What is Endometriosis?
The endometrium is the lining of the uterus, which naturally sheds each month during menstruation. To prepare for pregnancy, these cells grow rapidly each cycle, creating a healthy lining for an embryo to implant. Because of this, endometrial cells are highly sensitive to hormonal changes.
However, in some cases, these cells do not exit the body during menstruation. Instead, they implant and grow outside the uterus, often within the abdominal cavity. Common sites for endometrial implants include the ovaries (where they can form fluid-filled cysts called endometriomas), the lower bowel, the bladder, and the peritoneum (the inner lining of the abdomen).
What Are the Signs and Symptoms?
The symptoms of endometriosis vary depending on its severity and where the implants are located. Common symptoms include:
- Severe menstrual pain (dysmenorrhea) – intense cramping before and during periods
- Painful urination (dysuria) – discomfort when the bladder is full or while emptying it
- Pain during bowel movements (dyschezia) – especially around menstruation
- Pain during intercourse – particularly with deep penetration
- Infertility – especially when ovarian cysts are present
What Are Some of the Experiences of Your Patients?
For many individuals, endometriosis symptoms begin in their teenage years. Unfortunately, young people are often dismissed when they report severe period pain, despite needing regular painkillers or time off school. Many only receive a diagnosis later in life when they advocate for themselves and seek medical attention.
The impact of endometriosis extends far beyond physical pain. Chronic discomfort can affect work, education, and relationships. Many people endure multiple surgeries, take long-term medications, and experience significant disruptions in their daily lives. While endometriosis is not considered a cancerous condition, in some cases, patients undergo radical surgeries with serious risks and long-term complications.
How Does Endometriosis Impact Fertility?
Severe endometriosis (grades 3 and 4) can significantly affect fertility by:
- Reducing ovarian reserve – damaging egg supply
- Interfering with ovulation – making it harder for eggs to be released
- Blocking egg transport – preventing eggs from reaching the Fallopian tubes
Research, including our own studies, has shown that laparoscopic (keyhole) surgery can improve natural conception and IVF success rates in cases of severe endometriosis. However, ovarian surgery must be performed by an experienced specialist, as it can also further reduce the egg reserve.
Even milder forms of endometriosis may impact fertility. While the exact cause is uncertain, some studies suggest that inflammation in the pelvic environment could affect egg quality. In these cases, surgery may be beneficial, but many couples turn to IVF to conceive.
Does Endometriosis Affect Egg Count?
Yes—severe endometriosis can reduce ovarian reserve.
Disclaimer
This article is for general informational purposes only. It is not intended to be medical advice and is not a substitute for medical advice. You should speak with a medical professional if you wish to assess your fertility and before making any decisions about healthcare, including contraception.
