Endometriosis is a common problem that affects up to 10 % of all women. There are two main reasons that women seek my help. The first is extremely painful periods that affect their daily life. The second reason is they are having difficulty getting pregnant.
Endometriosis is a tissue (called endometrium) found within the cavity of the uterus. In normal menstruation, hormonal changes occur, and this tissue sheds as part of your period. Problems occur when that tissue abnormally implants in other areas of the pelvic cavity. This can lead to the tissue within the pelvis swelling, becoming inflamed and bleeding from where the endometriosis has spread and leading to pain around period times.
Over a prolonged time, scarring can occur leading to the ovaries and tubes become stuck to the pelvis and ovarian cysts containing endometriosis can result.
Endometriosis is diagnosed definitively by a laparoscopy, most commonly known as ‘keyhole’ surgery. While performing the diagnosis, I would also remove any skin within the pelvis that contains endometriosis.
Minimal endometriosis, with no blockage of the fallopian tubes, can have an impact on fertility by an assumed toxic effect. Laparoscopic surgery is a very useful procedure as a treatment of minimal endometriosis, and we often see a positive effect on pregnancy rates immediately after.
In moderate to severe cases, the scarring can interfere with the eggs release or journey through the fallopian tubes or the sperm from reaching the egg. Using dye studies as part of the diagnosis allows me to determine if the endometriosis has blocked the tubes.
Sometimes I see very severe endometriosis where the bowel and ovaries are all stuck down. In these cases, surgery to return the pelvic anatomy back to normal improves the chances of pregnancy.
Endometriosis treatment is a really satisfying thing to be involved with because when we treat it well the symptoms of pain and painful intercourse can really be improved. So, if you have a family history, severe period pains, painful intercourse or infertility, it’s worth investigating the possibility of endometriosis, and laparoscopy as a very beneficial procedure with a good outcome.
Endometriosis is a common reason for women being unable to conceive. Find out more about endometriosis and fertility
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