Endometriosis lesions can, as you know, strike many different areas of your pelvic region, but the ovaries — which are, of course, crucial for conception — are the most commonly affected, while the fallopian tubes also often "fall victim" to endometrial proliferation. Anywhere up to half of all endometriosis patients struggle to conceive, and this can be because:
- The inflammation associated with endometriosis can have a negative impact on your ovarian reserves.
- Endometriosis-related inflammation can prevent sperm and egg from meeting.
- Endometrial build-up in the fallopian tubes can lead to scarring and blockage.
Although at least half of endometriosis patients will not face infertility struggles, especially if they have Stage 1 or Stage 2 endometriosis, options are available to those who are not getting pregnant naturally. These are the laparoscopic removal of endometriosis lesions, intrauterine insemination, and IVF. Of these, IVF offers the highest chance of pregnancy. IVF is slightly less successful in women with endometriosis than in those undergoing it for other reasons, however.
Ovarian cysts, adhensions, and polyps
Women with endometriosis lesions around the ovaries have a higher risk of developing ovarian cysts, adhesions, and polyps. Surgical treatment can correct them, but recurrence is not uncommon.
Ovarian cysts, fluid-filled sacs in the ovaries, aren't rare in women who don't have endometriosis either, and most such cysts eventually go away on their own without treatment. Some cysts continue growing, however, potentially causing a lot of pain. In endometriosis patients, scar tissue, endometriosis-related ovarian bleeding, and adhesions contribute to the risk of ovarian cysts. Large, painful cysts and cysts that may be malignant should be removed.
Adhesions — structures that form from scar tissue that then causes abnormal attachments between and within organs — can be milder or very dense. In endometriosis patients, they can result both from damage caused by the disease itself and from surgery to remove endometrial lesions. Notoriously tough to diagnose through ultrasound and other imaging techniques, laparoscopy is the only reliable way to confirm their existence. The main symptom is pain, and adhesions can be removed surgically.
Polyps are benign growths of the uterine lining that typically remain asymptomatic. They can, however, be associated with bleeding between menstrual periods and pain during and after sex — two symptoms that are already frequently seen women with endometriosis. Polyps do not always need to be removed, but if they're making your life difficult, they can be.
How endometriosis can affect the bowel and bladder
Endometriosis lesions can appear in many different parts of the pelvic region, and the bowel and bladder are no exception. Endometriosis at these sites can, however, require extensive surgery. To treat bladder endometriosis, a surgical procedure in which a part of your bladder is removed may become necessary; patients can expect to need a urinary catheter for several days while they recover. In a case of bowel endometriosis, lesions are removed from the bowel without changing anatomical structures wherever possible, resections are sometimes the only viable option. This means that part of your bowel may have to be taken out, after which the remaining healthy sections are reattached. In some cases, a temporary colostomy is required during recovery.
Allergies and asthma
Many endometriosis suffers additionally have allergies, research indicates, and the following allergies have been shown to occur more frequently in women with endometriosis:
- Sinus allergic rhinitis
- Allergies to medications
Women with endometriosis are also more likely to have asthma as well as a family history of various allergies.
Autoimmune diseases: Multiple sclerosis (MS), lupus, and hyperthyroidism
Some studies suggest that endometriosis makes developing multiple sclerosis, Sjögren syndrome, and lupus between seven and 24 times more likely, though other research has different findings. This increased risk is probably caused by molecular differences that change immune system function, but the exact mechanism isn't well understood as of yet. The link between lupus and endometriosis requires further study, but since research does show that many endometriosis patients have the kind of musculoskeletal symptoms seen in lupus, this certainly deserves a closer look.
As for thyroid disease and endometriosis, one study showed that hypothyroidism (slow thyroid), including Hashimoto's thyroiditis, is more common in endometriosis patients, while another demonstrated that women with endometriosis are more likely to suffer from Grave's disease, which causes hyperthyroidism (fast thyroid).
Fibromyalgia and chronic fatigue syndrome
Fibromyalgia and chronic fatigue syndrome have both been said to fall into the umbrella category of "central sensitivity syndromes", conditions in which the central nervous system has a heightened response to various stimuli, including pain, noise, and light. Both fibromyalgia and chronic fatigue syndrome have some overlap with endometriosis, and that may be because endometriosis falls into the same category, something that should further be explored.
One study found that:
- Endometriosis sufferers have chronic fatigue syndrome at more than 100 times the rate of the rest of the population.
- Endometriosis is associated with double the risk of developing fibromyalgia, a chronic pain syndrome.
- One in five endometriosis sufferers had at least two other diagnoses, and of those belong to that group, nearly a third was affected by chronic fatigue syndrome or fibromyalgia.
It is important to note that the link between endometriosis and most of these cancers is very much inconclusive, with the exception of ovarian cancer — in most cases, some research has found a correlation, while other studies found no connection.
Endometriosis has been shown to be correlated with a slightly higher risk of ovarian cancer time and time again — at 1.8 percent in the general female population vs 1.8 percent in endometriosis patients, this risk is small but significant. The kinds of ovarian cancer that are more frequent in endometriosis patients — ovarian clear cell cancer and endometrioid ovarian cancer — are often diagnosed earlier on and are associated with a higher chance of successful treatment than other types.
Several studies have suggested that endometriosis is also associated with a higher rate of breast cancer, but other research either found no such increased risk or even indicate that women with endometriosis could have a lower risk of breast cancer. This link has, as such, not been confirmed.
Endometrial and cervical cancer
Some women with endometriosis may worry that their condition places them at a higher risk of developing endometrial or cervical cancer. Although further study is required in this area in order to reach a stronger conclusion, existing research has found no association between endometriosis and these kinds of cancer, while it is even possible that endometriosis patients actually have a lower incidence of cervical cancer than the general population.
The link between melanoma, a form of skin cancer, and endometriosis has been researched quite extensively, but with inconclusive results. Again, some studies suggest that endometriosis may increase your risk, though others find no connection between the two conditions at all.
Women with endometriosis sometimes have humoral immune abnormalities, which can cause Immunodeficiency, and research indicates that there is a possible connection between B-cell activation in endometriosis suffers and subsequent B-cell lymphoma. Further research is necessary to explore this link.