Painful cramps, heavy periods, and even painful intercourse are experienced by many women. All of these may be symptoms of endometriosis, a condition where the tissue that normally lines the uterus (womb) grows outside it, on your uterus, ovaries, fallopian tubes and even on other organs like your bladder and intestines. These growths can irritate the organs, causing pain and scar tissue called adhesions.
How do you know if you have endometriosis? If you are diagnosed with it, will you be able to have a baby?
The most common symptom of endometriosis is pain in the lower abdomen or pelvis, or the lower back, mainly during menstrual periods, according to the Office on Women’s Health of the U.S. Department of Health and Human Services. The amount of pain doesn’t depend on how much tissue has grown outside the uterus. Some women have a lot of pain with only a little growth, while others have no pain even though their disease affects large areas. Other symptoms are painful cramps, unusually heavy periods and pain during sexual intercourse.
Endometriosis is very common. An estimated three to five million women suffer from it. Some women have it and don’t have pain or other symptoms. The first symptom for them may be infertility. In fact, 30 to 50 percent of women with fertility problems have endometriosis, according to the American Society for Reproductive Medicine (ASRM.)
The only way to tell if you have endometriosis is to see a doctor. If you’ve been having trouble getting pregnant, you may want to consult a fertility specialist. Your medical history and physical exam will give the fertility doctor some clues, and he or she may perform an ultrasound and order blood tests to determine your hormone levels. The definitive test for endometriosis is a surgical procedure called laparoscopy, during which the abdominal cavity, ovaries and other organs can be seen. If you have pain in your abdomen or pelvis with heavy periods your doctor may recommend this.
Fertility Treatment for Endometriosis
Birth control pills and other drugs that block estrogen can be effective in relieving the pain. However, taking birth control pills and then discontinuing them to try to get pregnant usually does not improve pregnancy rates, according to the ASRM.
If you have a laparoscopy and your doctor sees endometriosis, she or he will assess its extent and if necessary will surgically destroy or remove the extra tissue and the scar tissue. This will allow your reproductive organs to function more normally. Your chances of becoming pregnant may be improved after the surgery. Some women with mild endometriosis are more likely to become pregnant after surgery. Experts say your best chance of conceiving is within a year after laparascopy. After that the endometriosis is likely to return. If you have severe endometriosis with a lot of scarring, blocked fallopian tubes and damaged ovaries, you may need additional fertility treatment to get pregnant.
As the ASRM observes, “Treatment of endometriosis in the setting of infertility raises a number of complex clinical questions that do not have simple answers.” It’s best to be treated by a reproductive endocrinologist (fertility doctor) as this specialist will do his or her best to enable you to get pregnant, focusing on that goal whether your condition is milder or more serious.
Although it may be possible to get pregnant after laparoscopic surgery, pregnancy rates are higher with in vitro fertilization (IVF.) If your ovaries are damaged, IVF with donor eggs may be a course you want to consider. Especially if you are over 30, your best course is to consult a fertility specialist so you lose as little time as possible in determining the right treatment for you.