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Past Article of the Month
Originally Published 01/08/2012
The Psychological Impact of Endometriosis
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<b>Endometriosis: What Is It?</b>
Endometriosis occurs when the tissue that lines the uterus (the endometrium) grows outside of it: on the ovaries, the fallopian tubes, or the outer wall of the uterus. In a normal menstrual cycle, your hormones cause the endometrium, or lining of the uterus, to thicken in preparation for an embryo. If a pregnancy does not occur, the endometrium breaks down and is passed as menses. If endometrial tissue is outside the uterus, the same hormones cause it to thicken as well. Problems occur because the tissue outside the uterus does not pass out of your body as a period; it can create scar tissue, damaging the ovaries and/or the fallopian tubes. As a result, getting pregnant may prove more difficult. A diagnosis of endometriosis does not mean you cannot conceive, but it does mean that it will most likely be more difficult.
<b>How Do I Know If I Have It?</b>
Endometriosis can be tricky to diagnose. For some women, endometriosis causes painful periods and/or pain during ovulation. Pain may occur during sex, others may experience it as rectal pain. The hurt can range from mild to severe, but surprisingly, there are many women who feel no pain at all. Because of this, women may not know anything is wrong until they have problems getting pregnant. Indeed, sometimes the only symptom of endometriosis is infertility.
The definitive test for endometriosis is a laparoscopy: a surgical procedure in which a small incision is made in the belly through which a thin lighted tube is inserted. This allows the doctor to see what is actually going on internally. Your doctor may also be able to remove scar tissue with this same surgery.
<b>What is the Treatment for Endometriosis?</b>
Aside from the surgical removal of scar tissue, birth control pills can help shrink its growth. The idea is to try to control the hormonal surges that cause the endometrium to grow. Obviously, if you want to get pregnant, taking birth control pills is the last thing on your mind. Your doctor will try to regulate your condition to optimize your chances of conception. With controlled ovarian stimulation, you may be able to better manage the endometriosis, and with in vitro fertilization (IVF), you can bypass damages that may have occurred to your ovaries or fallopian tubes. It is essential to consult with your doctor about the risks/benefits of IVF, as the medications to stimulate your ovaries can actually worsen the condition of endometriosis. Remember that endometriosis does not necessarily mean that you cant have children; the road there may just be more bumpy.
<b>Emotional Reactions to Endometriosis</b>
If you have known about your condition for a long time, you may feel better prepared for the emotional upheaval of infertility. Knowing that it may be difficult to conceive, your expectations may already be lower. No doubt you are still saddened by your condition, but you may have had time to process and grieve before you reach the point of seeking medical intervention to create your family.
If, however, you have had no symptoms and find out about your condition through a fertility workup, you may be extremely shocked: that you have a disease, that your body is not working the way you thought it would, and that akin to cancer there is something growing inside you that you had no previous knowledge of. You may walk into a laparoscopic procedure thinking of yourself one way, and leave with a totally different understanding of yourself. Not only are you coping with the losses of infertility, but you must also contend with the shift in your sense of self, and the medical interventions that endometriosis necessitates.
With endometriosis there can be feelings of inadequacy, that somehow you are less of a woman because of it. You may also worry that your partner will feel differently about you, as if you were damaged goods. In reality, neither of these concerns is true. It can help to remind yourself of all the other parts of you: your intellect, your wit, your warmth, your caring. None of this can be extinguished because of endometriosis or infertility. Although your path to parenthood may have hit a roadblock, it doesnt mean that you are at a dead end. Processing your feelings with your partner, close friends, a support group, or with a mental health professional can help you cope with your sense of loss, allow you to open up to new possibilities, and remember all that you are.
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