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Endometriosis can cause painful periods and infertility

Endometriosis is a condition where the lining of the uterus (the endometrium) that normally grows inside the uterus begins to grow outside the uterus. It can grow on the ovaries, the Fallopian tubes, the intestine, the outer surface of the uterus, or other places in the abdomen. These implants of endometrial tissue cause an inflammatory reaction that can result in scar tissue inside the pelvis. This scar tissue can cause pain as well as infertility.

Unfortunately, we do not know the exact cause of endometriosis. There are a number of theories. One theory is that, during a menstrual period, some menstrual fluid goes backward – through the Fallopian tubes and into the pelvis – rather than forward into the vagina. There may be living endometrial cells in this menstrual fluid that can implant and grow in the pelvis.

The symptoms of endometriosis can include painful periods, painful intercourse, and sometimes continuous pelvic pain. However, sometimes endometriosis does not cause any pain at all. The only symptom of endometriosis may be infertility.

How is it diagnosed and treated?

The only way to accurately diagnose endometriosis is to see it at the time of surgery. So it typically takes laparoscopy (an outpatient surgery) to diagnose it. While doing surgery to diagnose it, we can also treat the implants with laser or cautery (electrical energy).

Endometriosis can also be treated with medications such as birth control pills or injections of a medication called Lupron. These medications stop the hormonal stimulation of the implants. They are usually given for a minimum of 3-6 months, and unfortunately prevent pregnancy as well. Endometriosis can also be treated surgically with laser or cautery. Many women prefer surgical treatment, as they can usually start trying to conceive the month after surgery. Unfortunately, there is no cure for endometriosis.

Will treatment will help me to conceive?

For most women, treatment will improve the chance for pregnancy. According to studies, both surgical treatment and medical treatment can improve your chance for pregnancy. If endometriosis is severe, in vitro fertilization may be necessary for pregnancy to occur, especially if there are significant pelvic adhesions.

For more information about endometriosis, visit ASRM’s patient fact sheet HERE.  You can also read more about endometriosis and surgical treatment HERE.