But what is endometriosis exactly? Endometriosis is a condition where the tissue that normally grows inside the womb, also grows outside the womb. The most common places where endometriosis occurs are the ovaries, the Fallopian tubes, the bladder, the bowel, and the areas in front, in back, and to the sides of the uterus. It has also been found in liver tissue, the diaphragm, lungs, and even the brain! We don’t know exactly why it happens, but there are a few theories. One of the theories is retrograde (backwards) menstruation. When a woman has her monthly period, the menstrual fluid (which contains endometrial cells) flows not only through the vagina, but also Fallopian tubes. The endometrial cells then start to grow in those different locations. Another theory suggests that normal inner abdominal lining, for whatever reason, undergoes a conversion into endometriosis. This condition may be associated with cyclical and long-term pelvic pain, abnormal vaginal and rectal bleeding, and can also result in reduced fertility, which will be the focus of this article. Reduction of fertility can occur through damage to the normal anatomy, but also increased production of inflammatory chemicals released by endometriosis cells. Some of the damages to the normal structures of reproductive organs include blocked Fallopian tubes, scar tissue formation, as well as development of endometriosis cysts in the ovary - so called “chocolate cysts” or endometrioma. The thick fluid filling the cyst is basically old blood produced by endometriosis cells, and resembles chocolate, hence the name. Unfortunately, this is not the only way that endometriosis can affect a woman’s fertility. Endometriosis cells also release chemicals that adversely reduce the quality of the eggs, creating a hostile environment for a growing embryo. Pain associated with endometriosis can also indirectly reduces fertility, with the reduction of libido and frequency of sexual intercourse. Dr Erlich Sem, Obstetrician & Gynaecologist pindaramagazine.com.au Pindara Magazine 43
Pindara Private Hospital Magazine - Issue Nine
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