The month of March is Endometriosis Awareness Month, which is acknowledged globally.

Those diagnosed with Endometriosis are often impacted by pain and discomfort on a monthly basis. Endometriosis may also negatively affect conception and the ability to fall pregnant.

Through awareness comes support, innovation and understanding. We aim to help by giving you some helpful information on the disorder, as well as how to effectively diagnose it.

We suggest ways to elevate your general well-being and options for treatment, if diagnosed.

What is Endometriosis?

Endometriosis is a painful disorder in which tissue (similar to the tissue that normally lines the
inside of your uterus), the endometrium, grows outside of your uterus.

Endometriosis most often involves your ovaries, fallopian tubes and the tissue lining your pelvis. In rare cases, endometrial-like tissue may be found beyond the area where pelvic organs are located.

With conditions of endometriosis, the endometrial-like tissue acts as endometrial tissue generally would. It thickens, breaks down and bleeds with each menstrual cycle. But because this tissue has no way to exit your body, it becomes trapped.

When Endometriosis involves the ovaries, cysts called endometriomas may form. Surrounding tissue can be-come irritated, eventually developing scar tissue and adhesions. This in turn creates bands of fibrous tissue that cause pelvic tissues and organs to stick to each other.

Endometriosis can cause severe pain, especially during menstruation. Fertility problems also may devel-op.Fortunately, effective treatments are available.

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How Endometriosis Impacts Fertility

Endometriosis is a common cause of infertility. However, this is not set in stone. This can happen if the endo-metrial tissue implants around the ovaries, or fallopian tubes. This could cause inflammation and scar tissue.

Tissue can also implant on other organs in the pelvis and, in some cases, outside the pelvis. In some people, this endometrial tissue can grow into the muscle of the uterus and cause another form of endometriosis, called adenomyosis.

Endometriosis has also been shown to alter the immune system, and change the hormonal environment around the eggs. This can affect implantation of an embryo and impact the quality of your eggs.

Between 30-50% of people with Endometriosis may experience infertility. The normal chance of falling preg-nant for people without Endometriosis is approximately 10-20%, while people with surgically documented Endometriosis have a chance of only 1-10%.

It is however, important to remember that most often, Endometriosis can be removed. Along with any scar tissue. This means that your symptoms will improve, including your ability to conceive.

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How common is Endometriosis?

Endometriosis is a fairly common condition, affecting around 1 in 10 (10%) of women.

You are more likely to have endometriosis if you:

  • have a mother or a sister who had/have it
  • have any abnormalities in the female reproductive tract, which may stop menstrual blood (your period) from coming out of the vagina
  • have not been pregnant before
  • are a smoker
  • are white
  • have a low body mass index (BMI) or type of eating disorder
  • went through puberty early (before 11 years)
  • have another type of auto-immune disease

Symptoms of Endometriosis

Endometriosis symptoms are different for every person. Some people will have severe symptoms, and others will have mild signs. Some people don’t have any symptoms. It is important to understand your menstrual cy-cle and be aware of your body in order to detect Endometriosis.

The most common symptoms are:

  • pain in your lower stomach or back (pelvic pain)
  • period pain that stops you from doing your day-to-day activities
  • deep pain during, or after sex
  • pain when using the bathroom during your period
  • feeling sick, constipation, diarrhoea, or blood in your urine or faeces during your period
  • difficulties falling pregnant
  • heavy periods

Endometriosis can also cause irregular periods. This will not stop you from falling pregnant, but it could make it more challenging to know when you are most likely to fall pregnant.

If you suspect that you may have Endometriosis, book a consultation with one of our Fertility Specialists.

Endometriosis and IVF

It is hard to gauge the right time to start with the process of IVF if you have Endometriosis, but it is important to note is that IVF is almost always possible.

If you have mild Endometriosis, and have been trying to fall pregnant naturally for two years or more, IVF may be a good option to consider.

People with moderate to severe Endometriosis tend to have a lower chance of falling pregnant with the help of IVF, but results vary from case to case.

If you are considering undertaking an IVF journey, and you suspect that you have Endometriosis, then book a consultation with one of our Fertility Specialists. We will advise on the options available to you.

Pain Management Methods for Endometriosis

Endometriosis can be a severely painful condition. This may impact your quality of life.

We are here to give you some methods for pain relief for Endometriosis.

There are several medications that you can take to ease any pain. These include over-the-counter medica-tions and those prescribed by our healthcare professionals. You may be referred to a specialist pain manage-ment team if your pain is severe.

If you are looking to use a more natural route to improve your pain levels, we can highly recommend the fol-lowing:

  • reflexology
  • transcutaneous electrical nerve stimulation (TENS)
  • acupuncture
  • vitamin B1 and magnesium supplements
  • herbal treatments

Ultimately all of the above will improve your well-being, and not cure the condition, however pain manage-ment is vital when one is in discomfort.

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Treatments Available

There are a variety of tried and trusted treatments available for Endometriosis. You will need the advice from one of our specialists to undergo any of the following procedures:

  1. Hormone Treatment

Hormone treatment works by reducing or stopping ovulation (the release of an egg from the ovary).

Most hormone treatments are contraceptive, such as the pill or an implant. These will stop you from falling pregnant, so they are not recommended if you want to conceive. Hormone treatments may not affect your ability to fall pregnant in the future.

  1. Laparoscopy

During laparoscopy, also known as keyhole surgery, small cuts are made in your abdomen so the Endometrial tissue can be destroyed, or cut out.

This procedure is carried out under general anaesthetic. This kind of surgery can help with your symptoms and sometimes help improve fertility if you are having problems falling pregnant. This is not always a permanent solution.

  1. Laparotomy

This is an operation that requires a cut in the abdomen so that areas affected by Endometriosis can be re-moved – this is only necessary in very severe cases.

After a consultation with one of our Fertility Specialists, you will have a clearer idea of the direction that best suits your needs.

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How to create awareness

National Endometriosis Awareness Month is an initiation first taken by The Endometriosis Association 1993. This month is observed worldwide, through various activities that involve educating people about the condi-tion, doing fundraising, and marching for awareness. Yellow ribbons and brochures are distributed worldwide to honour National Endometriosis Awareness Month.

Endometriosis can have a devastating effect on the quality of life of women suffering from this disorder, and can have a huge impact on their physical, mental, and social well-being.

The objective of this month is to raise awareness about the causes, types, symptoms, and treatment of En-dometriosis, which can be a debilitating health condition that affects an estimated 176 million women world-wide.

Through awareness, we can create support for those suffering from this condition.