Endometriosis is a condition in which tissue similar to the uterine lining, known as endometrium, grows outside the uterus. This can lead to chronic pain, inflammation, and the development of scar tissue. Endometriosis affects an estimated 10% of women of reproductive age, yet knowledge of the condition is very low, which leads to delayed diagnosis and treatment. 

Dr Santosh Gupta- Fertility Specialist at Nova IVF Fertility, Koramangala, Bengaluru shares how to educate women about endometriosis and symptoms of women’s fertility.

Understanding Endometriosis

Endometriosis occurs when endometrial-like tissue appears on other organs within the pelvis, such as the ovaries, fallopian tubes, and pelvic lining. In rare cases, it can extend beyond the pelvic region. This tissue acts like regular endometrial tissue during menstrual cycles—it thickens, breaks down, and bleeds. However, unlike normal endometrial tissue, which exits the body after menstruation, this displaced tissue has no way out to leave the body, resulting in discomfort, cysts, scar tissue, and adhesion. 

 Impact on Fertility

Endometriosis can have significant effects on fertility. The condition may produce obstructions in the fallopian tubes, preventing the egg and sperm from meeting. It can also cause inflammation, which may impair the function of the ovaries, eggs, and fallopian tubes. In extreme circumstances, endometriosis can affect pelvic anatomy. Approximately 30-50% of women with endometriosis may be infertile, making early detection and treatment crucial for those hoping to conceive. 

Not only does it cause infertility, but endometriosis also reduces the ovarian reserve. Ovarian endometrioma is a surface lesion, and the ovarian cortex has all the developing follicles or eggs. Due to inflammation and scarring, it causes faster attrition of developing follicles and reduces ovarian reserve. Many patients come in later stages when their egg reserve is very low, meaning they have exhausted their eggs early because of endometriosis. If they come early when the egg reserve is good and the disease is milder, the patient’s fertility treatment outcome is as good as patients without endometriosis. Endometriosis patients who come very late with a very low egg reserve might need donor oocytes to conceive.

Recognizing the Symptoms

One of the most difficult aspects of identifying endometriosis is that its symptoms are varied and often subtle, making it difficult to distinguish from other medical conditions. Common symptoms include pelvic pain, particularly during menstruation, pain during intercourse, pain with bowel movements or urine, especially during menstrual periods, excessive bleeding during or between periods, infertility, and general exhaustion. In addition, some women may develop gastrointestinal problems such as diarrhea, constipation, bloating, and nausea. These symptoms can have a substantial influence on a woman’s quality of life; therefore, those who are experiencing them should seek medical care. Early identification can reduce challenges and enhance overall health. 

Treatment Options

Endometriosis treatment aims for improved fertility while also relieving symptoms. To ease minor discomfort, over-the-counter pain medications such as ibuprofen are frequently used first. Hormonal medication, such as birth control tablets, gonadotropin-releasing hormone (GnRH) agonists, and progestin therapy, can help lessen or eliminate menstruation, which relieves discomfort. In more severe situations, surgical procedures such as laparoscopy, a minimally invasive surgery, can remove endometrial growths, perhaps improving fertility. Women who continue to experience infertility may benefit from assisted reproductive technologies (ART), such as in vitro fertilization (IVF). Each treatment approach should be tailored to the individual’s symptoms and reproductive goals.

Educating women about endometriosis and its effects on fertility is essential for early detection and treatment. Awareness can lead to earlier diagnosis, more effective treatment, and better results for women with this condition. If you or someone you know is suffering from endometriosis symptoms, get medical help to learn about your options and take proactive actions toward better reproductive health.