Endometriosis and Fertility: How Treatment Options May Impact Reproductive Health

Did you know that endometriosis affects about one in 10 women and girls of reproductive age worldwide? It’s a chronic disease associated with severe, life-impacting pain during menstrual cycles that can have a major impact on your reproductive health– especially regarding fertility.

The more you know about endometriosis and the options that are available for treating the disease, the better you can protect your reproductive health.

How Endometriosis Affects Fertility

Endometriosis can start during your first menstrual period and last until menopause. Women diagnosed with the disease have tissue that is similar to the lining of the uterus, which grows outside the uterus. This leads to inflammation and the formation of scar tissue (adhesions or fibrosis) that can cause severe pain in the pelvic area and make it difficult to become pregnant.

There are several types of lesions associated with endometriosis. These include:

• Superficial endometriosis, which is found primarily on the pelvic peritoneum (located over the upper part of the urinary bladder and the front of the rectum)
• Cystic ovarian endometriosis found in the ovaries
• Deep endometriosis in the recto-vaginal septum, bladder, and bowel
• Endometriosis rarely found outside the pelvis

The cause of endometriosis is unclear, but it is believed to develop either as a result of retrograde menstruation, in which menstrual blood containing endometrial cells flows back through the fallopian tubes and into the pelvic cavity where it implants and grows outside the uterus; cellular metaplasia in which cells outside the uterus change into endometrial-like cells and start to grow; or stem cells that spread through the body via blood and lymphatic vessels.

Whatever the cause, there is no known way to prevent endometriosis, and there is no cure. Nevertheless, its symptoms can be managed with medication or, in some cases, with surgery. Signs and symptoms include:

• Chronic and severe pelvic pain, particularly during menstrual periods
• Heavy bleeding during or between periods
• Pain during sex or when urinating or moving your bowels
• Trouble becoming pregnant
• Abdominal bloating or nausea
• Fatigue
• Bloating or nausea
• Depression or anxiety

Since its symptoms are varied and broad, endometriosis may not be easily diagnosed. In fact, some people do not experience any symptoms of the disease, so they may not even be aware of the condition.

In terms of treatment, management of endometriosis will vary depending on the severity of symptoms and whether you wish to become pregnant. Medications that can help manage the condition and its symptoms include:

• Non-steroidal anti-inflammatory drugs (NSAIDs) and analgesics, like ibuprofen and naproxen, to treat pain
• Hormonal medicines, such as GnRH-analogues and birth-control methods (the pill, hormonal intrauterine devices (IUDs), vaginal rings, implants, injections, and patches), are also designed to help control pain

For those who have been diagnosed with endometriosis and are having difficulty getting pregnant, treatment options for infertility include laparoscopic surgery (which uses a small camera to see inside the body), which enables doctors to make smaller incisions to remove endometriosis lesions, adhesions, and scar tissues; ovarian stimulation with intrauterine insemination (IUI), and in vitro fertilization (IVF).

Endometriosis Treatment Near You in Wooster, Ohio

At Wooster Community Hospital Health System, our board-certified gynecologists specialize in diagnosing and treating diseases of the female reproductive system. Our comprehensive, full-service medical care includes treatment for endometriosis, as well as:

• Fibroids and polycystic ovary syndrome
• Menstrual irregularities
• Pelvic disorders such as pelvic organ prolapse
• Pelvic inflammatory disease (PID)
• STD (sexually transmitted disease) tests
• Urinary issues such as bladder infections and incontinence
• Vaginal infections

The highly skilled providers at Bloomington Women’s Care are a part of Wooster Community Hospital Health System, focusing on serving women’s health needs during all stages of life – including general gynecology care, minimally invasive surgery, and contraception services. For more information, call (330) 263-8144.