Endometriosis And Fertility: Myths And Misconceptions

The normalization of period pain is the first of many misconceptions when it comes to endometriosis

Dr Hima Deepthi V, Fertility Consultant, Nova IVF Fertility, Hyderabad

Menstrual cramps during your period can be the most painful part of this monthly process. Menstrual periods can be light and easy for some teens and some women but sometimes menstrual cramps are so painful that they are unable to continue with daily activities.

Women undergoing painful pelvic symptoms are often criticized for their low pain tolerance and face suggestive conclusions like “Period pain is normal; it’s just that time of the month”.

However, the normalization of period pain is the first of many misconceptions when it comes to endometriosis – an uncomfortable and, at times debilitating, inflammatory condition that according to the Endometriosis Society of India, affects approximately 25 million women across the country. And yet, it is a severe medical condition, rarely spoken about and seldom understood, possibly because of varied taboos around menstruation.

Endometriosis is a painful disorder, where the uterus lining or endometrium, grows in outside the uterus including the fallopian tubes, ovaries and along the pelvis. This growth during periods causes swelling and bleed the same way the uterus lining does every month. Hence, most of the people have misconception between period cramps and endometriosis. The usual age group of women affected with the condition is between 30-40 years, which makes it even more difficult to conceive.

Nevertheless, endometriosis does not always mean infertility. Here are a few most common misconceptions associated with it along with its connection to fertility and facts to dispel the existing myths.

Is Endometriosis equals to infertility?

Most of the women are often under the impression that having endometriosis will invariably lead to infertility. However, that is not the scenario, as most women with endometriosis do go on to have children. It is usually believed that the possibility of fertility complications increase with the severity of the disease and, for in women without endometriosis, with age.

Basis studies and surveys, we can say that around 40 -50 % of women with endometriosis are fertile. Furthermore, about half the women who have difficulties with getting pregnant do eventually conceive with assisted reproduction.

Many women with endometriosis are told that their severe period pain is ‘normal’, ‘part of being a woman’, or just ‘in their head’.

Others are told that they have ‘a low pain threshold’, or are ‘psychologically inadequate’. However, the net is that if pain interferes with one’s daily lifestyle, it is not normal and can be a sign of underneath severe endometriosis condition, which requires immediate medical intervention.

Though Endometriosis is a common issue amongst a specific age group, however, considering the evolving lifestyle choices, and other contributing factors, teenagers also can be prone to this condition.

According to a recent Global Study of Women’s Health, two-thirds of women sought help for their symptoms before the age of 30, many experiencing symptoms from the start of their first period as well. Therefore, this is high time to accept that teenagers and young women in their early 20s are not too young to have endometriosis – in fact, most women experience symptoms during adolescence, but unfortunately don’t get diagnosed and treated until they are in their 20s or 30s.

Can Hormonal Treatments cure Endometriosis?

Endometriosis is recurrent by nature; therefore treating it with synthetic hormonal drugs and in serious cases, surgeries might not have a permanent cure.

Hormonal drugs like the pill, progestins, Danazol, and GnRH-analogues have been used for many years to ‘treat’ endometriosis, however, it cannot be fully treated; these hormonal medications can though temporarily suppress the symptoms, but only while the drugs are being taken. Therefore, if one wants to take a chance curing Endometriosis, surgical intervention is required.

In addition, hormonal treatments are treatment sensitive and it is preferable that it should not be used to improve the chances of conceiving for women with Endometriosis. The drugs if used by women trying to conceive, the time frame for natural/assisted conception actually increases! If treatment is needed for infertility, surgery by a specialist gynaecologist and consultation with fertility expert is imperative.

To conclude, Endometriosis is a serious health concern, which can have a lasting impact on women and affect the quality of life, relationships, sex and intimacy. Although it can cause complications in pregnancy or natural conception, it does not necessarily result in infertility. Women can still achieve the dream of parenthood, irrespective of the Endometriosis with timely medical help.

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