Endometriosis affects millions of women globally, yet finding clear and reliable information to understand the condition, its diagnosis, and treatment can be challenging. To shed light on this topic, we spoke with Dr. Jessica Ryniec to help explain what endometriosis is, its treatment, and how it can impact your fertility journey.
Dr. Ryniec is a board certified OBGYN and reproductive endocrinologist. She currently practices at CCRM in their Boston and Falmouth, ME locations. Outside of caring for patients in the clinic, Dr. Ryniec is known for creating educational fertility content with a bit of added humor on her Instagram, @jessicaryniecmd.
Here’s what we asked Dr. Ryniec about Endometriosis:
1. We want to learn a little more about endometriosis. Can you give us a basic description of what goes on in someone's body when they have endometriosis?
Endometriosis is a condition where tissue that is similar to the lining of the uterus (the endometrium) grows outside of the uterus, often on the ovaries, fallopian tubes, and other pelvic organs like the bowel and bladder. Just like the endometrium in the uterus that grows and sheds in response to hormones, this tissue grows and sheds with the menstrual cycle- causing inflammation, pain, and possibly scar tissue.
2. What are some signs and symptoms of endometriosis? How is it diagnosed?
The most common symptoms are painful periods, chronic pelvic pain, pain during sex or pain with bowel movements or urination. Other symptoms can include lower back pain, leg pain, gastrointestinal (GI) issues like bloating, constipation, diarrhea, heavy menstrual bleeding, fatigue, and infertility. The only way to definitively diagnose endometriosis is with surgical visualization (often with laparoscopic surgery) and tissue biopsy to confirm the presence of the endometrial-like tissue [growing outside of the uterus]. However, anyone concerned about endometriosis needs a full medical history, physical examination, and possibly an ultrasound or even MRI. A review of these things may suggest a presumed diagnosis of endometriosis, which many people prefer to avoid surgery.
3. How prevalent is endometriosis?
Endometriosis affects about 1 in 10 people with female reproductive organs (assigned female at birth).
4. Does endometriosis have a cure? Or a treatment?
Unfortunately, there is no definitive cure for endometriosis. Treatment options include pain management with oral pain meds, hormone therapy that can suppress hormones and reduce or prevent the cyclical growth & shedding of the endometriosis implants, surgery with excision or ablation of endometriosis implants, or ultimately removal of reproductive organs. There are also some lifestyle changes that are beneficial like exercise, eating anti-inflammatory foods, and limiting foods that may trigger symptoms (for some individuals) like red meat, dairy, gluten, caffeine, and alcohol. Treatment for infertility related to endometriosis often includes assisted reproductive technologies like IUI or IVF.
5. Does having endometriosis mean that you will struggle with infertility?
Having endometriosis does not automatically lead to infertility, but it does increase the risk. In those with endometriosis, about 30-50% experience infertility. In those seeking treatment for infertility, about 25-40% may have endometriosis (and it is a common cause that is ultimately determined to be a factor for those with "unexplained" or "idiopathic" infertility).
Understanding endometriosis is the first step towards optimizing your personal health and beginning your fertility journey. Knowing the symptoms and treatment options will help you to have an informed discussion with your doctor about a personalized approach to your treatment.