If you're newly diagnosed, here's what you need to know about endometriosis and fertility.
Endometriosis is a gynecologic condition that causes the lining of the uterus (called the endometrium) to grow in places outside of the uterus, generally in the pelvic cavity, and occasionally on the ovaries as well. In addition to being very painful, endometriosis has been shown to decrease fertility in couples that are trying to conceive.
But how, exactly, does endometriosis harm fertility? Endometriosis causes scar tissue to form on pelvic organs, like the fallopian tubes, the uterus and the ovaries. Often, this scar tissue prevents the egg from being able to travel through the fallopian tubes. While surgery can be performed to remove the scar tissue, there is a good chance that it may return, as removing the scar tissue will not cure endometriosis.
Now that you have a basic understanding about endometriosis, here are four facts you may find surprising about this condition:
There are some patients with endometriosis who will have no visible signs of disease – meaning that during a surgery, doctors won’t be able to see any visible endometriosis. Yet these patients can have “invisible” bits of endometriosis on the lining of their pelvis (and possibly their uteri). Even though the endometriosis might be “invisible,” it can still cause significant pain during the menstrual cycle, just like normally diagnosed endometriosis.
So what if your period is painful – isn’t that normal? While a bit of cramping can accompany a healthy cycle, endometriosis can cause a significant amount of pelvic pain during the menstrual flow, as well as during intercourse.
Many people are unaware of the fact that endometriosis can cause small nodules to form on the ligaments that hold up the uterus, and during intercourse the extension of these ligaments may cause significant pain. During your annual gynecologic evaluation, a bimanual examination by the gynecologist can sometimes allow the doctor to palpate these abnormal nodules.
Some studies have shown that doing artificial insemination at the right time of the month may improve odds of conception compared to intercourse. The reasons for this aren't fully understood, but it may be because getting sperm directly into the uterine cavity can bypass poor cervical mucus and other factors, including poor sperm quality.
Outside of doing artificial insemination at the right time of the month, the use of certain lubricants such as Astroglide TTC (Trying to Conceive) can also allow for more pleasurable and comfortable intercourse, without impeding sperm motility.
The treatment for endometriosis may involve surgery, during which all of the scar tissue in the abdominal cavity is removed. Alternatively, some women may be a candidate for Lupron, which is an injection that puts the woman into a temporary menopausal state. This temporary menopausal state reduces the amount of estrogen in the body – as endometriosis is fueled by estrogen, this can suppress the disease.
While Lupron does help patients feel better, you cannot conceive while it is in use. The good news, however, is that after the use of Lupron, many individuals have a higher chance of pregnancy due to the fact that much of the endometriosis can be dormant or eliminated for at least a temporary amount of time.
Endometriosis can be a Pandora’s Box for a woman trying to conceive. If you are diagnosed with endometriosis and are trying to conceive, an evaluation by a fertility specialist is highly recommended. If any woman experiences significant pain with her period and/or discomfort during intercourse, they should see their doctor, as endometriosis could be a possibility.
Do you have endometriosis? Which of these facts surprised you? Let us know by tweeting us @AstroglideTTC!
Images are for illustrative purposes only.