Endometriosis is a condition where tissue similar to the endometrium (the tissue that forms the lining of the uterus) is found growing outside the uterus, most commonly in the female pelvis. This causes a chronic inflammatory response as scar tissue can form in the pelvis and other areas of the body. It can also lead to a build-up of fibrous tissues between nearby reproductive organs, causing them to ‘stick’ together.
Endometriosis is common and affects 1 in 10 women of reproductive age in the UK.
Endometriosis can present with many symptoms with the commonest being pain and discomfort. Endometriosis classically causes severe period pains and pain with intercourse and it can cause fertility issues. There are currently no cures for endometriosis, but treatments are available to help manage symptoms.
Common symptoms of endometriosis.
Symptoms can range from mild to severe and can have a significant impact on quality of life.
Symptoms can include:
- Severe period pain
- Chronic lower abdomen, pelvic or back pain
- Pain after or during sexual intercourse
- Painful bowel movements
- Painful urination
- Difficulty getting pregnant
- Fatigue, depression or anxiety
- Abdominal bloating and nausea
Causes of endometriosis.
There is no known cause of endometriosis, but there are a few theories as to what might cause it, including:
Retrograde menstruation: Endometrial tissue goes into the fallopian tubes and into the pelvis instead of exiting the body through the cervix during a woman’s period.
Cellular metaplasia: When cells change from one form to another. Cells outside the endometrium change into endometrial-like cells.
Stem cell theory: Stem cells in the uterus may be able to migrate outside of the uterus via blood and the lymphatic system
There is also a possible genetic predisposition as it can impact some families more than others.
Endometriosis risk factors.
Although there is no definitive cause of endometriosis – research has highlighted some things that put you at higher risk of developing the condition:
- A close female relative with the condition
- A structural abnormality of the uterus or uterine growth such as fibroids
- Early menstruation (before aged 11) or menstruation that lasts more than seven days
How does endometriosis affect fertility?
Women with endometriosis can still get pregnant and have a successful pregnancy.
A laparoscopy procedure can be used to evaluate all pelvic surfaces for endometriosis and adhesions. A dye will be used to check if there are any blockages in the fallopian tubes, ensuring that they are open.
If endometriosis is present, there are different options for removing any scar tissue, including diathermy treatment and surgical excision.
Endometriosis and endometrioma’s have been found to be associated with a lower ovarian reserve which can worsen over time, potentially reducing the number of eggs available. Freezing eggs is a good option for younger patients. Aria Fertility offers fertility preservation and the best in wrap-around IVF support to help women become pregnant.
It is essential to confirm a diagnosis of endometriosis from an expert if you are experiencing any symptoms. Consultant gynaecologist Miss Amanda Tozer at Aria Fertility has over 20 years’ experience helping couples with fertility issues, and is also an expert in general gynaecology and women’s health.
Miss Tozer has a comprehensive knowledge of menstrual disorders, including endometriosis, polycystic ovary syndrome and fibroids. She will carry out a medical history and will investigate symptoms with a physical examination and pelvic ultrasound.
She can advise on a range of tailored treatment options, including minimally invasive gynaecological surgery to remove endometriosis lesions, adhesions, and scar tissue and will advise on appropriate management to optimise fertility and pain management as necessary.