Endometriosis is one of the fairly common diseases in women. It occurs in every ninth woman of childbearing age. There are about 190 million of these women in the world. And unfortunately, it is closely related to the possibility of getting pregnant. But, let's talk about everything in order.
What is endometriosis?
Endometriosis is a disease in which cells of the endometrium (the lining of the uterus) grow outside the uterus. It occurs in the ovaries, Fallopian tubes and other pelvic organs.
The endometrium, which has formed outside of its normal location, functions in the same way during the menstrual cycle. This irritates the structures of the abdominal cavity, and as a result, scars and adhesions are formed – areas of dense tissue that fuse the structures of the pelvis together. When the ovaries suffer, endometriomas appear.
Factors that increase the risk of developing endometriosis include:
- abortions;
- performing a caesarean section during childbirth;
- late birth;
- diathermocoagulation of the cervix, which is used to treat erosion.
But the exact reasons for the development of this disease are still unknown.
What is the danger of endometriosis if it is not treated?
Firstly, of course, this is a decrease in the quality of life. With a common form of endometriosis, 80% of patients experience chronic pelvic pain syndrome. The pain may intensify during sexual intercourse or during hypothermia. When the endometrium grows, heavy and painful menstruation with clots is observed. Blood loss during such menstruation is greater than usual. And because of such constant heavy periods, women experience anemia and a decrease in hemoglobin levels. And the worst outcomes are infertility and cancer.
Is it possible to get pregnant with endometriosis?
In approximately half of cases, endometriosis is combined with infertility. An overgrown endometrium can lead to disruption of the release of the egg and negatively affect the functioning of the ovaries, and it can also make it impossible for the fertilized egg to implant into the uterine mucosa.
Hormonal disturbances in this disease are manifested in a large amount of female sex hormones estrogens, which are produced during endometriosis. With long-term endometriosis, adhesions appear in the genitals, which further increases the risk of infertility. But it is still quite possible to become pregnant with endometriosis. To begin with, you should conduct an analysis using a fertility monitor – which represents your genuine hormone levels. Easily analyze your results, keep track of your reproductive journey, and make educated decisions.
Now let's get back to planning a pregnancy with endometriosis.
Treatment of endometriosis
Because some treatments for endometriosis are incompatible with fertility, its treatment may look different depending on whether the patient's primary goal is symptom relief or having a baby.
The most common treatments for endometriosis are hormone therapy and surgical removal, while the most common treatments for endometriosis-related infertility are ovulation induction and in vitro fertilization (IVF).
Hormonal treatment
The most common hormone used to treat endometriosis is progesterone in the form of birth control pills. The menstrual cycle activates the thickening and shedding of the endometrium, and in people with endometriosis also activates the growth of endometrial deposits outside the uterus.
By regulating the menstrual cycle with progesterone, you can suppress this menstrual activity and therefore reduce the growth and symptoms of endometriosis. Although this treatment is not compatible with pregnancy, it is not associated with long-term harm to fertility, so it can be continued until you are ready to become pregnant.
Laparoscopic surgery
Laparoscopic surgery is used to remove endometrial tissue and scar tissue. This may provide long-term symptom relief, but it is important to note that surgery can create scar tissue that can harm fertility. As a result, surgery is usually reserved for cases where other treatments have failed.
Because pregnancy itself can suppress endometriosis, women with endometriosis who want to have children are often advised to try to become pregnant first. During pregnancy, menstruation stops, so deposits in the endometrium are not cyclical and may even be at rest. In addition, increased progesterone levels during pregnancy may suppress endometrial growth. This often relieves pain and reduces the need for other treatments.
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As you can see, endometriosis is a severe condition with dangerous effects. The condition can affect not only the internal genital organs (uterus, ovaries, and vagina), but also the intestines, bladder, and other organs. Endometriosis can be prevented by avoiding the following aggravating factors: acute or chronic inflammatory processes in the uterus, uterine traumas, and medical abortions. If you see the first signs of this condition, do not postpone diagnosis and treatment.