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December 15, 2009
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Endometriosis

Medical Author: Melissa Conrad Stoppler
Medical Editor: William C. Shiel, Jr., MD, FACP, FACR

Doctor to Patient

Endometriosis and Infertility

Medical Author: Melissa Conrad Stöppler, MD
Medical Editor: William C. Shiel, Jr., MD, FACP, FACR

Pain from EndometriosisViewer Question: Will endometriosis affect my ability to have children?

Expert's Answer: The mechanism for impaired fertility may involve both anatomic distortion from pelvic adhesions, endometriomas, and the production of substances (for example, prostanoids, cytokines, and growth factors) which are "hostile" to normal ovulation, fertilization, and implantation.

There has been a long-running controversy regarding how endometriosis might be related to infertility. Endometriosis is more common in infertile compared to fertile women, but the condition usually does not fully prevent conception.

The reasons for a decrease in fertility are not completely understood, but might be due to both anatomic and hormonal factors. The presence of endometriosis may involve masses of tissue or scarring (adhesions) within the pelvis that may distort normal anatomical structures, such as Fallopian tubes, which transport the eggs from the ovaries...


Doctor to Patient

What is endometriosis?

Endometriosis is the growth of cells similar to those that form the inside of the uterus (endometrial cells), but in a location outside of the uterus. Endometrial cells are the same cells that are shed each month during menstruation. The cells of endometriosis attach themselves to tissue outside the uterus and are called endometriosis implants. These implants are most commonly found on the ovaries, the Fallopian tubes, outer surfaces of the uterus or intestines, and on the surface lining of the pelvic cavity. They can also be found in the vagina, cervix, and bladder, although less commonly than other locations in the pelvis. Rarely, endometriosis implants can occur outside the pelvis, on the liver, in old surgery scars, and even in or around the lung or brain. Endometrial implants, while they can cause problems, are benign (not cancerous).

Who is affected by endometriosis?

Endometriosis affects women in their reproductive years. The exact prevalence of endometriosis is not known, since many women may have the condition and have no symptoms. Endometriosis is estimated to affect over one million women (estimates range from 3% to 18% of women) in the United States. It is one of the leading causes of pelvic pain and reasons for laparoscopic surgery and hysterectomy in this country. While most cases of endometriosis are diagnosed in women aged around 25-35 years, endometriosis has been reported in girls as young as 11 years of age. Endometriosis is rare in postmenopausal women. Endometriosis is more commonly found in white women as compared with African American and Asian women. Studies further suggest that endometriosis is most common in taller, thin women with a low body mass index (BMI). Delaying pregnancy until an older age is also believed to increase the risk of developing endometriosis.



Next: What causes endometriosis? »

Endometriosis - Symptoms Experienced

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The symptoms of endometriosis can vary greatly from patient to patient. What were your symptoms?

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Endometriosis

Introduction

A sexual problem, or sexual dysfunction, refers to a problem during any phase of the sexual response cycle that prevents the individual or couple from experiencing satisfaction from the sexual activity. The sexual response cycle has four phases: excitement, plateau, orgasm, and resolution.

While research suggests that sexual dysfunction is common (43% of women and 31% of men report some degree of difficulty), it is a topic that many people are hesitant to discuss. Fortunately, most cases of sexual dysfunction are treatable, so it is important to share your concerns with your partner and doctor.

What Causes Female Sexual Problems?

Sexual dysfunction can be a result of a physical or psychological problem.

  • Physical causes: Many physical and/or medical conditions can cause sexual problems. These conditions include:

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