Mother and Baby

Fertility A-Z: Endometriosis

Around two million women in the UK suffer from endometriosis, where the lining of the womb can spread to other organs and can lead to fertility problems

What is it?

In endometriosis, patches of the lining of the womb (or the endometrium) are found in other organs, usually close by, but in some extreme cases in other parts of the body.

Most commonly the endometrial tissue is stuck in the fallopian tubes and ovaries and also it can be found in the bladder and bowel. Some women may have no signs of the condition and only realise it is a problem when they undergo fertility tests after struggling to conceive.

No one is really sure exactly what causes it, but there is a theory that the womb lining fails to clear properly during your period and cells that get trapped in other areas continue to grow and bleed every month just as they would in the womb.

This process causes pain, swelling and can damage the fallopian tubes and ovaries which is when fertility problems can arise.

What are the symptoms?

‘As many as one in four women seeking help for fertility will have endometriosis,’ says Dr Yakoub Khalaf, consultant in reproductive medicine at Guy’s Hospital in London.

The symptoms are painful or heavy periods as well as pain in the lower abdomen and pelvis. But some women have the condition without any symptoms.

What can you do?

For women whose symptoms are mild and fertility is not an issue, they may decide against treatment.

Taking the Pill can help and there are other hormone treatments available

General painkillers can help for painful periods. For some women, taking the Pill can help and there are other hormone treatments available, which prevent the growth of the endometrial cells, causing the ‘patches’ to reduce in size or even clear.

Pregnancy can actually alleviate symptoms because excessive levels of the hormone progesterone inactivate the endometriotic tissue.

Yakoub explains that if women are having persistent problems or the condition is affecting their fertility, doctors will do a laparoscopy – a type of surgical procedure that allows a surgeon to access the inside of the abdomen and pelvis without having to make large incisions. ‘This is an opportunity to assess any damage to the fallopian tubes.’

And he adds that doctors can remove patches of endometrium during the operation. For women with extensive disease, IVF may be the best option to have a baby.

See your GP…

If you have very heavy or painful periods or you have been trying to get pregnant for a year with no success.

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