Hi, I am Dr. Ankita Srivastava. I am a gynaecologist and obstetrician with over 10 years of experience. I currently practice at Sir Ganga Ram Hospital in New Delhi and at Zoe Nutrition For Life. I am the co-creator of the conceive effortlessly online program. It is a 3 month online program designed to provide personalised care and attention to you from leading experts in the country and help you get pregnant faster, naturally, easily & most definitely. 😊
I often interact with several patients who are a part of my online program to give them personalised consultations and guide them regarding the problems that they are facing in their pregnancy journey. This, along with my experience practicing at Sir Ganga Ram Hospital in New Delhi, have together helped me understand and know some of the most common and unaddressed queries, issues and concerns that modern couples face when they are trying to start their family and conceive a baby. I also believe that we can all learn from each other's journey as well as the experiences, hence, I document interactions with several of my patients so that others can learn from these documentations as well. One such case has been shared by me below.
"What exactly happens in the uterus if I have a fibroid or endometriosis? How does it affect my fertility and how can I overcome it?"
This is something that I get asked quite often. I've tried to address several questions around fibroid, endometriosis and it's affect on fertility in the recommendation section below.
"Let's first start with understanding what exactly happens in the uterus when you have a fibroid. A fibroid is nothing but an estrogen dependent tumor. It's a benign tumor and not a malignant tumor. If estrogen is going to be present in the body, of course the fiber is going to be there. Now, estrogen and progesterone are the hormones that balance each other, if the estrogen goes beyond the level of progesterone, that means that there is an unopposed estrogen activity and there is not enough progesterone to oppose it. This then causes proliferation of cells and that will form the fibroid. So now, during the course of the life, the fibroid will keep increasing and this will come to a point where it may cause infertility. It's a common saying that a uterus that doesn't produce a baby, produces a fibroid. Why? That's because when you're pregnant, that is when the progesterone levels go high and it'll equalize the estrogen level. So, during pregnancy, the fibroids stop growing. Now, the question arises, what should you do if you have fibroids? If your fibroids are less than five centimeters, they're not causing any heavy bleeding, then there's nothing you have to do. No medication, no surgery, nothing. But, if they increase to more than five centimeters, plus they start giving you symptoms like increase in bleeding or it is seen that the duration of bleeding is increased, eg: If you're bleeding for five earlier, and now you start bleeding for eight days, nine days, all of a sudden, plus, during those days when you're bleeding, your bleeding is heavier than normal, ie: you're passing too many clots while you're having your periods, then you need to get an ultrasound done. There might be a fibroid. A lot of us don't even know we have fibroids because we don't even get ultrasound done on a regular basis. So you need to get an ultrasound. If there are certain changes of pattern of your periods, or there is increased pain during your periods, etc. all these things will tell you that this is the time that you need to get ultrasound. Also, when you diagnose a fibroid or an endometriosis from an ultrasound, there's nothing to worry about. We have good treatments for it. If the estrogen is increased, what we do is that we give progesterones from outside. So we'll give you progesterones from outside as a medicine or something, to insert in the uterus, like a medicated copper-T, which we put inside the uterus in order to release progesterones and help stop the growth of fibroid. So now, let's understand what can you do when you have fibroids and they are affecting your fertility ie: they are not letting you conceive? So, in this case, there are surgeries that we can do to remove the fibroid and if the size is less, then we can give medicines to control the size. So these can be treated, but we need to get a proper diagnosis, which can only be done with an ultrasound. Also in endometriosis, we will give you medicines to stop the growth. But first, let's understand what is endometriosis? The glands in the the lining of the uterus are supposed to be inside the uterus. Now, if they go anywhere else, they will cause pain. So, that is why you will just have pains every cycle. When you're bleeding, you'll have more pain than you used to have, or it will not let you work, it will debilitate you, it'll not let you do your regular activities. If that's the amount of pain, the excruciating pain points towards endometriosis, all of us will have some little amount of pain during the periods, which will be more during the first two days. What is normal pain is when you have pain just before your mens that you start feeling, okay, now I'm about to have my periods and for the first two days of your period, period pain is completely normal. But, if you start having pain all throughout the periods, five days, six days of your bleeding, your pain is there all throughout or there's excruciating pain or there is pain that's not letting you work. All these things will point us to endometriosis and you will need to get a treatment for it because endometriosis can, you know, delay or hamper your conception. So, you need to get treatment for it and after you've taken treatment, what we've seen is the conception is normal. The baby comes out normal and the pregnancy also can be healthy and normal. So this will not hamper the quality of your pregnancy, but this will need to be treated for you to have a healthy pregnancy. These are some of the things that you have to do. You have to first look out and watch out for your symptoms. A lot of us don't even know what are the symptoms we need to watch out for. Also, once you have a little bit of a doubt, you need to go to the gynecologist, get yourself investigated and figure out whatever is the problem. You need to treat it there and then, and have a healthy pregnancy thereafter."
I hope you found this article useful. If you want a detailed consultation with me, you can write to me or drop me a whatsapp. You can also read another article by Dr. Parul Chopra Buttan on understanding all about PCOS by clicking here.
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Love and good health,
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