Living with Endometriosis

Many women in America are secretly living with fertility problems or painful symptoms of unknown causes. If you’re one of these women, you might be tempted to ignore the issue in hopes that it will get better on its own. What you may not realize is that your symptoms could signify a deeper problem. If treated properly, your symptoms may clear up and your fertility could improve or completely return. One prime example of such an underlying cause is endometriosis, a deeper condition often characterized by infertility.

In fact, according to the National Institutes of Health, endometriosis affects as many as 40 percent of infertile women. Because the condition may or may not show up with obvious symptoms, a patient may be suffering with endometriosis unknowingly. Often, the exact cause is difficult to pinpoint without deeper testing.

What Exactly Is Endometriosis Anyway?

Every woman has a membrane that lines her uterus, and this lining is what sheds during her period each month. For an unknown reason, this lining will sometimes grow in a location outside the uterus.  

Depending on the location of the growth, endometriosis may cause scarring or damage to the reproductive organs. In addition, you can imagine how painful the condition might be when symptoms do show up. Although researchers don’t know whether the condition actually causes infertility, the two problems do seem to have a correlation.

Common places for endometriosis growths are the ovaries, body of the uterus, Fallopian tubes or bowel. In rare cases, endometriosis has occurred in the brain, liver and even old surgical scars.

Once your doctor has determined that you have endometriosis, he will likely categorize it in one of four stages: I = minimal, II = mild, III = moderate and IV = severe. While your doctor may get an idea that you have the condition through a normal physical exam, he cannot confirm the problem without at least further imaging. Still, the most accurate ways to confirm are through biopsy or outpatient surgery.

Common Signs of Endometriosis

Even if you do have endometriosis, you may not always experience definite symptoms. However, if you’re suffering from infertility, you should check in with your doctor about any of the following signs.

  • Pelvic pain, especially before and during menstruation
  • Pain or cramping during intercourse or pelvic examinations
  • Infertility
  • Cramping during urination or bowel movements
  • Irregular bowl habits (diarrhea/constipation)
  • Lower back or stomach pain
  • Irregular periods
  • Chronic fatigue

Pain associated with endometriosis doesn’t always indicate its severity. Instead, painful symptoms are likely more related to the depth of the growth’s implant, scarring or implants in areas with many nerves.

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Getting Help

Pain and infertility don’t have to rule your life. In many cases, a woman suffering from endometriosis can increase her fertility and significantly reduce any pain upon treatment. For treatment, doctors may recommend one of many medication therapies or surgery to reduce the problem. He may prescribe:

  1. NSAIDS (non-steroidal anti-inflammatory drugs)

Often, the first route of treatment starts with NSAIDS to reduce pain associated with endometriosis. This medication does nothing to reduce the growths themselves. However, if the NSAIDS work well to control your pain, you may not need any other treatment.

2. Birth control pills

In many cases, the patient’s pain will increase around the time of menstruation. If the pain is severe enough, a doctor may prescribe birth control pills, which combine progesterone and estrogen.

The pills may stop menstrual flow altogether, resolving the pain as long as the patient keeps taking them. The side effects, however, may include nausea, irregular bleeding or weight gain.

3. Progestins

This medication is more potent than birth control pills and can often solve the issue of pain if contraceptives don’t work. Again, menstruation may stop completely even after several months without the medication. Side effects include bloating, stomach pain, depression and abnormal bleeding in the uterus.

4. Aromatase inhibitors

With this therapy, the medication works by inhibiting the ovaries from producing estrogen and cutting off estrogen within the growth implants themselves. Researchers are still undergoing testing for this therapy to determine its effectiveness for endometriosis. One major side effect of using aromatase inhibitors for a long period is bone loss, and thus experts must find the best course of action when using the therapy.

5. Surgery

If you are unable to manage the symptoms of endometriosis with the above therapies, your doctor may recommend surgery. You may also need surgery if the condition is obstructing your bowel in any way.

The first route of surgery is the less invasive laparoscopy, where the abnormal growths will be destroyed using a form of energy. You can usually undergo this procedure with minimal anesthesia and without a hospital stay.

The downside to laparoscopy for endometriosis is that you have a high chance of recurrence. In some severe cases, a doctor may recommend hysterectomy instead.  

Millions of women in America are living with endometriosis, and infertility may give the first sign for this condition. To make diagnosis more confusing, however, you may or may not experience any symptoms at all. If you do suspect that your infertility is related to an underlying cause, don’t be afraid to check into it. You could improve your pain or infertility and start feeling better with proper treatment.