How Endometriosis Can Affect Your Fertility

Endometriosis is a condition that most often causes symptoms during a woman’s reproductive years and can occur as early as a girl’s first period. It affects women of all nationalities and races. Unfortunately, it can go undiagnosed for years, and patients’ symptoms can be confused with irritable bowel syndrome, ovarian cysts, and other conditions.

What is endometriosis?

Endometriosis is a disorder in which the same tissue that makes up the inside lining of the uterus, the endometrium, grows outside the uterus and attaches to other structures, such as the fallopian tubes, ovaries, and the peritoneum (the lining of the abdominal and pelvic cavity). In some cases, it can develop on other organs, such as the bladder or intestines.

When endometrium is inside of the uterus, it thickens and then sheds through a woman’s monthly period. However, when the lining grows on other organs, it can cause inflammation, scar tissue formation, adhesions that cause organs to stick together, and pain.

What are the symptoms?

The most common symptoms of endometriosis include:

  • Abdominal or pelvic pain, occasionally severe, especially before and during your period
  • Heavy periods or bleeding between periods
  • Infertility
  • Painful sexual intercourse
  • Pain when urinating or passing a bowel movement
  • Severe cramps that aren’t relieved by over-the-counter pain relievers

Other symptoms—often during your period—include:

  • Bloating
  • Constipation
  • Diarrhea
  • Fatigue
  • Nausea

It is important to note that the severity of pain does not necessarily correlate with the severity of endometriosis. We see women with severe cases of endometriosis who have little to no pain and other women who have mild findings but have serious pain.

Who is at risk?

If your mother or sister has endometriosis, you may be at risk. Unfortunately, there is no cure for endometriosis, though it may temporarily improve during pregnancy, and most of the time, symptoms decrease after a woman goes through menopause.

Endometriosis and infertility

As many as 40 percent of women with infertility have endometriosis. Some women learn for the first time that they have endometriosis when they have trouble conceiving. Scar tissue may distort or block the fallopian tubes and prevent sperm from fertilizing an egg. It may also damage eggs or sperm, according to some research. 

That said, it is still possible to become pregnant, even if you have moderate endometriosis. Your doctor may recommend that you not delay having children if you are considering getting pregnant, as the condition often worsens with age.

How is endometriosis diagnosed?

If your OB/GYN suspects endometriosis, he or she can rule out other conditions during a pelvic exam or ultrasound. However, the only definitive way to diagnose endometriosis is through surgery.

How is endometriosis treated?

Although there is no cure, we have several methods to treat endometriosis:

  • Hormonal medications, including progestin-only medications (such as Depo Provera, oral progestins, or intrauterine devices with progestin) and gonadotropic-releasing hormone antagonists. Birth control pills can help treat endometriosis symptoms.
  • Laparoscopy with surgical treatment or removal of endometriosis.
  • Hysterectomy is typically a last resort for severe cases of endometriosis. Some women may need to have their uterus and ovaries surgically removed.

What should I do next?

If you have symptoms, contact your primary care physician or OB/GYN and schedule an appointment. Otherwise, see your OB/GYN for a yearly well-woman checkup. If you do not have a physician, visit


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