Endometriosis Affects Fertility

Endometriosis is often under-diagnosed. Here is what you can do if you suspect or have this condition.

Endometriosis is a serious health concern. It is underdiagnosed and overlooked frequently by medical providers. This painful menstrual condition can affect fertility and quality of life. In short, if you suffer from painful periods, painful sex, and ovarian masses, you might have endometriosis.

what is endometriosis?

I would call this condition a major health threat for women. This gynecologic disease occurs when the shedding of endometrial tissue is found within the abdominal cavity, outside the uterus. It is often accompanied by very painful periods and painful intercourse. You can have endometriosis for a long time and not know it. 

Firstly, bleeding outside the uterus can go undetected, as it would naturally be reabsorbed by the body with time. This is not to be confused with internal bleeding or blood loss, this is only when endometrial cells are outside the uterus. Those endometrial cells proliferate and shed blood during every menstrual cycle.

Secondly, there is not a good tool to diagnose endometriosis. It is an assumed diagnosis by symptoms alone. And, occasionally this take multiple office visits of complaints to your medical provider. However, endometriosis is only definitively diagnosed by surgery. A vaginal exam with a positive pain response, a long history of painful periods and painful intercourse is enough to assume a diagnosis of endometriosis.

Thirdly, there isn’t a great way to treat endometriosis. More on this later.

Why is this a health threat?

Endometriosis causes inflammation and irritation of the reproductive organs. Constant abnormal cells and tissue near the ovaries and fallopian tubes can cause scarring and alter the health of the ovaries. Most importantly, it can damage your fertility over time.

Endometriosis is an inflammatory process.¹

I have had patients that are only in their twenties suffer from severe endometriosis (category 4) and have infertility problems. The best they can do is protect their fertility now is by freezing eggs and going on long-term birth control therapy.

Endometriosis alters the cell structure of ovarian tissue.¹ It also can disturb embryo implantation.¹

Disturbingly, endometriosis is associated with a higher number of miscarriage rates.²

So, What are the ways to trEat it?

Medical providers recommend birth control to reduce the number of periods experienced and to help control the bleeding. This will help for only the time you are on birth control. It does not help the long-term effects of endometriosis and inflammation of your reproductive tract. Surgery is considered a final step and is done minimally. Primarily, it is used to eliminate the scar tissue and reduce pain symptoms. Laparoscopic surgery is used to effectively remove the endometrial tissue and overgrowth occurring within the abdomen.

Therefore, if you have been trying to get pregnant on your own and suffer the symptoms above, it is recommended you talk to your medical provider. They can perform the fine, precise surgery to eliminate most of the scar tissue and endometrial cells. If you have a severe case of endometriosis, they might recommend fertility preservation.

You may need assistance in getting pregnant.

Assistance sounds scary, but if you have severe scarring and degradation of your tubes and ovaries, this might be the only way to get pregnant. Women may need to stimulate their ovaries in order to retrieve and fertilize eggs into embryos for later implanting.

So, what you can do now is get that severe pain checked out by a medical provider. Numerous other conditions (like irritable bowel syndrome and gallstones, etc.) mimic endometriosis pain. Having a thorough workup for all abdominal pain involving your reproductive system is important.

Follow a low-inflammatory diet to reduce overall bodily inflammation. Lead a low-stress life. Take CoQ10 to reduce oxidation and improve long-term ovarian cells quality. Supplement with fish oil as seen as beneficial in endometriosis in this study. ³

But, overall, seek help from a reproductive endocrinologist. They can categorize the severity of endometriosis and can properly manage it in order to achieve pregnancy. The younger a woman is in diagnosing the condition and treating it, the higher the chance of pregnancy in the long run.

This is not intended to replace medical advice. Please consult with your medical provider for your medical care.

¹Endometriosis and infertility: A committee opinion. (2012). Fertility and Sterility,98(3), 591-598. doi:10.1016/j.fertnstert.2012.05.031
²Schwartz, A. S., Wölfler, M. M., Mitter, V., Rauchfuss, M., Haeberlin, F., Eberhard, M., . . . Leeners, B. (2017). Endometriosis, especially mild disease: A risk factor for miscarriages. Fertility and Sterility,108(5). doi:10.1016/j.fertnstert.2017.08.025
³Herington, J. L., Glore, D. R., Lucas, J. A., Osteen, K. G., & Bruner-Tran, K. L. (2013). Dietary fish oil supplementation inhibits formation of endometriosis-associated adhesions in a chimeric mouse model. Fertility and Sterility,99(2). doi:10.1016/j.fertnstert.2012.10.007


  1. Shanna says:

    I found out I have endometriosis 1 year ago…I am trying to get pregnant since but it’s just not working…I dont have a painful period…..some times I trouble with a lower back pain and abdomen pain but it hardly affect me painful

    1. Chloe Quinn RN, ARNP, WHNP-BC says:

      Every woman can be affected differently. It’s good to hear that you don’t experience pain! Best of luck in getting pregnant!

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