Endometriosis awareness is highlighted through the month of March, which is Endometriosis Awareness Month. Endometriosis specialist, Dr Raewyn Teirney shares with us the ins and outs of this common condition and discusses ways those affected may be able to have a baby.
Endometriosis – What Is It?
It is a very common condition that affects about one in 10 women. Endometriosis occurs when cells that are similar to the ones that line the uterus, called Endometrium Tissue, grow in other organs, including ovaries, fallopian tubes, bowel or bladder. This tissue can also be present in other areas of the pelvis.
As with Endometrium tissue in the uterus, the tissue that is in the other organs also breaks down when female hormones set off monthly menstrual bleeding. However, as the tissue is not in the womb, it becomes trapped and it cannot leave the body in the sae way normal tissue does via the womb. This in turn causes inflammation and rather a lot of pain for those who are affected. Over time, the tissue simply builds up, so with each menstrual cycle, the condition becomes increasingly painful. This also becomes exhausting – both physically and emotionally, for women who have endometriosis.
The good news? Endometriosis is treatable. However, if not diagnosed and treated, it can cause fertility struggles in those affected.
Endmetriosis – The Symptoms
Endometriosis can be quite a painful condition. Having said that, some women have it without experiencing any symptoms. So how do they know? One sign is that you may be trying to have a baby, but you are simply not having any luck. If this sounds like you, I would suggest asking your GP to refer you to a fertility specialist to have tests that can either confirm the condition, or rule it out.
For many women though, they will experience the gamut of symptoms, with pain being the first sign something is wrong. Many women with endometriosis will experience painful cramping around two weeks before their monthly period. Once their period arrives, they are likely to feel strong, stabbing pain in the pelvic region. This pain is often quite prolonged and accompanied by an extremely heavy period with a lot of dark blood in the first few days.
Other symptoms include nausea, fatigue and weakness, pain during intercourse, lower back pain throughout your period, as well as uncomfortable bowel movements or urination. Some women will only experience mild forms of these symptoms while others will have very intense, strong pain.
Endometriosis is what we call a progressive conditions, which means that its symptoms typically become increasingly strong over time. The symptoms are usually quite mild to moderate in the beginning stages of the disease, with lots of women reporting only mild pain for up to two days before menstruating. As the condition progresses, symptoms tend to become quite severe and last a lot longer. Many women even report that the symptoms are present even before or after their period.
What Causes Endometriosis?
The causes of this are still only theories, and there are several of them. one theory is a condition known as condition called ‘Retrograde Menstruation’. In Retrograde Menstruation, blood that is meant to flow out through the cervix of the womb and vagina, actually flows backup the fallopian tubes and into the pelvic region.
Another theory is that endometriosis might be caused by a condition called ‘coelomic metaplasia’. This is where the cells that line the pelvic organs begin to change structure and behave in a similar way to endometrial cells in the womb. We believe that this is caused by puberty or oestrogen surges.
We also think it could be linked to immunity deficiencies, however we also see a lot of women whose mother or aunt may have had the condition. Typically, a family link means that you could be seven times more likely to have endometriosis too. If you know that someone in your family has endometriosis, consider having a check up as early as possible, as it could save you a lot of pain and stress later on.
So, What Can We Do About it?
The great news here is that Endometriosis is very treatable. We can treat you with medication and in some cases laparoscopic surgery, which has a really great success rate.
In terms of medication, we use those that relieve pain alongside hormone-based treatments that reduce oestrogen. The medications only work while you are taking them though, so if you cease taking them, the endometriosis may recur.
The best method we have to both diagnose and treat endometriosis is laparoscopic surgery. It’s a minimally invasive procedure that involves viewing the abdominal cavity via a small incision in the navel. It helps us confirm endometriosis, as well as treat the condition at the same time. Usually, this is the only treatment required to relieve the condition as well as improve your chances of conceiving naturally. It can also improve the success rates IVF treatment, should you them.
Can I Have A Baby If I Have Endometriosis?
In most cases, yes. It is thought that endometriosis is a barrier to falling pregnant, simply because endometrial cells release chemicals that hinder either your ability to conceive or that they affect early stage embryo development. Endometriosis can also interrupt ovulation, as it is known to distort the fallopian tubes and ovaries. In cases where scar tissue or cysts have developed, they may also block the the release of the egg release, or the transportation of sperm.
Remember though – we can treat endometriosis. Even though it is a common cause of infertility, in most cases we can correct the condition and help you have a happy, healthy baby!