Unlike other conditions that can sometimes resolve by themselves, endometriosis is a condition that doesn’t because it’s progressive, unless in very rare cases where it’s mild. Most endometriosis treatments often just manage pain enough to get through each day. This can create a gap for long-term disease management that can actually preserve reproductive health. When endometriosis is left untreated, a variety of complications can arise that have serious and potentially debilitating long-term consequences.
INFERTILITY
It’s estimated that between 30% and 50% of women with endometriosis will experience infertility. The mechanism for why this happens can vary widely between women. Common links include:
- Distorted pelvic anatomy caused by adhesions that make conception more difficult.
- Inflammation that may impact fallopian tube function or embryo development.
- Triggering of antibodies that impair receptivity to embryo implantation.
- Endocrine and ovulatory disorders that contribute to abnormal follicular growth or luteal phase dysfunction.
- Impaired implantation.
- Poor embryo quality.
When endometriosis is a suspected cause of infertility, laparoscopic confirmation is necessary to plan the next steps. Common signs that you’re experiencing endometriosis-related infertility include painful and heavy menstrual cycles, chronic pelvic pain, spotting between periods, gastrointestinal symptoms like bloating and diarrhea, and painful intercourse. Endometriosis-related infertility should also be considered in cases when conception does not occur after six to 12 months.
CHRONIC PELVIC PAIN
When endometriosis is left untreated, it’s very common to experience pelvic pain that becomes more severe and chronic over time. The pain is a symptom of the chronic inflammation experienced when tissue grows outside of the uterus. Generally, the pain intensifies during menstruation because of extra nerve irritation. However, adhesions and nerve growth can make pain a constant presence even outside of menstruation. When tissue grows beyond the uterus, the blood that is released during menstruation has nowhere to go. It can pool within the scar tissue to cause inflammation, acute irritation, and the development of large blood-filled cysts called endometriomas.
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MENTAL HEALTH DETERIORATION
The mental health toll of endometriosis is severe. Women who have endometriosis develop psychological distress at higher rates. This puts them in a high-risk category for things like anxiety, depression and stress-related disorders. Some research shows that half of all women with endometriosis have depressive symptoms. Another 30% to 40% of women show clinically significant anxiety levels.
The link between endometriosis and mental health has many connection points. For many women, the frustration and despair that come from not being believed about their symptoms can cause isolation and hopelessness. Social withdrawal is a very real threat to mental health for women who live with this condition. Additionally, we know that elevated stress responses and hypothalamic-pituitary-adrenal (HPA) axis dysregulation are linked with the development of mood disorders.
OVARIAN CANCER RISK
There is a known elevated risk for ovarian cancer when endometriosis is left untreated. While risk factors can vary by person, it is highly advisable to undergo regular screenings as part of endometriosis management. While the risk deserves attention, it’s still important to note that the vast majority of women with endometriosis will not develop ovarian cancer.
It appears that women with deep and infiltrating endometriosis or cysts have the highest chance of developing ovarian cancer. The risk appears to come from the elevated estrogen levels and chronic inflammation that are characteristic of endometriosis.
BLADDER AND BOWEL COMPLICATIONS
When uterine tissue grows outside of the uterus, it often adheres to other organs like the bladder and bowel. In the early stages, this often leads to feelings of pressure or pain. These symptoms are often mistaken for irritable bowel syndrome (IBS) or bladder infections. Common signs that scarring is affecting the bladder or bowel include diarrhea, constipation, feelings of “fullness” in the bladder or bowel, painful bowel movements, painful urination, or urinary urgency. In some cases, symptoms may be cyclical with menstruation. When endometriosis is left untreated, it’s possible for scarring to become so severe that symptoms become constant.
When endometriosis is left untreated, no part of a woman’s health is left untouched. That’s why an accurate and early diagnosis is so important. Treating endometriosis isn’t just important when you’re trying to conceive. It is also critical for maintaining your reproductive, sexual, and overall health at every stage of life. Dr. Michael Tahery is an Obstetrician-Gynecologist (OB-GYN) with subspecialty in Advanced pelvic surgery and Urogynecology in Los Angeles and Glendale, CA, with more than two decades of experience in diagnosing and treating endometriosis, and other complicated gynecological disorders, urogynecology, and cosmetic care. Dr. Tahery offers a personalized approach to treating endometriosis based on its progression in each patient. Book a consultation today.