What is it?
Endometriosis is a relatively common condition affecting 10-15% of women worldwide. The most well-known problems it causes are intense pain, especially during menstruation, as well as irregular menstrual cycles. Additionally, it can cause fertility issues because it may create damage to the fallopian tubes, endometriomas (also known as endometriotic cysts) on the ovaries, and inflammation in the uterus, all of which complicate conception.
The endometrium is the tissue that lines the inside of the uterus. It consists of two parts, one of which is shed during menstruation. Furthermore, during pregnancy, the endometrium develops to form the placenta, which supplies the fetus with oxygen and nutrients.
Endometriosis, therefore, is a condition where tissue similar to the endometrium grows outside the uterus, causing the symptoms mentioned above.
Where can this endometrium-like tissue develop?
In the ovaries, fallopian tubes, and the tissue surrounding the uterus and ovaries. Less commonly, it can appear in other parts of the body.
Symptoms of Endometriosis
Symptoms vary from person to person, but some are more common.
The most frequently reported symptom is severe menstrual pain, much worse than typical period cramps. Some women may experience pain during or after sexual intercourse.
Other symptoms may include chronic pelvic pain and pain during urination, especially during menstruation. Heavy or irregular bleeding during the cycle is also possible. Less frequently, it may cause fatigue, diarrhea, or constipation.
In mild cases, symptoms can be mild or even absent.
One of the most significant problems endometriosis can cause is fertility issues, as endometriomas may be found on the fallopian tubes or ovaries, affecting reproductive function.
Why does endometriosis occur?
The two most common theories for the cause of endometriosis are retrograde menstruation and genetic predisposition.
In retrograde menstruation, menstrual blood flows backward through the fallopian tubes and deposits in the tubes and ovaries. As a result, endometrial cells grow in abnormal locations.
In genetic predisposition, endometriosis is more frequent in women with a family history, suggesting that genes play an important role.
How is endometriosis detected?
- Transvaginal ultrasound: Can detect endometriomas on the ovaries, but small endometriosis lesions may go undiagnosed.
- Magnetic Resonance Imaging (MRI): Used for detailed imaging of internal tissues and can detect endometriomas more accurately than ultrasound.
- Laparoscopy: The most accurate diagnostic method, where a doctor inserts a small camera through a small incision in the abdomen to directly view endometriosis lesions and, if necessary, surgically remove them. This is the gold standard for diagnosis and immediate surgical treatment.
- Blood markers (CA-125): This test is indicative and can aid diagnosis when combined with the above methods.
Endometriosis and fertility
- Damage to fallopian tubes: Endometriotic lesions and adhesions (scar tissue) can block the tubes, preventing the natural transfer of the egg to the uterus and making conception difficult.
- Impaired ovarian function: Endometriosis can cause cyst formation on the ovaries (endometriotic lesions or endometriomas), reducing the quality and quantity of eggs produced.
- Inflammation: Pelvic inflammation caused by endometriosis can affect egg quality and the environment where fertilization occurs.
- Implantation: Endometriosis can create a less favorable environment for the implantation of the fertilized egg in the uterus, reducing the chances of a successful pregnancy.
If you have endometriosis, it is important not to delay discussing your condition with a specialized reproductive gynecologist so you can evaluate your options together and make informed decisions.
How is endometriosis treated?
The main treatment options are surgery and assisted reproduction when it comes to fertility. Painkillers and hormonal therapies help reduce pain and lesion growth but do not cure the condition. Laparoscopy is the surgical removal of endometriomas, and in more severe cases, hysterectomy may be necessary. Treatment is individualized based on symptoms and potential problems.
Additionally, adopting a healthier lifestyle is recommended. A healthy diet and exercise can positively influence symptoms.
You are not alone
The medical team at Southeastern Fertility Solutions has managed many cases of IVF and assisted reproduction in women with endometriosis and has the experience to provide the highest quality treatment.
Our commitment is to offer ongoing support at every step of your treatment and personalized care, especially if you wish to try for a child.
Dr. Ioannis Zervomanolakis, head reproductive gynecologist, has 25 years of experience across a wide range of infertility cases. Learn more about our doctor.
Book a 10-minute phone call with Dr. Zervomanolakis to ask any questions you may have!
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