Endometriosis
What is endometriosis?
Endometriosis is a common condition that can cause pelvic pain and can sometimes affect fertility. Endometriosis happens when the same type of tissue that lines the uterus and is shed during menstrual cycles, is found elsewhere in the body. This tissue can be around the stomach, on the lungs, or other organs in the abdomen. Similar to menstrual cycles, the tissue builds up throughout the month and breaks down and is shed during periods. When the lining is shed from the uterus, it exits the body from the vagina. In endometriosis, the blood and tissue that are shed have no way of leaving the body and this causes pain, scarring, and inflammation and sometimes, difficulty getting pregnant.
Diagnosing endometriosis can be difficult since symptoms and location of endometriosis in the body can be different from person to person. Some of the symptoms of endometriosis are:
- Severe, painful menstrual cramps
- Painful intercourse
- Pain when urinating or during bowel movements
- Lower back, pelvic or abdominal pain
- Diarrhea, constipation, and nausea
If you are experiencing any of these symptoms, you may want to visit your healthcare provider for further advice. Many of these symptoms are similar to other conditions, so further investigation by a healthcare provider can help identify what is going on.
If I plan on getting pregnant, what should I know?
Endometriosis can make becoming pregnant more challenging for women with severe endometriosis as scar tissue in the fallopian tubes can prevent the egg and sperm from meeting. Fortunately, many women with endometriosis are able to become pregnant. Below, we outlined some of the things to look out for or keep in mind when trying to get pregnant with endometriosis:
- Continue managing your mental health. Managing endometriosis can impact your mental health and challenges with infertility can impact your mental health as well. It is important to seek out support and continue using support while trying to conceive.
- Talk to your healthcare provider about your medications. If you are using pain medications to manage your endometriosis, your healthcare provider may suggest that you minimize or stop using non-steroidal anti-inflammatories (NSAIDs), codeine, and acetaminophen (Tylenol) to avoid effects to the baby when you conceive. They may suggest alternative medications or pain management strategies. It is important to consult with your healthcare provider before you stop any pain medications.
- Talk to your healthcare provider about your hormonal treatments. When trying to conceive, you may need to stop any hormonal treatments for endometriosis because they mimic pregnancy or menopause. Speak to your healthcare provider before you stop any hormonal treatments.
- Surgery. You may be offered surgery to remove endometriosis scar tissue to improve fertility, especially in cases of severe endometriosis. The surgery may be minimally invasive (laparoscopic) or more invasive (laparotomy). These surgeries can sometimes improve fertility in women with endometriosis.
- Reproductive technologies. If you are having trouble conceiving with endometriosis, you may be offered assisted reproductive technology options such as intrauterine insemination (IUI) and in vitro fertilization (IVF). You can read more about IVF HERE.
Pregnancy with endometriosis
There are a few things to consider when pregnant with endometriosis.
- Some research suggests that women with endometriosis may be more likely to miscarry, however, the reasons for this are unclear.
- Complications related to endometriosis in pregnancy are rare. However, women with endometriosis may be more likely to have placenta praevia (a low-lying placenta). Placenta praevia means that the placenta attaches to a lower part of the womb.
- Managing a condition such as endometriosis can impact your mental health, and during pregnancy it is important that you continue to use strategies that work well for you to manage your mental health.
For resources on managing endometriosis: