Understanding endometriosis: A fertility specialist on what you need to know

Remember, period pain isn’t ‘normal’.

Endometriosis affects one in 10 Australian women of reproductive age.

It’s often tricky to diagnose and the condition is a complex one. Common symptoms of endometriosis include pelvic pain, painful menstrual periods, pain during or after sexual intercourse, and fertility issues.

The severity of symptoms can vary, with some individuals experiencing mild discomfort while others may face debilitating pain and fertility challenges.

We asked renowned fertility specialist, Dr. Raewyn Teirney from IVF Australia, to demystify the condition.

What exactly is Endometriosis?

Endometriosis is characterised by the growth of endometrial-like tissue outside the uterus. Women who have it face both physical and emotional challenges, and it impacts overall quality of life, as well as fertility.

It can show up in teenage years and can take up to 10 years to diagnose, especially if someone is asymptomatic, as was the case with my patient, Sam from Channel Nine’s reality series on fertility and the path to parenthood, Big Miracles.

Sometimes, as was the case again with Sam, a woman might not know she has endometriosis until she starts trying to conceive.

Read this next: Big Miracles: How overcoming endometriosis helped Sam and Jason to become parents

What causes Endometriosis?

The exact cause of endometriosis is unknown, One theory we have is that it’s caused by retrograde menstruation. This means menstrual blood and endometrial tissue flows back along the fallopian tubes and into surrounding tissue. It then implants and grows, which causes the intense pain.

Another cause could be ‘coelomic metaplasia’. This is when the cells that sit around the pelvic organs change structure. They begin to function in the same way as endometrial cells. We believe puberty and/or changes in oestrogen levels trigger it.

We also think some women have a genetic predisposition to endometriosis. If someone in your family has the condition, you are up to seven times more likely to develop it. Finally, there may be a link to immune deficiencies, which underscores the importance of a healthy, well-balanced diet.

Diagnosing endometriosis

This can often be an arduous journey in itself. Symptoms include mild or intense pelvic pain, irregular bleeding (bleeding a great deal, or very little), and fertility struggles. Women with endometriosis may also experience back, bowel and bladder pain. Likewise, changes in urination or bowel movements can indicate its presence, as can pain either during or following sexual intercourse. Understanding these symptoms is crucial for the early detection, diagnosis and management of endometriosis.

If you think you might have endometriosis, it’s vital to see your GP and ask for a referral to a specialist for further tests. One detailed endometriosis test is a Deep Pelvic Endometriosis scan “DIE” for short. This pelvic scan can pick up smaller nodules of endometriosis that are not seen in normal scans.

The surgical procedure called a Laparoscopy is the gold standard for diagnosing endometriosis. Here, a surgeon inserts a miniature camera into the abdominal cavity and looks around for the presence of endometriosis and surgically removes it. It’s minimally invasive, and often is all you need to do to improve your natural fertility and reduce pain. It also can improve chances of successful IVF treatments.

Remember, period pain isn’t ‘normal’. Mild cramping from time to time is to be expected, but anything more may signify a greater issue. If a doctor doesn’t seem to hear you or tells you it’s just a normal part of being a woman, seek a second opinion. It’s better to be tested and find nothing, than not be tested and have endometriosis interfere with your future fertility.

Managing Endometriosis

There are medications that can help manage the condition, however they only work as long as you take them. They include pain medication and hormone treatments like the contraceptive pill or the Mirena™ IUCD which your GP or specialist can organise.

Holistic measures to manage the condition

You can help manage the symptoms of endometriosis by leading a healthy lifestyle. This means enjoying regular exercise and enjoying a well-balanced, healthy diet including foods containing the Omega 3 fatty acids. It’s also important to reduce your alcohol, smoking and processed foods.

Don’t fear for the future  

If you receive a positive endometriosis diagnosis, try not to stress too much. In most cases, you can manage the disease, most women conceive naturally and go on to have a happy, healthy baby.

Ask for advice from your Gynaecologist and Fertility Specialist.