Opinions please.

[BlackCat]

Im just after some opinions really...

Short back story is this... have had painful periods for over 3 years, to the point where I am doubled over in pain and unable to function to perform every day tasks. Have also for around the same time frame had painful bowel motions and passing of gas but only when I have my period.

Went to GP1 and they prescribed Ponston for pain relief and to go onto the pill. Which I did. Problem solved...

Recently went off the pill and all the symptoms are still there! So went to GP2 who believes that there may be an underlying cause of endometriosis but the only way to know for sure is a laproscopy(?).

Now GP2 also gave two options to me... If I am done having children there is really no need to go through the diagnostic process and I can just keep on the pill and pain relief as it works efficiently for me in masking the symptoms.
However, if Im not done having children, then she recommended checking things out to see if this is the case for me as there is a "theory that it could affect fertility" (her words) for later on... and hopefully if it could be removed then the pain for TTC would hopefully be much better.

Im not sure which to do. Im undecided about more children, but Im not keen on the procedure to diagnose either.

WDYT? Is it really that likely that if I do have it that it will effect fertility? I had no issue conceiving before (last in my early 20s have only had this issue since after they were born) and Im now in my late 20s.

Thanks

[Mummy&Daddy2Be]

may i ask why did you go off the pill? are you possibly thinking of TTC again? or just wanting to see if the pain would come back etc?

i personally wouldn't want to "mask the pain" with the pill + pain relief (even if i didn't want another baby) because i would worry way too much and think something is wrong with me :/. if you're only in your late 20's i still believe there may be a chance down the track that you will want to TTC again.

in the end it's your decision what does your DH think?

[juniper76]

In my case, it absolutely, 100%, definitely affected my fertility! I cannot stress that enough. It sounds like your GP was downplaying the risk. Yes, many women with endo have no difficulties conceiving, but many of us have great difficulty! "A theory" my a***. Ugh, that makes me so angry!

I had suspected endo since my early 20s based on symptoms similar to yours, but was told by countless Drs that my pain was "normal". I wish I could go back and (metaphorically) slap them all in the face for putting me through 10 years of unnecessary pain. I would spend 3 days every cycle curled up in a ball unable to function. I could not leave the house, let alone go to work.

When we started seeing a FS after 1 year of TTC, I asked about endo and he dismissed it. We did 2 years of treatments with that Dr and he repeatedly refused to do a lap to check for endo. We spent a fortune on 6x IUI, 4x IVF and 1x FET! In between IVF#3 and #4, I started acupuncture and we managed to get our first ever BFP (natural conception), which ended in m/c. Did you know endo increases the risk of m/c? I was very, very angry when I found that out.

After 2 years (so 3 years TTC total) we changed to a new FS. Within 5 mins of meeting me, he said it was "very likely" I had endo and I was immediately booked in for a lap. He found severe endo and told me that one day I will need to have part of my bowel removed due to the damage caused by the endo. Thankfully, that day has not yet arrived (I had a second lap 2 months ago to check on it). 2 months after the lap, we did our first IVF with the new FS (#5 overall) and that gave us DD. I firmly believe that the lap is the only reason we have DD. Without that lap, I have no doubt we'd have had yet another BFN and would have given up by now, resigned to a childless life.

If you don't want to TTC again, I'd still seriously consider having the lap (ideally with the best endo surgeon to whom you have access, because they'll remove the most possible with the lowest risk of collateral damage). Based on your symptoms, I'd say there's a good chance that you'll have endo on your bowel and it will be best for you to have that treated sooner rather than later, so that it doesn't have time to progress. Fertility aside, endo causes organ damage. It is better for your long-term health to have it removed.

If you may want to TTC again, then I'd definitely do the lap. Endo is linked to diminished ovarian reserve and egg damage.

All of that said, it is a surgery and there are risks, so you need to carefully consider your situation and decide whether those risks are worth the return for you. If you are uncertain, get a second opinion (from someone who specialises in endo, not a regular GYN). Heck, if you need to, get a 3rd and 4th opinion.

If you decide to go ahead, get the best surgeon you can. It is worth it. Get someone who is skilled in removing endo, not just someone who will do an exploratory lap to diagnose and leave it untreated. You want a surgeon with the advanced laparoscopic skills to remove as much as possible.

[faye*]

It definately sounds like endo to me and my opinion would be to go ahead with the laparoscopy before it gets any worse. I had a diagnostic lap done in February and just had another lap to remove severe endo 3 weeks ago. If you hold off it may go through the wall of the bowel resulting in having to have a bowel resection. I didn't find the procedures that bad. I was feeling really good after about a week and was totally back to normal within 2 weeks. A bit of discomfort for a short period of time was so worth it for me... My endo has definately affected my fertility - I have been TTC for years with no luck and am starting IVF next week. So in a nutshell whether you intend on having more children or not I would say the surgery is the way to go.

[BlackCat]

Thank you for the replies. Thats very helpful information Juniper and Faye.

[k4t]

I may be wrong but I thought the fertility benefits of having laparoscopic removal of endo decrease with time. So if you want to conceive soon by all means have a lap but if you don't want to for a couple of years then go on the pill for now and consider laparoscopy then. Either way it sounds like referral to a Gynaecologist who has an interest in endo would be a good idea.

[juniper76]

I may be wrong but I thought the fertility benefits of having laparoscopic removal of endo decrease with time. So if you want to conceive soon by all means have a lap but if you don't want to for a couple of years then go on the pill for now and consider laparoscopy then. Either way it sounds like referral to a Gynaecologist who has an interest in endo would be a good idea.

Yes, the endo does usually grow back, so there is a "window of opportunity" for full benefit for your fertility. For some women it's as little as 6 months, for others it can be many years. However, if you wait, say, 2 years to TTC, should you therefore allow the endo to do 2 years of extra organ damage before treating it? It will still be there doing damage while on BCP. It may (or may not?) be slowed down, but it will still be there, progressing...

[BlackCat]

Thanks guys, you've given me a lot more to think about and consider. My family are all for me doing the surgery but Im very reserved about it. I know it should be nothing to worry about, that they do this sort of thing all the time etc, but I just don't trust the medical profession anymore really. So it feels like a really big thing. I know the pill treatment is essentially just buying myself a little time, it would be nice to feel "normal" again even for a little while and have a definite 'your not going crazy there is a reason' answer.

Thanks again