The American Society for Reproductive Medicine (ASRM) states: many women have pain in their pelvis (lower part of the belly) from time to time, usually during their period. However, if you have daily pelvic pain, it could be a sign of a bigger problem with your bladder, bowels, reproductive organs, or pelvic muscles. Many conditions cause pelvic pain, including endometriosis, adhesions, chronic appendicitis, or hernias. Sometimes medication is necessary to treat the problem; other times surgery is needed.
Endometriosis: Endometriosis can cause daily pelvic pain, painful periods, and pain during bowel movements or sex. Having endometriosis can also make it harder for you to get pregnant.
Pelvic adhesions (scar tissue): Adhesions in and around the pelvic cavity may form if you have endometriosis, a pelvic infection, surgery on your pelvis, a cyst on an ovary, or have had surgery on your pelvis. Scar tissue causes organs that normally are separate from each other to become attached. For example, your ovary can be attached to your bowel, and your doctor will separate the adhesions with laparoscopic scissors to help relieve pain. This seems to work best when the adhesions are not too severe.
Endometriosis is a disorder of the female reproductive system in which endometrial tissue (the normal lining of the uterus) is found outside the uterine cavity. An estimated three to five million American women of reproductive age suffer from endometriosis. This disease is prevalent in women 30-40 years of age, though it can begin in the late teens and early twenties. About 40% of patients with endometriosis will experience some degree of infertility.
The relationship between endometriosis and infertility is not completely understood. The primary cause of infertility resulting from endometriosis appears to be a blockage caused by scarring and adhesions in the tubes. These adhesions can prevent the egg and sperm from meeting or prevent the fertilized egg from moving down the tube normally (resulting in an ectopic pregnancy).
The other connection between endometriosis and infertility is the generalized effect or irritation of the endometrial tissue causing the fimbriae ( fallopian tube fingers which pick up the egg) not to perform properly in allowing the egg and the sperm to meet.
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