Endometriosis: Q&A with Dr Anne Poliness

Endometriosis Q&A

By Dr Anne Poliness, a specialist at Rainbow Fertility Melbourne

This month is endometriosis awareness month, also known as Endo March, which is a worldwide campaign aimed at raising awareness of endometriosis and the symptoms, causes, impacts and treatment options available.

Below I answer five of the most common questions I hear about endometriosis.

What is Endometriosis?

Endometriosis occurs when cells from inside the uterus (womb) begin to grow outside the uterus causing pelvic pain and other disturbances. It is a common health condition affecting 1 in 10 individuals who have a uterus.

How do I know if I have endometriosis?

Many people I see who have endometriosis have lived with it for many years and have just thought what they were experiencing was “normal”. Some of the more common symptoms to look out for are painful heavy menstrual periods, painful intercourse, spotting, pelvic pain, lower back pain, painful bowel movements/urination. If you are experiencing some of these symptoms it is worthwhile checking in with your GP as a start.

What causes endometriosis?

There is no definitive answer yet as to the cause, but some of the leading theories are retrograde menstruation -the backward flow of menstrual bleeding through the fallopian tubes and into the pelvis which might cause the endometrial cells to implant on pelvic organs or metaplasia -where endometrial tissue replaces other types of tissues outside the uterus. Other theories: lymphatic or vascular distribution of endometrial fragments, immune system dysfunction or environmental toxins. There is evidence, however, that endometriosis is likely to be partly genetic with first-degree relatives of individuals with the disease more likely to develop it.

What do I need to do to get rid of endometriosis?

Unfortunately, there is currently no easy cure for endometriosis but it can be treated in several ways, depending on the severity of the condition and whether the primary goal is to treat pain or maximise fertility.

Medication is the least-invasive treatment but is only suitable if you are currently not trying to fall pregnant. The medication works by suppressing the pituitary gland and the secretion of hormones (oestrogen) that may stimulate endometriosis.

Surgical procedures such as laparoscopy (keyhole) or laparotomy (open surgery) can work to surgically remove endometrial implants or adhesions (scarring) that result from endometriosis. Surgical treatment is the best options for increasing fertility.

Assisted Reproductive Technology (ART) can be considered if surgical treatment has not helped.

Will endometriosis impact my fertility?

While some individuals with endometriosis fall pregnant easily, unfortunately, many do not.

Endometriosis is found to be present in approximately 50% of cases that have been unable to conceive after trying for 12 months. The impact on fertility is thought to be due to the endometriosis causing some distortion of the anatomy resulting in blockages or changing the function of the fallopian tubes. In many cases, endometriosis can alter ovulation/egg production, cause menstrual cycle disruption, impact the fallopian tubes and in turn embryo transport, and have detrimental effects on the endometrium (womb lining). A laparoscopy surgical procedure is normally required to confirm the diagnosis of endometriosis and several treatments can help set you on the right path to achieve a pregnancy.


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