Endometriosis, a disorder in which tissue that normally lines the inside of your uterus starts growing outside your uterus, affects between 2-10 per cent of the female population.

The painful conditions involves the misplaced tissue thickening, breaking down and bleeding with each menstrual cycle, causing scaring and adhesions to the surrounding tissue. Mary McAuliffe, Head of Clinical Service at Waterstone Clinic, leading fertility specialists with clinics nationwide, discusses the six things you need to know about endometriosis and your fertility.

1. Endometriosis can affect any woman. The primary symptoms of endometriosis are pelvic pain, heavy periods, bladder and bowel problems, fatigue and depression. Women with endometriosis typically describe menstrual pain that's far worse than usual, heavy bleeding, cramping and lower back pain that begins before your period and extends several days after. Some will even bleed between cycles. Frequently women with endometriosis can report discomfort during or after sex, and some will experience pain with bowel movements and urination during their period.
2. If you have any of the above symptoms, don’t wait until you start trying for a baby to get checked out. If you are thinking about starting a family in the future, we always recommend availing of a simple and cost effective fertility assessment. This will either reassure you that all is well, or inform you of an underlying issue.
3. Having endometriosis does not mean you are infertile. It is estimated that 60-70 per cent of women with endometriosis are fertile and can get pregnant without the need for medical assistance. But we would always recommend that if you have endometriosis that you start your family early, as the damage that endometriosis causes may get worse over time. You may also be recommended to take the oral contraceptive pill (if it is safe for you to do so) if you are not trying for a pregnancy as this can protect against some of the damage that can occur over time.
4. There’s no cure for endometriosis. Treatment is instead directed at minimising symptoms and include surgery, hormone treatments and pain relief. Surgery is advised with caution – as it can sometimes have a negative impact on ovarian reserve. If you are recommended surgery for endometriosis, it is advisable that you have this discussion with a fertility specialist first. Any surgery of this nature must be carried out with fertility preservation in mind.
5. There is a myth that pregnancy cures endometriosis… it does not. However, symptoms do improve during pregnancy. This is because higher progesterone levels can suppress the condition.
6. Fertility options are available if needed. As each case is different, and the degree to which this condition can affect your fertility will depend on its severity - minimal, mild, moderate and severe - which is diagnosed by laparoscopy, it’s best to speak to a fertility specialist on what would be the best treatment for you. For some women endometriosis can be diagnosed for the first time when they seek help in trying for a pregnancy, while for many others it is diagnosed much earlier when pain or other symptoms are investigated.

If you are suffering from endometriosis or are having problems conceiving, contact Waterstone Clinic directly at 0818 333310 to talk through your options, or visit www.waterstoneclinic.ie.