Endometriosis

When you’re trying to become pregnant, you are hyper-aware of all that goes on during your menstrual cycle. You may have noticed that you have more painful cramps than other women or that you suffer from additional gastrointestinal issues during your monthly cycle. If this is the case, you may have endometriosis. 

Endometriosis is a common disorder that affects more than 11% of American women, and it is the diagnosis in 70%-90% of patients with pelvic pain.

What is Endometriosis?

Endometriosis is a gynecologic disease where tissue similar to that which lines the uterus grows in other areas of the body, most commonly on other pelvic organs. These areas of abnormal tissue growth are called endometrial implants. 

Various forms of endometriosis can be found in patients, including clear vesicles, red flame lesions, dark pigmented lesions and white scarring. Each form may result in different types of pain.

Signs & Symptoms of Endometriosis

Although many women with endometriosis have no symptoms at all, you may experience one or more of the following:

  • Pelvic pain
  • Painful intercourse
  • Painful pelvic exams
  • Cramping during bowel movements or urination
  • Spotting between menstrual cycles
  • Especially painful menstrual cramps
  • Digestive issues, especially during menstrual cycles (diarrhea, nausea, bloating, constipation) 

Some of the above symptoms can also be attributed to gastrointestinal, urinary, musculoskeletal, and psychological conditions, so it is important to rule out any other causes before pursing endometriosis treatment.

Endometriosis Causes

While the truth is unknown, there are several working theories about endometriosis causes.

  • Retrograde menstrual flow – tissue shed during the menstrual cycle flows back through the fallopian tube into other areas of the body, implanting endometrial cells there
  • Genetic factors – endometriosis seems to be hereditary, so it may be a gene problem
  • Endocrine issues – extra estrogen promotes endometriosis, so perhaps your hormones are out of whack
  • Immune system problems – your immune system may not appropriately find and destroy endometrial tissue growing in the wrong place
  • Surgery – abdominal surgery, such as a Cesarean (C-section), could cause endometrial tissue to be moved by mistake

The 4 Endometriosis Stages

Endometriosis is a progressive disease that can worsen over time, though that is not the case for every patient. For some of those who suffer from endometriosis, the disease may remain static at one particular stage.

There are four endometriosis stages: I-minimal, II-mild, III-moderate, and IV-severe. The stage of your disease is diagnosed by evaluating the location, depth, and extent of endometriosis implants along with the presence and severity of scarring. Your diagnosed stage may not correlate with the severity of your symptoms, though infertility is especially common in the more advanced stages.

How does endometriosis affect fertility?

While the reason endometriosis often results in infertility is unclear, it is estimated that 25%-50% of infertile women have endometriosis and that 30%-50% of women with endometriosis are infertile.

Women with endometriosis may have trouble conceiving due to scarring or cysts associated with the disease, inflammation and hormone imbalances. However, it is estimated that 70% of women with mild-to-moderate endometriosis are able to conceive on their own within three years. 

How do you get rid of endometriosis?

Unfortunately, endometriosis is considered a chronic disease that never goes away. However, there are treatments available to lesson the symptoms and help you get pregnant.

Medication is available to relieve pain associated with endometriosis, but it does not improve fertility. In fact, it prevents pregnancy since endometriosis medications inhibit ovulation.

If pregnancy is the goal, your Inovi fertility specialist will consider your stage of endometriosis along with your age, duration of infertility, family history and other fertility factors before developing a treatment plan. 

In some cases of mild endometriosis laparoscopy may be recommended, though it often does not improve fertility odds. Typically, intrauterine insemination (IUI) and in vitro fertilization (IVF) are the best options to help you achieve pregnancy.

Endometriosis & Pregnancy Risks

While many women with endometriosis experience healthy pregnancies, studies have shown that they have an increased risk of preterm delivery, pre-eclampsia, antepartum bleeding, placental complications and Cesarean (C-section).

Think you might have endometriosis?

If you’ve been trying to get pregnant and suspect you have endometriosis, give Dr. Stephan Krotz a call at 713-401-9000 to schedule a consultation. He will give you a thorough examination to look for evidence of endometriosis and explain your options for pregnancy.

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