Some women need more than one type of treatment in order conceive. Even if you have endometriosis, you may have not pain. Endometriosis may or may not worsen over time. It tends to get better in pregnancy and after menopause, when you are no longer bleeding into the pelvis. It depends on how much pain you are having. If hormone therapy fails or if the implants are affecting other organs in the pelvis, you may need to have surgery. Surgery can remove the implants and any scar tissue you may have.
Laparoscopic removal of the implants can reduce your level of pain and can increase your chances of becoming pregnant. While it may result in an early menopause, it may be worth it if you are having extreme pain. Birth control pills usually shrink the size of the implants and decrease pain from bleeding but, if this does not work, you may need surgery or a stronger type of pain medication. If you are having a hard time getting pregnant, even after infertility surgery, you may wish to undergo IUI intrauterine insemination or in vitro fertilization IVF , or you may wish to take fertility drugs to increase your chances of becoming pregnant.
Talk to your doctor if you are trying to get pregnant and are not having success because of your endometriosis. There are several complications of endometriosis that you might want to consider if you have the disease. These include the following:.
Dr Andre is from the Caribbean Island of Dominica. Dr Andre has a special interest in minimally invasive GYN surgery and fertility. She and her husband Kester are enjoying their move to Northern Virginia. Read more. Skip to content. Facebook page opens in new window Instagram page opens in new window YouTube page opens in new window Twitter page opens in new window. I was put on a morphine drip, sent for several tests and eventually a puzzled and slightly annoyed-looking doctor told me they could not find anything wrong.
I was repeatedly brushed off by health professionals who told me I just had "bad periods". Eventually, I gave up, figuring I just had a low pain tolerance and that maybe I actually was a hypochondriac.
But when I was 21, my best friend heard endometriosis mentioned in a podcast and messaged me, saying: "This sounds like you! I set off to my regular and empathetic GP, who had tried for years to figure out my symptoms, but now armed with new information, the pieces started to fit together. She referred me to a gynaecologist, who said my symptoms sounded like endometriosis and booked me in for a diagnostic laparoscopy — the only way to diagnose the condition.
A telescope-like instrument is inserted through incisions into the stomach to look for signs of the disease, and a biopsy is taken to confirm.
Waking up from the procedure, I was told I had "textbook endometriosis". I was so happy to finally have an answer — but devastated to find the condition is incurable and I would need surgery every two years to help treat the symptoms.
I was told I needed my first surgery as soon as possible, so booked it in during my university holidays. Warned of the possibility of a hysterectomy if the growths were bad enough, I was terrified.
Thankfully that was not necessary. My diseased peritoneum was entirely removed — it grows back — and endometriosis was cut off various areas in my abdomen.
The surgery aims to give temporary relief from symptoms, and to slow down the endometriosis's growth. Almost two years later, my symptoms are back and I have been told I will need another operation soon. I know the value of getting second opinions from GPs, using support networks and becoming an "expert patient". If you are not trying to get pregnant, hormonal birth control is generally the first step in treatment. This may include:.
Hormonal treatment works only as long as it is taken and is best for women who do not have severe pain or symptoms. If you are trying to get pregnant, your doctor may prescribe a gonadotropin-releasing hormone GnRH agonist. This medicine stops the body from making the hormones responsible for ovulation, the menstrual cycle, and the growth of endometriosis. This treatment causes a temporary menopause, but it also helps control the growth of endometriosis.
Once you stop taking the medicine, your menstrual cycle returns, but you may have a better chance of getting pregnant. Surgery is usually chosen for severe symptoms, when hormones are not providing relief or if you are having fertility problems.
During the operation, the surgeon can locate any areas of endometriosis and may remove the endometriosis patches. After surgery, hormone treatment is often restarted unless you are trying to get pregnant. Other treatments you can try, alone or with any of the treatments listed above, include:. Learn more about endometriosis treatments. For some women, the painful symptoms of endometriosis improve after menopause.
As the body stops making the hormone estrogen, the growths shrink slowly. However, some women who take menopausal hormone therapy may still have symptoms of endometriosis.
If you are having symptoms of endometriosis after menopause, talk to your doctor about treatment options. Many women with endometriosis get pregnant. But, you may find it harder to get pregnant.
Researchers think endometriosis may affect as many as one in every two women with infertility. No one knows exactly how endometriosis might cause infertility. Some possible reasons include: 7. If you have endometriosis and are having trouble getting pregnant, talk to your doctor.
He or she can recommend treatments, such as surgery to remove the endometrial growths. Research shows a link between endometriosis and other health problems in women and their families.
Some of these include:. For more information about endometriosis, call the OWH Helpline at or contact the following organizations:. Department of Health and Human Services.
ET closed on federal holidays. Breadcrumb Home A-Z health topics Endometriosis. Endometriosis Endometriosis happens when tissue similar to the lining of the uterus womb grows outside of the uterus. What is endometriosis? Most often, endometriosis is found on the: Ovaries Fallopian tubes Tissues that hold the uterus in place Outer surface of the uterus Other sites for growths can include the vagina, cervix, vulva, bowel, bladder, or rectum.
What are the symptoms of endometriosis? Symptoms of endometriosis can include: Pain. This is the most common symptom. Women with endometriosis may have many different kinds of pain. These include: Very painful menstrual cramps. The pain may get worse over time. Chronic long-term pain in the lower back and pelvis Pain during or after sex. This is usually described as a "deep" pain and is different from pain felt at the entrance to the vagina when penetration begins.
Intestinal pain Painful bowel movements or pain when urinating during menstrual periods. In rare cases, you may also find blood in your stool or urine. Bleeding or spotting between menstrual periods. The misdiagnoses and wide array of symptoms may contribute to how long it takes healthcare professionals to diagnose this condition. Yet the complexity of endometriosis symptoms is only half of the story when it comes to the delays in diagnosing the condition.
Why should this be so? One review of the existing literature, published in Pain Research and Management in , suggests that the answer may lie in the persistence of gender stereotyping the experience of pain. Studies about pain and healthcare, the review shows, tended to make questionable value judgments about men versus women and their subjective perception of pain. There are many misconceptions about treatments and causes as well.
After receiving a diagnosis, women may be offered an excision surgery, which will remove the abnormal growths of endometrial-like tissue.
This excision does not stop the tissue from growing back, however, and repeated surgeries may follow to keep removing these growths. Doctors may also offer an endometriosis management plan, depending on how much pain and bleeding a person experiences as a result of endometriosis. In the first instance, doctors may prescribe the same drugs they would advise for the management of menstrual cramps : nonsteroidal anti-inflammatory drugs NSAIDs , which are over-the-counter pain relievers, such as ibuprofen.
Other prescribed treatments to manage endometriosis include hormone therapy , such as birth control pills, or the insertion of an intrauterine device IUD. None of these options, however, are ideal. NSAIDs often do not reduce the severe pain that endometriosis can cause, and both birth control pills and IUDs can produce side effects that further impact quality of life. Martha told MNT that the treatments and coping strategies that her physicians offered kept falling short of their aim and did not help with her symptoms.
Martha told us that only excision surgery helped, but in the long term, she needed a solid management plan. Birth control pills may help slow down the growth of endometrial-like tissue outside the uterus.
However, they can have many side effects — including bleeding between periods, migraine , decreased libido , and mood changes. With endometriosis, matters get even more complicated.
For some, birth control could work wonders. For her, this strategy is successfully keeping endometriosis symptoms at bay. Lisa, however, did not experience the same relief and worried that birth control might mask symptoms rather than address them. Why these differences? A study published in The Journal of Clinical Endocrinology and Metabolism found that it may all come down to the type of endometrial-like tissue growing outside of the uterus.
The study authors found a link between the progesterone receptor PR status of endometriosis lesions and whether or not they responded to progestin therapy. In short, PR-positive lesions tended to respond to progestin therapy, and PR-negative lesions responded much less.
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