Endometriosis is a common condition that can cause painful periods as well as infertility. We see many women who have endometriosis at our fertility clinic in Tucson, and many have been suffering for years without having a name to put to their pain.

What is endometriosis?

The endometrium is the lining of the uterus. During each menstrual cycle, the endometrium gradually grows thicker, becoming ready to receive an embryo. If an embryo doesn’t implant itself into the endometrium, then this lining sloughs off and passes out of the body during the menstrual period.

For most women, the endometrium is present only inside the uterus. However, for those with endometriosis, some of the endometrial tissue is present in other parts of the body. It may be on the outside of the uterus, on the ovaries, on the outside of the intestines, or in other parts of the pelvic cavity. It’s thought that this happens when endometrial tissue passes through the fallopian tube and out into the pelvic cavity, although researchers still aren’t sure why some women develop endometriosis while others never do.

What are the symptoms of endometriosis?

The symptoms of endometriosis are most obvious during the menstrual period. At this time, the endometrial tissue inside the uterus is dying back and sloughing off. The same thing happens to the endometrial tissue outside of the uterus, because it’s subject to the same hormonal cycle as the normal endometrial tissue. However, because it’s not in the uterus, this abnormal endometrial tissue has nowhere to go after it dies off. This irritates other structures in the area, which can cause severe pain in some women. It can also interfere with fertility, as the egg may have trouble getting from the ovary into the fallopian tube and from there into the uterus.

Can endometriosis be treated?

When the primary problem is pain, the usual treatment for endometriosis is hormonal medication that stops the proliferation of the endometrial tissue. However, because this type of treatment also prevents the patient from getting pregnant, this isn’t the first choice for our patients.

In some patients, a surgery can be done to remove the abnormal endometrial tissue. This is usually done laparoscopically (through tiny incisions, using cameras and small instruments on long handles). Although this surgery can relieve pain and may also help you to get pregnant, the condition often comes back later because the abnormal endometrial tissue grows back. The surgery also doesn’t always correct the infertility.

Patients with endometriosis and infertility can be treated using IVF. This goes around the inflamed and irritated ovaries and fallopian tubes, depositing the embryo directly into the uterus. This is often successful at causing pregnancy, although it won’t treat pain or other symptoms. However, during your pregnancy, you generally won’t have symptoms of endometriosis because you won’t be having periods, and you can always choose to take hormonal medications later (if you still have pain when your period comes back after delivering the baby).

For our patients with endometriosis at our fertility clinic serving Phoenix and surrounding communities throughout Arizona we usually recommend IVF, because it’s the most likely to lead to a successful pregnancy.