What is endometriosis? According to Dr. Estil Strawn, professor of obstetrics and gynecology at the Medical College of Wisconsin and director of Froedtert Hospital’s Reproductive Medicine Center, endometriosis is most likely a genetically inherited disease where some of the blood during a woman’s menstruation cycle gets backed up and is not released from the body.

“For some reason, women with endometriosis have lost the ability to get rid of this blood,” says Dr. Strawn. “This blood then changes in the body and implants itself and grows on various other parts of the anatomy, such as the uterus, ovaries, fallopian tubes, intestines, rectum, etc. Once this blood changes and implants itself it can cause scarring and alterations in a woman’s anatomy.” He says that for the majority of women, endometriosis affects the fallopian tubes, uterus and ovaries.

Endometriosis then becomes a concern for women when the endometriosis causes enough distortion of the female anatomy to cause extremely painful menstrual cramps, painful intercourse or severe pelvic pain, says Dr. Strawn. He pointed out that this is not the type of cramping that can be calmed by an over-the-counter medication, such as ibuprofen, and then life goes on. This type of cramping is so severe it literally disrupts the daily lives of these women. They simply cannot do the things they would normally do. And for some, intercourse has become so painful that they just don’t want anything to do with it.

If you are suffering from any of these symptoms you may want to consult your physician to find out what is the exact cause of your extreme discomfort. It may not be endometriosis. It could be something else that has similar symptoms.

For those women with endometriosis, it can affect the chances of conceiving a child; however, usually this is only in the extreme cases of the disease. When infertility issues do occur due to endometriosis it is usually because of one of the following:

–The fallopian tubes have become so blocked or damaged that it disrupts the transportation of the eggs or sperm.

–The ovaries have been affected to the point that it disrupts the eggs development or release.

–The uterus is affected causing problems with the implantation of fertilized eggs.

One very important point Dr. Strawn wants every woman to know is, “Just because you might have endometriosis, it doesn’t mean you’ll have infertility issues.” In fact, he said a woman could get pregnant, have a normal pregnancy and not know she has endometriosis until she is diagnosed during her C-section delivery.

Dr. Strawn says endometriosis can only be diagnosed during a surgical procedure, such as a C-section, abdominal surgery or a laparoscopy, which is when a small camera is inserted into small incisions in the abdomen allowing the doctor to look for any abnormalities. In other words, endometriosis can only be determined and verified through a surgical diagnosis.

When trying to determine the best form of treatment, Dr. Strawn says it depends on a patient’s primary desired result. “If the patient’s primary focus is to address the pain then we would use a combination of medical and surgical procedures.” In most cases, birth control pills or hormonal manipulation is used to medically treat endometriosis. Surgically, a patient may have an outpatient surgery where the doctor uses laparoscopy to remove most of the scar tissue in the distorted or affected area, or a patient may have a laparotomy, where the abdomen is cut opened like a C-section and the endometriosis is then removed.

“If the patient’s primary focus is infertility then in vitro fertilization is recommended,” says Dr. Strawn. “In some cases, surgery can repair the anatomy enough to allow for regular fertilization and pregnancy; however, in the worst cases, in vitro is the best option.”

In any case, Dr. Strawn says, “Patients need to be their own advocates. Endometriosis is often diagnosed in the teenage years. For these women, they should be seen by a doctor who is empathic to their concerns, pain and discomfort.”

“Although most doctors can help a woman suffering from endometriosis, women with severe forms of the disease need to see a sub-specialist in the area of reproductive endocrinology and infertility,” says Dr. Strawn. This will give them the best chance of conceiving a child.