Endometriosis: Symptoms & Fertility - all your qns, answered.
Image by Allyssa Olaivar, via Unsplash.
Endometriosis (also known as 'endo') is more than just a painful or heavy period, as it's sometimes dismissed as - it's a complex and often misdiagnosed condition that affects millions of women worldwide. It's currently Endo Awareness Month - and if you've been following us on @moxieHQ TikTok, we've been talking about all things endo - from the signs and symtpoms, to how it's diagnosed and treated. But the Moxie community has a lot of questions - particularly around endo and fertility - and so, we thought we would compile them in this go-to FAQ guide, starting with some of the most common FAQs and then a deeper dive into endometriosis and its role in fertility and pregnancy. Fact checked by our resident Sydney-based OBGYN, Dr. Nicole Stamatopoulos.
Remember: if in doubt, always get checked out! If you have any concerns about your intimate health whatsoever, or your fertility, see a trusted medical professional for a proper personalised diagnosis and treatment plan.
WHAT IS ENDOMETRIOSIS?
Endometriosis occurs when tissue similar to the lining of the uterus (the endometrium) grows outside it - often causing significant pain, particularly during menstruation (though can occur at anytime during the menstrual cycle), and possibly also impacting fertility. Recognising symptoms, seeking diagnosis, and exploring treatment options are essential for those affected by it.
HOW IS IT DIAGNOSED?
Endometriosis is typically diagnosed by your doctor through a combination of a medical history review (especially period pain, pain with sex, bowel or bladder pain, chronic pelvic pain, painful bowel movements during periods, infertility, or symptoms that cycle with menstruation), pelvic exams, imaging tests (like ultrasound or an MRI), and sometimes laparoscopy - a surgical procedure where a small camera is inserted through a tiny incision in the abdomen to directly visualise and diagnose the presence of endometrial tissue outside the uterus.
IS IT HEREDITARY?
While the exact cause of endometriosis is still not fully understood, there's some suggestion that genetics might play a role. Research indicates that those with close relatives (like your Mum, sister, or aunt) who have endometriosis are at a higher risk of developing the condition themselves. However, it's important to note that not all cases of endo are hereditary, and environmental factors may also contribute to its development. It's also said that retrograde menstruation (where menstrual blood flows back up through the fallopian tubes and into the pelvic cavity instead of out through the vagina) may also be a possible cause. Hopefully with better awareness and research, we can find a cause!
CAN MEN GET ENDOMETRIOSIS?
Endometriosis is a condition primarily affecting those assigned female at birth, as it involves the presence and growth of endometrial-like tissue outside the uterus. While extremely rare, there have been reported cases of transgender men or females who later transitioned to males and retained their reproductive organs experiencing symptoms suggestive of endometriosis.
While exceedingly rare, cases of endometriosis in those assigned male at birth have been reported. Some cases have been linked to elevated estrogen levels due to liver cirrhosis, obesity (which is believed to raise estrogen levels), and prolonged hormone therapy for prostate cancer treatment (also containing estrogen). Interestingly, the common thread here is the hormone estrogen.
In all cases, diagnosis and management of endometriosis in men requires specialised medical attention due to its rarity and unique challenges (please see your gyno or an endo specialist if you think this is you).
WHAT DOES ENDOMETRIOSIS FEEL LIKE?
Endometriosis can manifest differently for everyone, but common symptoms include severe pelvic pain (especially during menstruation), chronic pain in the lower back and pelvis, pain during or after sexual intercourse and painful bowel movements or urination. Some people may also experience fatigue, diarrhea, constipation, bloating, nausea (particularly during menstrual periods) and may have issues with infertility or trouble conceiving.
WILL ENDOMETRIOSIS CAUSE WEIGHT GAIN?
Endo itself is not directly linked to weight gain, but those living with it may experience changes in weight due to factors like hormonal changes, medication side effects, changes in appetite or physical activity levels due to pain or discomfort, or emotional distress associated with managing the condition.
CAN ENDOMETRIOSIS CAUSE BACK PAIN?
Yes, endometriosis can sometimes cause back pain. It's not the most typical symptom, but that sharp ache or discomfort in your lower back could be related to it. Sometimes it gets worse around your period. If you're dealing with back pain along with other endometriosis symptoms, chatting with a doctor can help figure out what's going on.
CAN ENDOMETRIOSIS CAUSE A UTI?
Endo doesn't cause urinary tract infections (UTIs) but can sometimes lead to symptoms that mimic them. It can cause inflammation and irritation in the pelvic region, which may result in urinary symptoms like frequent urination, the feeling of needing to pee urgently, or a burning sensation whilst peeing. These symptoms can sometimes be mistaken for a UTI. Some women may also have a tight pelvvic floor which may make them have the urge to void frequently, much like with a UTI.
ENDOMETRIOSIS, FERTILITY & PREGNANCY
HOW DOES ENDOMETRIOSIS AFFECT FERTILITY?
Endometriosis can affect fertility by causing scar tissue (formally known as 'adhesions') and inflammation, making it more challenging for sperm to reach the egg. However, many affected by endometriosis still conceive: sometimes 'naturally', other times with the assistance of fertility treatments.
According to Endometriosis Australia, about 1/3 of women with endometriosis will have fertility issues, though the majority will be able to conceive naturally.
If you have any queries or concerns whatsoever relating to your fertility, it's best to consult with your healthcare provider or a fertility expert who can help you explore options for managing any endometriosis-related fertility concerns.
HOW DOES ENDOMETRIOSIS AFFECT PREGNANCY?
Pregnancy with endometriosis is often uncomplicated, and many people find that endometriosis symptoms improve during pregnancy because progesterone is the dominant hormone and menstruation stops. Endometriosis is often considered less active or dormant in pregnancy, although every case is different. Research on endometriosis and pregnancy complications, including miscarriage, preterm birth, and pre-eclampsia, has been mixed, so these outcomes should not be assumed. Overall, most people with endometriosis can have a healthy pregnancy with routine, individualized prenatal care..
DOES GETTING PREGNANT CURE ENDOMETRIOSIS?
We wish this were true but put simply, no, pregnancy isn't a miracle cure for endometriosis. It may feel that way during pregnancy, because your body isn't experiencing the usual hormonal fluctuations associated with your period - which in turn means that you're endo symptoms likely aren't flaring up. Unfortunately, pregnancy is, in some ways, just masking it, and the symptoms will likely return once you've given birth. Remember, there is currently no known absolutely definitive 'cure' for endometriosis.
CAN YOU GET ENDOMETRIOSIS AFTER HAVING A BABY?
While pregnancy might provide temporary relief from endometriosis symptoms for some people, it's possible for symptoms to return after giving birth. The hormonal changes that occur during pregnancy, particularly the temporary suppression of ovulation and menstruation, can alleviate symptoms for many women with endometriosis. However, once hormone levels return to normal postpartum and the menstrual cycle resumes, endometriosis symptoms may reappear.
Additionally, the physical and hormonal changes associated with childbirth and breastfeeding can sometimes influence the progression of endometriosis. If symptoms recur or worsen after childbirth, it's recommended to consult with your healthcare provider for proper evaluation and management.
Some women will be diagnosed with endo after pregnancy, which is unusual, but not uncommon.
Endometriosis may present unique challenges, but knowledge is power. By understanding its symptoms, seeking timely diagnosis, and exploring effective treatments, those of us affected can better manage this chronic disease. Whether early in a diagnosis, or navigating fertility concerns or pregnancy, seeking support from healthcare providers and fellow endo-warriors can make all the difference in your endo journey.
PLEASE NOTE: The information provided here and anywhere on our site is to inform and educate only - this does not constitute, nor should it replace, a personalised medical diagnosis from your doctor. If you have any queries or concerns relating to your own fertility or health in any way, please consult your own trusted medical practitioner for advice.
