregnancy goals, and the severity of the condition.
Pain Relief Medication
The most challenging symptom of endometriosis is painful periods. Extreme pain in the pelvic area and your back can be relieved with over-the-counter painkillers. NSAIDs, like ibuprofen, can provide you relief from the pain, but you can ask your doctor for stronger painkillers if these do not work.
Hormonal Therapy
Increased estrogen levels can escalate the growth of endometriosis. So, one way of managing the condition is hormonal therapy that blocks estrogen production and temporarily stops your periods. As a result, the endometrial tissues in your pelvic cavity and other parts bleed less.
Your doctor will put you on birth control medication, through injectables or oral pills, to manage your estrogen and progesterone levels. While they provide you relief from heavy bleeding, hormonal therapy doesn’t work for patients trying to conceive.
GnRH medication is another way to stop your menstrual cycle, providing relief from pain, excessive bleeding, and other symptoms associated with endometriosis. These medications work as long as you continue them. The symptoms will most likely return once you stop the medication.
Surgery
Surgical treatment for endometriosis includes cutting the endometrial tissues that might have blocked the fallopian tubes, have grown in an area that’s restricting the fetal growth, or other parts. Like any surgical procedure, surgery for endometriosis comes with risks, but it can relieve your symptoms and might help improve fertility in some cases.
Laparoscopic surgery makes small incisions on your abdomen to remove the lesions. These lesions can develop again, though. If you want permanent relief from endometriosis, a hysterectomy is your best bet. That’s, however, not an option for women planning a pregnancy or are currently pregnant.
Lifestyle Changes
Your diet plays a crucial role in managing the symptoms of endometriosis. While it doesn’t directly affect the pain and bleeding, foods like red meat are linked to higher estrogen production, which in turn can worsen endometriosis.
A diet rich in fruits, vegetables, and omega-3 fatty acids can help somewhat manage the symptoms. Alcohol and caffeinated beverages are your worst enemies if you are at a high risk of developing endometriosis or are already diagnosed with it.
Physical exercises like running and swimming release endorphins that help you manage pain. Moderate exercises improve your blood circulation and relieve stress. Yoga and meditation are also effective in keeping you calm and de-stressed.
Alternative Therapies
There’s limited research regarding the role of alternative therapies in curing endometriosis or relieving its symptoms. However, some patients have found relief from therapies like acupuncture, massage, and herbal supplements. It’s important to discuss these therapies with your healthcare provider before considering them.
Living with Endometriosis
Endometriosis can affect your mental or emotional well-being. Depending on the symptoms, you might face difficulty socializing or conducting your routine activities. Pain and bleeding associated with endometriosis are usually severe enough to stop you from carrying out your regular chores. This might affect your work, relationships, and overall mental well-being.
Reach out to a counselor if you are struggling with mental health issues due to endometriosis. You can also join support networks of other patients diagnosed with this condition. Talking to other patients about your symptoms and discussing the coping strategies that have worked for them can relieve your stress and help you get the proper mental support. Besides that, treatment options can help you deal with the physical symptoms.
Note that it’s possible to conceive with endometriosis. Discuss the best endometriosis treatment and your fertility options with your doctor.
Conclusion
There might not be a cure for endometriosis, but living with the condition and achieving your life goals, such as pregnancy, are possible with the right treatment. Pain-relieving medications and hormonal therapies can manage your symptoms. Moreover, surgical removal of the tissues can improve your chances of getting pregnant. Counseling and endometriosis support groups are available for patients struggling with emotional symptoms.
