Endometriosis treatment for infertility
The functions of a female body are often unpredictable. Every muscle strain and cramps that happen irregularly is like a reminder that your body needs ample care. Every one of us gets such reminders irrespective of gender. However, female bodies are likely to be more vocal for such reminders, and endometriosis and fibroids are, one of them.
Endometriosis is a painful condition that results in many complications, including infertility in women. Endometriosis is a condition, where a mass of cells similar to endometrium cells grow irregularly outside the uterus.
The endometrium is a thin layer covering the uterus from inside, and it is linked with the menstrual bleeding that occurs every month.
Most of the time, endometriosis grow on the uterus, but in some abnormal situations, it might develop on the:
- fallopian tubes that connect ovaries to the uterus
- tissue around the cervix
- tissues that line the pelvis
In some rare cases, endometriosis may even occur in other body parts as well. Some surveys say that endometriosis affects around 3 to 10% of reproductive-age women.
Symptoms of Endometriosis
Severe pelvic pain during periods is a common symptom that may indicate endometriosis. Mild pain during natural mensuration is common for women, but the pain will be higher than usual with endometriosis.
Other symptoms of endometriosis include:
- Pain during or after sexual intercourse
- Menorrhagia(heavy periods) – abnormally heavy or prolonged bleeding during periods
- Early bleeding – before mensuration starts
- Painful bowel movements
- Urinating more than usual
- Dysmenorrhea – Painful periods, severe and frequent menstrual cramps along with pelvic pain
- Lower back pain
- Abdominal pain
Some women might also have symptoms like fatigue, constipation and bloating etc., particularly during menstruation.
Tests to diagnose endometriosis:
- A complete pelvic examination
- Ultrasound test
- Magnetic resonance imaging (MRI)
- In some rare cases, diagnostic laparoscopy is performed
Causes of Endometriosis:
The exact cause of this condition is yet to find. But some underlying conditions mentioned below can lead to endometriosis:
- Immune system dysfunction: when the immune system in your body fails to identify and destroy the endometrial cells, they accumulate and form a lump of tissues.
Retrograde menstruation: In this condition, the menstrual blood flows back to the pelvic cavity instead of passing out of the body. The menstrual blood contains endometrial cells, and they might stick to the walls of the pelvis to other pelvic organs. Slowly, they start to grow into a mass of tissues and tend to create complications during every menstrual cycle.
- Peritoneal cell transformation: Here, coelomic cells and peritoneal cells are transformed into endometrial-like cells by hormones or your immune system.
- Embryonic cells transformation: Here, embryonic cells transform into endometrial like cells during puberty by the hormones like estrogen, which may tend to develop endometriosis.
- Scar endometriosis: Surgeries like hysterectomy or C-section leaves an incision, and these endometrial cells sometimes stick to the surgical incision that may cause “Scar Endometriosis.”
- Transport of endometrial cells: the cells might travel to other body parts through the blood vessels or lymphatic system; when they stick there, they grow into a mass of cells called endometriosis.
Some risk factors that may end up with endometriosis are:
- Early puberty
- Menopause between the age 45-50 years
- Menstrual cycle less than 27 days often called short menstrual cycles
- Heavy periods that last more than 7 days
- Increased levels of estrogen production in your body
- Underweight women are also at risk of endometriosis
- Consumption of alcohol heavily
- Family history of endometriosis (Hereditary )
- Irregular menstrual cycle
- Never having a pregnancy also increases the risk of endometriosis
- Structural deformity of uterus, cervix, or vagina
Endometriosis ranges from mild to severe, and it has the potential to cause life-threatening complications. However, with early diagnosis and treatment, endometriosis can be managed effectively.
Both medical and surgical treatments are available to manage potential complications. Based on the condition, the doctor starts with conservative treatment initially. If there is no improvement, then the mass of tissues are removed surgically.
Pain medication like NSAIDs or ibuprofen is given to ease the symptoms like painful menstrual cramps. They might be effective for some women, and others will be suggested with the following treatment options.
Hormone therapy is very effective in some woman where it can control the hormonal changes in your body that tend to influence endometrial tissue growth. Hormonal supplements also provide relief from pain and prevent endometriosis growth.
- Hormonal contraceptives
Hormonal contraceptives like birth control pills and vaginal rings can be used to regulate the hormones that trigger the growth of endometrial tissue every month.
- Progestin therapy
Different types of progestin therapies are used in the treatment of endometriosis. Some of them are contraceptive implants and injections, levonorgestrel intrauterine device, or a progestin pill that stops menstrual periods and reduces the chance for break-through bleeding and possesses similar functions against endometriosis.
- Gonadotropin-releasing hormone (Gn-RH) agonists and antagonists
The GnRH therapy can stop ovarian-stimulating hormone production, also reduces estrogen levels and prevents periods. Eventually, the endometrial tissue starts to shrink.
Conservative surgery involves removing the endometrial tissues without damaging other organs with the help of laparoscopy, a minimally invasive surgical procedure that can diagnose and remove endometrial tissue. It is commonly recommended for women with fertility issues and seek pregnancy or have unbearable pain and ineffective hormonal treatments.
This surgery is the last resort for endometriosis treatment and suggested when all other options fail to improve the condition.
During this surgery, the surgeon eliminates the lesions. Sometimes uterus, cervix, and ovaries might need to remove as they make estrogen, which stimulates the growth of endometrial cells. Unfortunately, after a hysterectomy surgery, a woman can’t become pregnant anymore. So it is performed rarely and in women who have completed their family.
Know the risk factors, watch for the symptoms and take extra care if you are at risk of endometriosis. Consult expert doctors for early diagnosis and treat endometriosis. At ZIVA Fertility clinic in Hyderabad, our fertility doctors and gynaecologists are well-versed in treating mild to severe endometriosis. We also educate every woman who comes to us about other diseases or disturbances associated with their menstrual cycle. To know more information, book an appointment with our experts.