Endometriosis and Infertility–What Is The Link?
For a condition that afflicts something like 5 million American women, Endometriosis is not very well understood by the medical community. There is pretty solid agreement that a strong link exists between moderate to severe cases of endometriosis and infertility. Many women have mild cases and suffer no ill effects and have no trouble getting pregnant.
What is this strange disease? First recall that the endometrium is the lining of the uterus that thickens during ovulation to prepare for the egg. For reasons that are not entirely known, sometimes this specialized tissue grows outside the uterus and attaches to other organs; this clearly is not desirable. Mild cases are probably never diagnosed and cause no problems. Some are of the opinion that up to 70% of those with mild cases will be able to conceive within three years with no treatment; however three years of trying is a long time.
More substantial levels of influence (the medical community has a rating system for the severity of the situation) can cause significant pain, damage and infertility. One study reported a connection between endometriosis and infertility in 5-15% of cases, but another source placed this as the cause in 25% to 35% of infertile women.
The renegade tissue, growing outside the uterus, behaves like regular endometrium tissue, thickening and falling away during the cycle. The fact that other parts of the abdomen are not equipped to deal with this, so that can cause other related problems with possible infection, etc. As irritated portions heal and scar, the disease can actually bind organs together. It can cause scarring in the fallopian tubes, which can reduce the mobility of the egg.
This can be a slowly progressive disease, gradually expanding within the abdominal cavity. It can attach to ovaries and affect their ability to create and release healthy eggs. Endometriosis located around the uterus can cause painful spasms and particularly difficult periods.
It seems that estrogen is involved in allowing or causing the tissue to grow where it is not welcome, so treatments sometimes center on controlling estrogen. Too much estrogen can cause other complications that result in infertility as well.
It would be convenient if there were symptoms that made it easier to link endometriosis and infertility, but such is not really the case. Some of the symptoms for this disease can also be related to other conditions, so if is sometimes mis-diagnosed. However, some clues are (unusually) painful menstrual periods, abnormal bleeding and pain during sexual relations. Chronic pain in the pelvic region, backache and leg pain, nausea, high blood pressure, diarrhea and other seemingly unrelated symptoms can actually be pointing to endometriosis. Sometimes it is diagnosed as appendicitis, ovarian cysts and pelvic inflammatory disease (PID, another cause of infertility).
Treatments can vary widely, from hormone treatment to specialized drugs to surgery to remove the tissue. A visit to a specialist can help avoid the possibility of years of an incorrect diagnosis and improper treatment. The treatment may differ for women who want to become pregnant compared to those who no longer plan to have children. It is important to deal with the effects of endometriosis and infertility, but this condition should be treated even if pregnancy is not the issue.
The disease can reoccur even after treatment. And it is important to obtain a proper diagnosis in the first place. The actual course of action will be decided by the specialist depending on several factors, including personal history and health and the stage of severity.
