I am hearing from more women now in their late forties, early fifties who are still hoping to have a family. Fertility is reduced at this age, but if you have a history of endometriosis then it can impact on your chances of becoming pregnant.
Endometriosis and the Link to Infertility
Endometriosis is sadly not uncommon and is generally agreed to be stimulated by oestrogen dominance which can cause both irregular cycles and retention of old blood. Endometriosis occurs where the endometrium, tissue from the lining of the uterus, forms and grows in places outside the uterus. These growths may lead to pain and infertility.
Normally, the endometrium within the uterus thickens each month to prepare for a possible pregnancy and when this doesn’t occur, the extra lining breaks down and is shed during menstruation. However, with endometriosis, the endometrial tissue that is outside the uterus also thickens, breaks down, and bleeds, except it can’t be expelled vaginally like normal endometrial tissue. Instead, it builds up over time and forms patches, scar tissue, cysts, and adhesions.
Usually, these endometrial growths form in the pelvic region, including on or near the ovaries, but they can also appear less commonly near the rectum, vagina, fallopian tubes, or even in the urinary or gastrointestinal tracts.
Although some women experience no symptoms and discover the endometriosis only after an infertility evaluation, others experience painful periods and painful sexual intercourse.
How endometriosis may affect fertility:
Between 30 to 50% of women with endometriosis experience infertility although of course not every woman with endometriosis will have trouble conceiving. There are several ways a woman’s fertility can be impacted by endometriosis and these are some of them:
- Endometrial growths, scar tissue, adhesions, or cysts that are around the ovaries may prevent an egg from entering the fallopian tubes.
- Endometrial tissue, if in the ovary, may actually prevent ovulation from occurring.
- Endometriosis may form inside the fallopian tubes, blocking passage inside the tubes and preventing the egg and sperm from meeting.
Endometriosis can make sexual intercourse painful and this pain may be more acute around the time of ovulation. Not having sex at that time would certainly reduce your ability to get pregnant.
How Is Endometriosis Treated?
Treatment of endometriosis will depend on several factors including the severity of the disease, if you’re experiencing pain, your age, and on whether you want to get pregnant. Some treatments for endometriosis would lead to decreased fertility, which would not be an option if you’re trying to conceive.
The conventional medical treatment may include laparascopic surgery to remove endometrial growths, scar tissue, and adhesions caused by the endometriosis. Although not a cure, as the endometriosis may return later, it can temporarily increase fertility for up to 9 months after surgery.
Other options women are offered can be IVF treatment, Intra uterine devices such as the Coil with its synthetic progestins, fertility drugs, painkillers and surgery which can include hysterectomy.
What Can You Do?
Because endometriosis does have a strong inflammatory component, and is strongly influenced by oestrogen, simply rebalancing with bioidentical natural progesterone can be sufficient to bring the condition under control as it deals with both these conditions.
Many women with endometriosis have found relief by using bioidentical natural progesterone, and if these are also combined with changes in dietary habits then this can help relieve symptoms by reducing inflammation and addressing the oestrogen dominance that underlies it.
An anti-inflammatory diet includes a wide variety of fresh food, fruit and vegetables and looks to reduce consumption of dairy, processed and fast foods. To reduce oestrogen exposure eat organic hormone-free meat, limit alcohiol and eat an abundance of fruits and vegetables.The suggested dietary intake for women is 1500-2000 calories a day with 40 to 50 percent from carbohydrates, 30 percent from fat, and 20 to 30 percent from protein.