Can having endometriosis at 26 cause fertility issues?

Question

Hello doctor,

I am 26 and was diagnosed with endometriosis last month after years of experiencing severe cramps and very heavy bleeding during my periods. My cycles are completely irregular; sometimes they are 21 days apart, other times up to 45 days. The pain is so intense that I often miss work and need strong painkillers to get through it.

My biggest concern is whether this condition will affect my ability to have children in the future. I am hoping to start a family in the next two to three years, but I am scared that endometriosis might make me infertile.

What treatment options are available that could help preserve my fertility? Should I consider freezing my eggs now?

Please advise.

Answer 1

Hello,

Welcome to iCliniq.com.

I understand your concerns, and I want to reassure you that your worries are valid and important.

Based on the FIGO (International Federation of Gynecology and Obstetrics) classification of menstrual bleeding, your menstrual cycle is considered abnormal. Here is a breakdown:

Cycle frequency:

Absent (amenorrhea): No periods.
Frequent: less than 24 days.
Normal: 24 to 38 days.
Infrequent: More than 38 days.

Cycle duration:

Prolonged: More than eight days.
Normal: Up to eight days.

Cycle regularity:

Regular: Variation between shortest and longest cycles is less than nine days.
Irregular: Variation is more than 10 days.

Flow volume:

Heavy.
Normal or light.

Based on this classification, your cycle appears to be irregular and abnormal, which, along with your symptoms, is consistent with endometriosis.

To address your active symptoms of dysmenorrhea (painful periods) and irregular cycles, I recommend the following treatment:

Tablet Norethisterone 5 mg: Take one tablet three times a day continuously for three months.
Tablet Mefenamic acid 500 mg: Take one tablet twice a day for one week to manage pain.
Inomel-F Sachet (Myo inositol, Folic acid, Melatonin, and Vitamin D3): Take one sachet daily in the evening for three months. Consult your specialist doctor, discuss with him or her, and take the medicines with their consent.

These medications should help control your symptoms effectively. There is no need to consider egg freezing at this stage, as your condition is being actively managed.

Endometriosis is classified into four stages (grades 1 to 4):

Grade 1 and 2: Many women can conceive naturally or with the help of ovulation induction.
Grade 3 and 4: Assisted reproductive techniques like IVF (in vitro fertilization) may be necessary.

Please do not worry. With proper treatment and monitoring, many women with endometriosis go on to have successful pregnancies.

I hope this helps you.

Thank you.