What You Need To Know About Endometriosis And Your Fertility
By Stacey Colino; Photography by Freepik
The mysterious disease affects approximately 1 in 10 women. But what the hell is it?
When Senie Byrne, 25, was 15, her periods were accompanied by vomiting and cramps so bad she’d pass out from the pain. She went from doctor to doctor until finally, at age 21, she found out she had endometriosis, a uterine disease that can take up to a decade to diagnose.
What Is It?
When a woman has endometriosis, the uterine lining (the one you’re supposed to shed each month during your period) gets stuck elsewhere. It can travel down through your cervix and vagina, but also up through your Fallopian tubes, where it can attach to your bowel, bladder or ovaries.
“This abnormally located endometrial tissue triggers the body’s immune system, which attempts to clear the tissue, leading to inflammation and scarring,” says gynae Dr Sascha Edelstein, who specialises in reproductive medicine. Dr Saleema Nosarka, reproductive medicine specialist at the Cape Fertility Clinic, adds that this can result in decreased implantation and pregnancy rates. Depending on the location, it can also result in killer cramps, painful sex, diarrhoea or constipation – or no aches at all. “The peculiar thing is that the amount of pain you’re in may have no correlation to the amount of endometriosis you have,” says ob-gyn Dr Mary Jane Minkin.
But even pain-free patients are at risk of a troubling side effect – infertility, often caused by scarring or inflammation. Endometrial tissue also releases fluid that can mess with egg sperm interaction. The best way to preserve fertility is to catch and treat the problem early. Scientists aren’t sure exactly what causes endometriosis, but they do know that genetics plays a leading role in risk (if your mom or sister has it, your chances increase sixfold); exposure to pollutants such as dioxin, a chemical used in pesticides and bleached paper, might also be a prime risk factor.
For now, the only way to score a definitive diagnosis is through surgery, because gynaecologists need to physically see the tissue where it doesn’t belong. This procedure involves general anaesthesia and a camera exploring the inner abdomen and pelvis. If a physician finds any wayward tissue, it can often be removed right then, though it can also grow back. Of course, after getting the diagnosis, you still have to live with the condition, which can come and go or persist for as long as you menstruate.
Birth control can decrease the pain and bleeding, and hormone-manipulating drugs such as danazol can shrink the growths by “turning off” the ovaries. (“Endometriosis is driven by the ovarian cycle, which is switched off during pregnancy and lactation. This is why you’d experience symptom relief while pregnant and breastfeeding,” says Edelstein.)
Scientists are now studying how anti-progesterone and breast cancer drugs may help. If prescription medicine doesn’t yield relief, alternative treatments like acupuncture may ease pain. And if nothing else works,more surgery may be in order. But the crucial thing is for each endometriosis patient to receive a tailored health plan that lets her move past the pain and get on with her life.
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