Endometriosis is condition affecting the female reproductive system. It (usually) gives rise to painful symptoms and causes infertility in around 40% of women who suffer from the disorder. Endometriosis starts when endometrial tissue, which usually grows only inside the uterus, develops in other parts of the body. As a result, clumps of this tissue can grow in and around important reproductive organs such as the fallopian tubes or the ovaries. This can prevent normal functioning of the reproductive system, making it more difficult for a woman to become pregnant. Unfortunately, there is no cure for endometriosis; the condition can only be controlled. Pain-killing drugs, hormone treatment and surgery are offered to women with endometriosis. The type of treatment you accept will depend on your priorities regarding pregnancy and pain management.
The most appropriate treatment for you will depend on your age, the severity of your symptoms, your plans for pregnancy now and in the future, and whether or not you have been treated for endometriosis in the past. The reasons for giving you treatment for endometriosis may also vary. Your doctor might be focused on reducing your pain, helping you get pregnant, stopping your condition from deteriorating, or protecting important parts of your reproductive system for future pregnancies. It's important that you talk to your doctor about your plans for having children before beginning any treatment, because some drugs used to treat endometriosis will prevent you from getting pregnant while you are taking them.
If you want to get pregnant as soon as possible, and your symptoms are severe enough to warrant immediate action, surgery to remove the clumps of endometrial tissue blocking up your reproductive system may be recommended. An estimated 1/3 of women with endometriosis manage to conceive after surgery. If you no longer wish to have children and you suffer greatly as a result of your endometriosis, a full or partial hysterectomy may be carried out (removal of the uterus and other reproductive organs). After this surgery, you will no longer be capable of having children. Often, hormone treatments may be administered for six to nine months following surgery to prevent recurrence of the endometriosis. For the duration of the hormone treatment and for some time afterwards, you may not be able to get pregnant, because these drugs control your endometriosis by stopping ovulation.
Various hormone-based drug treatments (including birth control pills) help to control endometriosis by stopping ovulation and therefore reducing oestrogen levels in your body. Oestrogen is the hormone which feeds endometrial tissue and encourages its growth. While you are taking these drugs (particularly the birth control pill) the chances of you becoming pregnant are greatly reduced. The drugs may be suitable, however, for women who are hoping to be pregnant in the future but for the time being need to get their endometriosis under control. When you stop taking the drugs, it's likely that your endometriosis will eventually come back. Some hormone treatments, particularly drugs containing synthetic male hormones, which induce an artificial state of menopause, have unpleasant side effects.
No Treatment At All
Some women decide not to treat their endometriosis at all. It is estimated that 1/3 of women with mild endometriosis will find that the condition disappears within a year even without treatment. They may use over-the-counter or prescription pain medication to control their symptoms in the meantime. If you decide not to treat your endometriosis, you are taking the risk that it will either get gradually worse, or stay the same, until you enter menopause, at which point your oestrogen levels drop and your symptoms will be alleviated. In fact, some women get pregnant despite receiving no treatment for their endometriosis. One study has found that 1 in 5 women with endometriosis will get pregnant despite having taken no action to treat the condition. Many women experience some relief from endometriosis during their pregnancies, because their periods stop.
Unfortunately, endometriosis often recurs no matter what type of treatment you receive (even after surgery). That doesn't mean, however, that you should give up hope. With patience and close cooperation with your doctor, you can control your symptoms and get your body to the point at which you have the highest possible chance of getting pregnant. You may have to accept that managing your endometriosis will be a life-long challenge (at least until menopause).