For some women, painful periods are a part of life. But many women experiencing painful periods do not know their pain is signaling a larger health issue. Approximately 176 million women and girls worldwide are diagnosed with the chronic disease endometriosis. Many women do not know they have endometriosis because in most cases they can only be diagnosed through surgery.
The cause of endometriosis remains unknown, and a permanent cure may be difficult. Building awareness of this disease is critical in aiding effective diagnoses, pain management and infertility treatment for women.
What is endometriosis?
Every month during menstruation, a woman sheds the endometrial lining in her uterus. When the endometrium tissue normally found in the uterus grows outside the uterus or in other places of the body, it is known as endometriosis.
Each month, endometrial tissue continues to break down and shed as it would during a normal menstrual cycle. Endometrial tissue in other parts of the body follows the same pattern, causing period-like symptoms such as cramps and discomfort. Without the ability to drain through the uterus as it would during menstruation, the endometrial tissue is released into the body, causing pain, inflammation, and scar tissue.
Endometrial growths have been found on the ovaries, fallopian tubes, bladder, on the outside of the uterus, lining the pelvic cavity and between the vagina and rectum. In rare cases, growths have been found in other parts of the body.
Endometriosis affects the body in many different ways. For some, fertility, bowel function, gynecological health and quality of life are disrupted.
What are symptoms of endometriosis?
Symptoms of endometriosis vary greatly from patient to patient, with some exhibiting no symptoms, and others experiencing the full gamut. For those without symptoms, the endometrial tissue grows in areas without nerve endings that activate pain signals.
Common symptoms of endometriosis include painful menstruation, pain during sexual activity, and painful urination or bowel movements during menstruation. Endometriosis may also cause fatigue, nausea, constipation, diarrhea, recurrent yeast infections, chemical sensitivities, and allergies.
For many women, infertility is also a common symptom. Scarring and adhesions from endometriosis can restrict movement of the ovaries, change the position of the fallopian tubes and ovaries, as well as block the fallopian tubes. Endometriosis can also increase production of prostaglandins, the hormones that affect fertility.
Roughly 35 to 50% of women diagnosed with endometriosis also have infertility, with endometriosis being one of the top three causes of infertility.
How is endometriosis treated?
Endometrial tissue only forms in women with active ovarian hormone production, restricting diagnoses to women of reproductive age. By regulating hormone production with medication or birth control, symptoms can be greatly reduced, minimalizing scarring and adhesions.
To improve fertility, doctors can surgically remove adhesions and scar tissue in the female reproductive system. Surgical options are not always necessary to achieve pregnancy, however. Stimulation of the ovaries with fertility medications and In Vitro Fertilization (IVF) and will often overcome the impact of endometriosis on fertility. IVF allows doctors to bypass any damaged tissue due to endometriosis. Using medications such as gonadotropin-releasing hormone agonist (GnRH–A) can help improve pregnancy rates as well.
Not all individuals with endometriosis are infertile. Approximately 60 to 70% of women with endometriosis conceive. While this is a painful disease, it is also a very common and treatable disease.
Women with endometriosis should take comfort in knowing that modern medicine allows for treatment of endometriosis symptoms and the infertility that may result. At Fertility Centers of Illinois, we have helped hundreds of women overcome endometriosis and have the family of their dreams. We invite you to contact us to see how we can help you.
Angeline Beltsos, M.D.