1300 241 654
admin@oasisfertilitycentre.com.au
GP Resources Here
Make A Booking

Endometriosis

Endometriosis is a medical condition that affects the tissue lining the uterus, known as the endometrium. In this condition, endometrial-like tissue grows outside the uterus, commonly in the pelvic region, ovaries, fallopian tubes, and other nearby structures. This tissue behaves similarly to the normal endometrial tissue, thickening and shedding during the menstrual cycle. However, unlike the tissue in the uterus, it has no way to exit the body, which can lead to various problems and symptoms.

Endometriosis effects 1 in 9 women, with the average time to diagnosis being ~6.5 years.

Symptoms

Endometriosis can cause a range of symptoms, which may include:

    • Painful menstrual periods (dysmenorrhea)
      • The pain may cause you to take time off work/study/socialising
      • The pain may radiate into the lower back or down the thighs
    • Chronic pelvic pain all throughout the menstrual cycle
    • Pain during or after sexual intercourse (dyspareunia)
      • Typically felt on deep penetration
    • Painful bowel movements or urination during menstruation
    • Heavy or irregular menstrual bleeding
    • Infertility or difficulty getting pregnant
    • Fatigue

It is important to note that pain severity does not necessarily predict disease severity. Many patients presenting with infertility as a result of their endometriosis may experience no other disease related  symptoms.

Diagnosis

Diagnosing endometriosis often involves a combination of medical history assessment, physical examination, and imaging tests like ultrasound.

Findings on history, examination, pathology and imaging may be suggestive of endometriosis however a laparoscopy with biopsy of tissue is required for definitive diagnosis to be made.

Impact on Fertility

Endometriosis can affect fertility in several ways. The exact mechanisms are not fully understood, but potential factors include inflammation, hormonal imbalances, and distortion of the pelvic anatomy. The severity of endometriosis and its location can also influence fertility outcomes. It is important to remember that not all patients with endometriosis will experience infertility.

Management

Management of endometriosis requires a multi-disciplinary approach. Endometriosis is a chronic condition for which there is no current cure.

Lifestyle changes: Key areas of lifestyle management for symptom control include;

  • smoking cessation
  • stress reduction
  • maintaining a healthy body mass index
  • potential role of anti-inflammatory diets

Pain management: Pain relief can be achieved through over-the-counter pain medications (paracetamol, ibuprofen) or prescription drugs (opioids) as advised by your doctor. It is vital that patients engage with pelvic floor physiotherapists, psychologists and pain specialists as part of their pain management journey. Alternative therapies such as acupuncture and naturopathy may also alleviate pain.

Hormonal therapy: Birth control pills, hormonal patches, or intrauterine devices (IUDs) can help manage symptoms and slow the growth of endometrial tissue. Hormonal therapy is usually employed in attempts to “suppress” disease and prevent further damage and scarring within the pelvis.

Surgery: Laparoscopic surgery can be performed to remove endometrial growths and scar tissue, which may improve fertility in some cases. Typically the highest chances of conceiving are within six months of endometriosis excision. Historically it was thought that hysterectomy may cure the disease but research has shown >10% of women post hysterectomy continue to experience symptoms.

Assisted reproductive technologies (ART): For those struggling to conceive due to endometriosis, fertility treatments like in vitro fertilisation (IVF) may be considered.