Endometriosis

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​Endo is commonly found upon further investigation into infertility. The women that come for fertility treatment with endo often have more mild cases than those that are coming strictly for the endo itself (generally for pain and/or heavy bleeding). Due to cultural and logistical factors in industrialized nations, those with endo and fertility issues are usually women >35 years of age. Regardless of the condition, as we age our healing potential slows down.

 

The ectopic (out of place) endometrial tissue will thicken, enlarge and bleed in response to stimulating hormones. This bleeding produces inflammation, which then produces scar tissue (adhesions). This process can obstruct the fallopian tubes, thus causing infertility and/or ectopic pregnancy.

 

It is only definitively diagnosed through laparoscopy. Surprisingly, patient-reported severity of pain is often not related to the severity of the endometriosis. Endometriosis (as the name suggests) tends to spread to various areas of the body. It is often found in the intestines, colon, rectum and urinary bladder, but also in the spine, lungs, heart, liver and even the brain. However, the most common areas of implantation are the ovaries and the walls of the pelvis. In all of these locations, the endometrioma’s are liable to cause pain. When the endo spreads to the bladder, a misdiagnosis of IC (Interstitial Cystitis) may result.

 

Less severe, but still quite terrible, is adenomyosis. This condition also involves migration of the endometrial cells, but in this case the growth stays within the uterus where the endometrial cells grow into the myometrial layer. Adenomyosis also frequently causes pain, heavy bleeding, dyspareunia and infertility. There may be signs of general pelvic pain, and pain with bowel movements.

 

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