There are a number of possible complications of endometriosis.
The primary complication of endometriosis are fertility issues. This can manifest as subfertility, or trouble in getting pregnant, or infertility, i.e. not being able to get pregnant at all. In some cases, adhesions or ovarian cysts could be factors. Endometriosis is thought to be responsible for about one-third of cases of infertility in women. While it rarely causes a total inability to conceive, it can contribute to the issue of infertility in both direct and indirect ways.
Endometriosis complications related to infertility can occur in the following ways:
• Adhesions forming among the ovaries, uterus and fallopian tubes can impede transfer of the egg to the fallopian tube.
• Implants occuring in fallopian tubes may block the egg's passage.
• Implants occurring within the ovaries can prevent release of the egg.
The longer a woman has endometriosis, the higher the risk of their fertility being affected.
However, there are many variables at play, and up to 70% of women with mild to moderate endometriosis may still be able to get pregnant. Additionally, pregnancy has been known to reduce the symptoms of endometriosis, however the symptoms often return when the menstrual cycle resumes. Surgery may improve fertility through the removal of endometriosis tissue, however this is no guarantee that a pregnancy will result.
Ovarian Cysts and Adhesions
Other issues and complications can include the formation of adhesions, or "sticky" clumps of endometriosis tissue that can actually fuse organs together. Ovarian cysts, which are fluid-filled cysts within the ovaries, can occur if the endometriosis tissue accumulates in or around the ovaries. In some cases, ovarian cysts can become quite large and quite painful.
Both of these complications can be addressed through surgery, however the symptoms may recur if endometriosis returns.
Pelvic pain is the most common complaint of women with endometriosis. In some cases, pain levels can significantly impair quality of life. Adhesions, or the dense areas of scar tissue that can attach to internal organs, can be the root cause of significant pain. Tissue can also occur in the bladder, causing pain and sometimes bleeding during urination. Painful bowel movements, constipation and diarrhea have been reported.