Endometriosis

Treating a Mystery

Endometriosis is a mysterious and frequently painful disease. It is caused by pieces of endometrium, the lining inside the uterus that is normally shed during a woman's menstrual period, becoming lodged in other areas of the reproductive and digestive system, and growing into cysts, adhesions, and lesions. These cause the sufferer a great deal of abdominal and pelvic pain, especially during her period. It is also known to cause or co-present with infertility, and may be diagnosed after a series of failed pregnancy tests.

Neither the cause nor the cure are known, and treatments vary depending on the physician. Many physicians are ignorant of the extent of the disease, and some choose to believe it's a subset of symptoms for a different disease entirely. No official diagnosis of endometriosis can be made without a laparascopy to observe where and how the disease is presenting. There are four stages of endometriosis severity, though a patient can display low severity with extreme pain, or high severity with no pain at all, and all degrees in between.

The Effect on Fertility

Endometriosis sufferers are often also infertile. Some sources claim pregnancy can ease the symptoms; others claim it only makes them worse. Luckily, there are treatment options, so negative pregnancy tests don't need to be an additional burden to the patient with endometriosis.

In a case where a patient wants to get pregnant, surgery is often recommended to remove adhesions. Surgical procedures are kept conservative since the disease is known to relocate in incisions and scar tissue. Adhesions resulting from the surgery may cause future complications, but the results of pregnancy tests should improve.

With a combination of medication and surgery, pregnancy can become an option for otherwise infertile patients. Medications that encourage ovulation, combined with intrauterine implantation of a fertilised egg, can finally summon the positive pregnancy tests the patient has wanted. This may come as a relief to patients who have struggled with negative results on pregnancy tests for years, but the strain of pregnancy and childbirth may contribute to worse symptoms in the future.

It should also be considered that, while the initial news of positive results on pregnancy tests may lift endometriosis sufferers out of their mood swings and fatigue, the patient should be realistic about the challenges of raising a child (or children, if multiples) with such a life-altering disease. Pain medications and management can make raising a child difficult, not to mention fatigue, irritability, and pain while walking or running. Additionally, there is some evidence that endometriosis is genetically linked; women with a first-degree relative with endometriosis are about ten times more likely to present with the disease. In that sense, positive pregnancy tests should be considered with deliberation by the patient.

Other Aspects

Endometriosis, like chronic fatigue syndrome and fibromyalgia, may also have symptomatic chronic fatigue, mood swings, and back pain, among other symptoms. The stress and anxiety generated by repeated failures on pregnancy tests may cause depression, anxiety, or panic attacks. The stress generated by the children resulting from those positive pregnancy tests may cause the same effects!

With a successful pain control plan in effect, it is possible for a woman with endometriosis to live a happy and functional life. Attitude, communication, and adaptability are key. However, it is important to find a physician who believes and supports their claims, and will be ready to aid them, whether their goal is to improve fertility rates and "pass" pregnancy tests or simply get their pain managed enough to return to work.