Endometriosis is a condition where tissue similar to the lining inside the uterus grows outside of it. This misplaced tissue can be found in various areas of the body, most commonly within the pelvic region. This article explores the impact of untreated endometriosis over time.
How Endometriosis Progresses Without Treatment
When endometriosis is left untreated, the endometrial-like implants continue to grow and spread beyond their initial locations. This progressive growth often occurs in the pelvic cavity, affecting organs such as the ovaries, fallopian tubes, and the outer surface of the uterus. The presence of these implants triggers a chronic inflammatory response within the body.
This ongoing inflammation leads to the formation of scar tissue, known as adhesions. These fibrous bands can cause organs to stick together, distorting normal anatomy and restricting organ function. The misplaced tissue responds to hormonal changes during the menstrual cycle, thickening and bleeding like the uterine lining. Since this blood has no exit, it leads to internal irritation, cyst formation, and further scar tissue development, including fluid-filled cysts called endometriomas, most commonly found on the ovaries.
Impact on Fertility and Pregnancy
Untreated endometriosis can significantly affect a person’s ability to conceive, with fertility challenges affecting approximately 30% to 50% of individuals with the condition. The chronic inflammation caused by endometrial-like implants creates an environment that can be hostile to both eggs and sperm, potentially impairing their quality and function. Adhesions, or scar tissue, can physically block or distort the fallopian tubes, which are essential for egg transport from the ovaries to the uterus. This physical distortion can prevent the egg and sperm from meeting or hinder the passage of a fertilized egg.
Endometriomas, the cysts that form on the ovaries, can also negatively impact ovarian function and diminish ovarian reserve. Beyond conception difficulties, untreated endometriosis may also be associated with certain pregnancy complications. There can be an increased risk of ectopic pregnancy, where a fertilized egg implants outside the uterus, and a higher chance of miscarriage. Some studies suggest an elevated risk for conditions such as placenta previa, preterm birth, and low birth weight, along with a higher likelihood of needing a cesarean delivery.
Living with Persistent Pain
A significant consequence of untreated endometriosis is the experience of persistent and often severe pain. This pain can manifest in several forms, including dysmenorrhea, which is severe menstrual pain that can worsen over time. Many individuals also experience chronic pelvic pain that is not directly tied to their menstrual cycle.
Painful intercourse is another common symptom, with deep pain during or after sex affecting about 50% of those with the condition. The growth of endometrial-like tissue on or near the bowel and bladder can lead to painful bowel movements or urination, particularly during menstrual periods. This persistent pain can severely diminish a person’s quality of life, impacting daily activities, work productivity, and personal relationships. The chronic nature of the pain and the unpredictability of symptoms can also contribute to fatigue, anxiety, and depression, affecting overall mental well-being.
Complications Beyond Pelvic Organs
While endometriosis primarily affects organs within the pelvis, if left untreated, it can, in rare instances, spread to other areas of the body. For example, endometrial-like tissue can grow on or near the bowel or rectum. This can lead to symptoms such as painful bowel movements, constipation, diarrhea, and abdominal bloating.
Similarly, the bladder can be affected, causing pain during urination or, less commonly, blood in the urine. In very rare cases, endometriosis can spread to the diaphragm or lungs. Symptoms in these areas might include chest pain, shortness of breath, or coughing up blood, often coinciding with menstruation. Other uncommon sites of involvement include the liver, umbilical region, or even around the sciatic nerve.
Importance of Early Diagnosis
Seeking medical attention for symptoms that might suggest endometriosis can mitigate its potential progression. Early diagnosis and appropriate management can prevent or reduce the severity of complications. Early intervention can slow or halt the growth and spread of endometrial-like tissue and adhesion formation.
Receiving a timely diagnosis can improve the chances of effectively managing pain and preserving fertility. An early understanding of the condition allows individuals to make informed decisions about their health journey.