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Endometriosis Can Cause Painful Periods and Infertility

Endometriosis is a condition in which 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 outer surface of the uterus, or even on non-reproductive organs and tissues, such as the bladder, intestine or abdominal lining. 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.

Scientists still do not know the exact cause of this condition. There are a number of theories. One theory is that, during a menstrual period, some menstrual fluid and tissue goes backward – through the Fallopian tubes and into the pelvis – rather than forward into the vagina. Others believe that cells inside the pelvis turn on genes to make them act like they’re in the uterus, even when they’re really not.

These endometriosis implants can cause painful periods, painful intercourse and sometimes infertility. However, sometimes endometriosis does not cause any pain at all. The only symptom of this condition may be infertility.

How is endometriosis diagnosed and treated?

Surgery is required to make a definitive diagnosis of endometriosis. The only way to accurately diagnose this overgrowth of endometrial tissue is to see it at the time of surgery. Most of the time, this minimally invasive surgery (laparoscopy) is outpatient, and while completing surgery, your fertility doctor can often treat the implants with laser or cautery (electrical energy).

Endometriosis can also be treated with hormone suppression through oral medications, implants, or monthly or semi-monthly injections. The suppression gives the chance for the endometriosis to “cool off,” and is usually given for a minimum of three to six months. Unfortunately for fertility patients, most of these medications act as contraceptives and can prevent pregnancy during their use. However, pregnancy rates may be higher once treatment is complete.

Your fertility specialists will talk with you about your options for the treatment of endometriosis. Fortunately, the symptoms of endometriosis usually get better during pregnancy and stay better after a successful pregnancy. While there isn’t a cure for endometriosis, there are many effective treatment options that our fertility doctors are experienced in using.

Will treatment help me conceive?

Decreasing the inflammation and treating endometriosis can help achieve pregnancy. Many fertility treatments expedite the time to pregnancy, meaning that the endometrial tissue has less of a chance to grow back before pregnancy occurs. If endometriosis is severe, IVF may be necessary to get pregnant, especially if endometriosis has caused significant scarring of the tubes.

For more information about endometriosis and infertility, read the American Society for Reproductive Medicine’s patient fact sheet. If you’re ready to get help, contact us for an appointment with a skilled reproductive endocrinologist at Texas Fertility Center.