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How does Endometriosis (Endo) impact fertility?
“Women’s troubles” … yep, that old chestnut!
Just live with it?! I call bullsh*t. Nope you don’t have to live with it.
For literally generations the most trusted people around us – our mothers, sisters, aunts and grandmothers – have told us that pain is all part of being a woman. We just have to put up with it. Month after painful month.
Then there’s the doctors (let’s face it, mostly male) who dismiss the incredible discomfort you experience month on month. They have no idea what it feels like and never will. They just don’t get it.
So, let’s get it all out in the open and talk about period pain.
Period pain can range from mild discomfort one month to crippling pain other months. Some months you can work through it and deal with the slight discomfort, others you need to tuck yourself up in bed curled around a hot water bottle and chewing down anti-inflammatories like they’re lollies. Sound familiar?
Why is does it differ and what IS period pain you ask?
You know that each month you shed the lining of your uterus – we call this a period, right? Well our muscles contract to help us shed this lining. Doctors refer to these contractions and the discomfort experienced with them as dysmenorrhea. You probably know it as cramps.
If you’re finding it hard to separate yourself from your water bottle more months than not, it’s likely there’s an underlying condition causing your pain. If this hideous pain goes hand in hand with heavy or irregular periods, it’s even more possible you have an underlying condition. Some of these include:
Endometriosis – where the uterine tissue grows outside of the uterus (generally fallopian tubes, ovaries, or your pelvis).
Adenomyosis – where uterus tissue grows in the muscle wall of the uterus.
Pelvic Inflammatory Disease (PID) – caused by a STD, an infection of the uterus, fallopian tubes or ovaries.
Fibroids – non-cancerous growths or tumours inside of the uterus
Let’s focus on Endometriosis (or endo as it’s commonly called). So, what is it and how common is it?
More than 11% of women experience endometriosis at some point in their lifetime. In Australia one in nine women or girls will experience endo. Yep it’s common!
The lining of your uterus is called endometrium. The endometrium is only supposed to only be found in the uterus. When you develop endo, tissue has spread to other organs – such as ovaries, fallopian tubes or the pelvis. It’s incredibly painful and generally gets steadily worse. In chronic cases endo can spread to the abdominal cavity, or even the bowel.
Symptoms vary from woman to woman, but some common symptoms include:
Severe pain in your pelvis and back;
Painful sex (especially during or after orgasm – how much does that suck!);
Pain when you empty your bowel or bladder (painful pees and poos);
Heavy bleeding either with or without clots – and can be irregular, long or include ‘spotting’ before a period
If you experience any of these symptoms, it’s worth a conversation with your doctor. PSA though, endo can be really hard to diagnose! In fact, the only certain diagnosis of endo is through laparoscopic (keyhole) surgery to investigate and remove endometrial tissue. It sucks, but these are the facts.
What about the impact on fertility?
Most – approximately 60-70% of women with endo will become pregnant – but endo is a leading cause of infertility. About 30% struggle in a big way!
Have you heard of Dr Katrina Moss? Probably not, and yet we need to thank her for her recent research on undiagnosed endometriosis and poorer fertility treatment outcomes.
Thanks to her work many women won’t have to waste precious time and money on fertility treatments where success is highly unlikely.
Dr Moss suffered from endo herself. So she has a very personal interest in the care of women suffering from endo. Through her research she discovered that women with undiagnosed endo had a greater chance of failure during fertility treatment.
Her research found that diagnosis can take many years and often you’ll need to see numerous doctors before you get a confirmed diagnosis. And during that time waiting for answers, you’ve lost valuable time (not to mention money!), and the pain and suffering takes an emotional toll.
The research showed that if endo was diagnosed and treated before starting ARTs, there was a no difference in treatment outcomes for women who suffer endo and those who don’t. This research is a game-changer!
Where to from here for you
Were you nodding your head while reading the symptoms? Maybe you’ve just thought this is the way it is and there’s nothing you can do about the excruciating pain and the toll it’s taken on your life? Well here’s the truth: it isn’t normal, you don’t have to put up with it and you can (and should) ask for help.
Trust your body. You need to be the expert here. So here are a few tips:
Track your pain month on month;
Track the heaviness of your periods;
(this is gross) but if you see any clots, take a photo to show your doctor;
Talk to your doctor and provide them with your data. Be open and clear about the impact it’s having, the symptoms you’re experiencing and the toll it’s taking on you.
From there your GP will refer you to a gynaecologist who will perform some tests – for example an internal scan and possibly laparoscopic surgery to find and remove the endo.
Laparoscopic surgery is usually day surgery and you may have some pain and feel unwell for a few days (with a very swollen belly) but the good news: your endo will be gone – so it’s likely you’ll get your life back … and have a much greater chance of falling pregnant. Game-changer!
Remember though – diet and exercise are big players in your recovery. You may also need some physio (pelvic physio). But, most importantly this journey has taken an emotional toll on you so mindfulness and MindBody medicine will be your friend. Trust me on that one.
It’s time to stop putting up with debilitating pain. Stop shutting up. Speak up and get help. Your body is telling you what you need to know – listen to it, and TRUST it.
Are you ready to start thriving through your fertility journey? Learn how here – trust me, it’s possible!