Endometriosis can cause fertility problems. This is not fully understood, but is thought to be because of damage to the fallopian tubes or ovaries.
But not all women with endometriosis will have problems and will eventually be able to get pregnant without treatment.
Medication will not improve fertility. Surgery to remove visible patches of endometriosis tissue can sometimes help, but there's no guarantee this will help you get pregnant.
If you're having difficulty getting pregnant, infertility treatments, such as in vitro fertilisation (IVF), may be an option.
But women with moderate to severe endometriosis tend to have a lower chance of getting pregnant with IVF than usual.
Adhesions and ovarian cysts
Some women will develop:
- adhesions – "sticky" areas of endometriosis tissue that can join organs together
- ovarian cysts – fluid-filled cysts in the ovaries that can sometimes become very large and painful
These can both occur if the endometriosis tissue is in or near the ovaries.
They can be treated with surgery, but may come back in the future if the endometriosis returns.
Like all types of surgery, surgery for endometriosis carries a risk of complications.
The more common complications are not usually serious, and can include:
- a wound infection
- minor bleeding
- bruising around the wound
Less common, but more serious, risks include:
- damage to an organ, such as a hole accidentally being made in the womb, bladder or bowel
- severe bleeding inside the tummy
- a blood clot in the leg (deep vein thrombosis) or lungs (pulmonary embolism)
Before having surgery, talk to your surgeon about the benefits and possible risks involved.
Bladder and bowel problems
Endometriosis affecting the bladder or bowel can be difficult to treat and may require major surgery.
You may be referred to a specialist endometriosis service if your bladder or bowel is affected.
Surgery for endometriosis in the bladder may involve cutting away part of the bladder.
A tube called a urinary catheter may be placed in your bladder to help you pee in the days after surgery.
In a few cases, you may need to pee into a bag attached to a small hole made in your tummy. This is called a urostomy and it's usually temporary.
Treatment for endometriosis in the bowel may involve removing a section of bowel.
Some women need to have a temporary colostomy while their bowel heals. This is where the bowel is diverted through a hole in the tummy and waste products are collected in a bag.