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Endometriosis Endometriosis occurs when small deposits of the endometrium (the medical term for the lining layer of the uterus) grow outside the uterus. Deposits commonly form on the external surface of the uterus, around the tubes or ovaries, or on the wall of the pelvis. The bowel or bladder may sometimes be involved. Endometriosis most commonly presents with pelvic pain; pain with your periods, pain with sexual intercourse, and discomfort associated with the use your bladder or your bowels. In a smaller proportion of cases, however, the main presenting symptom may be fertility problems. It is well documented that endometriosis may affect fertility. In more advanced cases the endometriosis causes marked damage to the ovaries and other pelvic structures and may cause extensive pelvic adhesions. Even in more minor forms of endometriosis, however, there is evidence to suggest that endometriosis may reduce the chances of a pregnancy occurring. We do not have any simple way, as yet, of diagnosing endometriosis. A normal pelvic ultrasound examination (a scan) does not exclude mild to moderate endometriosis. At the present time, the only way that the diagnosis can be made is by performing a laparoscopy examination. If you have symptoms that make you suspicious that you might have endometriosis you should certainly consider being reviewed by a gynaecologist, and if appropriate, consider a laparoscopy examination. We believe that endometriosis may often begin very early in a woman’s menstrual life. In some women it is a gradually progressive condition. If you have endometriosis, from a fertility preservation point of view, it is vitally important that the diagnosis is made as early in your life as possible. It is also vitally important that you ensure that the condition is kept well under control and not allowed to progress to a severe stage. You should preferably be under the care of a gynaecologist with a special interest in fertility problems. Young women with severe endometriosis need to give some thought to the concept of fertility preservation (see “fertility preservation”), especially if it will be a long time before they might wish to start a family. |
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