Understanding Endometriosis, Fertility, & Hormonal Health
Expert Q&A with Dr. Prati Sharma, Reproductive Endocrinologist and Infertility Specialist
When it comes to endometriosis, fertility, and hormonal health, many questions remain unanswered—or worse, unasked. We spoke with Dr. Prati Sharma, a leading fertility expert, to get clear, compassionate answers to some of the most common and overlooked questions about endo, trying to conceive, and advocating for your reproductive health.
Endometriosis & Symptoms
Q: What symptoms of endometriosis aren’t talked about enough?
Dr. Sharma: In addition to the more recognized pain during menstruation (dysmenorrhea), there’s pain that interferes with daily life—like missing work or social events. Other common yet under-discussed symptoms include painful sex (dyspareunia), chronic pelvic pain, and infertility.
Q: Can someone have endometriosis without experiencing severe pain?
Absolutely. The severity of endo doesn't always match the severity of pain. You can have extensive disease and minimal symptoms—or intense pain with minimal visible disease. This is sometimes called "silent endo."
Q: Is endometriosis hereditary?
There is a hereditary component, although endo is multifactorial. We do see it cluster in families—so if a sister or close relative has endo, your chances are higher.
Q: How does endometriosis affect fertility?
Endo can affect egg reserve, egg development, fallopian tube function, and implantation due to inflammation. Endometriomas (cysts) may impair follicular development and can complicate IVF access. Signs of endo in fertility patients include pain, endo cysts, poor response to ovarian stimulation, or recurrent implantation failure.
Fertility & Trying to Conceive (TTC)
Q: Does low-grade endo impact fertility?
It can, depending on age, egg reserve, and sperm quality. Mild endo may not prevent conception, especially in younger patients. But in older patients or those with other issues, it can contribute to infertility. Surgical removal of mild endo has been shown to improve natural conception rates.
Q: Can someone still be fertile with irregular or absent periods?
Irregular or absent periods often signal problems with ovulation, which can reduce fertility. Pregnancy is still possible, but usually more difficult.
Q: How can someone find out their fertility status?
A fertility clinic can assess egg reserve, hormone levels, anatomy, and sperm quality. At-home fertility kits (like those from Bird&Be) can offer a preliminary snapshot of ovulation and fertility for both men and women.
Q: What support is available for monitoring fertility?
Fertility clinics can monitor cycles, induce ovulation, and recommend assisted reproductive technologies (ART) as needed. The right approach depends on your diagnosis.
Q: What are the options for those with Endo or PCOS trying to conceive?
For endo, options range from medical or surgical management to IVF. For PCOS, lifestyle changes, supplements like inositol, and medications like letrozole for ovulation induction are common.
Q: Does laparoscopic surgery improve chances of pregnancy?
Yes, for patients with mild endo and good egg reserve. However, in those with advanced endo or low ovarian reserve, surgery may further reduce egg supply. In such cases, freezing eggs or embryos before surgery may be advisable.
Q: How can we support our fertility through lifestyle?
Maintain a balanced diet, normal BMI, and reduce exposure to toxins. Stress management, early fertility evaluation, and supplements—like Bird&Be products or inositol for PCOS—can be helpful.
Q: Any products or habits that help with both endo and fertility?
I recommend Bird&Be prenatal supplements and hormone-balancing blends for both men and women. Lifestyle habits like regular exercise, minimizing stress, and reducing endo triggers (like caffeine and chocolate) also help.
Hormonal & Menstrual Health
Q: How does hormonal imbalance affect menstruation and ovulation?
Hormonal imbalance can stem from thyroid issues, elevated prolactin, perimenopause, or PCOS. These affect the menstrual cycle and ovulation quality. A fertility specialist can run a complete hormonal workup to identify the cause.
Advocacy & Diagnosis
Q: How can I advocate for myself when my symptoms are dismissed?
Trust your instincts. If something feels off, you deserve a thorough evaluation. If your family doctor won’t refer you, you can self-refer to a fertility clinic. Early assessment can make a big difference.
Q: While waiting for a diagnosis, is there anything I can do to manage the pain?
NSAIDs like Advil or Tylenol taken before and during periods can help. Hormonal treatments require a specialist, but lifestyle adjustments—like avoiding known triggers, staying active, and seeking emotional support—can also ease symptoms.
Workplace & Lifestyle
Q: Should I tell my employer if I have endo or chronic period pain?
It’s a personal choice, but if you need flexibility at work, disclosing it—possibly with a note from your doctor—can help advocate for accommodations.
Supplement Advice
Q: Would you recommend Vitex (chasteberry) for endo?
These are alternative treatments and results vary. It's best to consult with a naturopath alongside your gynecologist or fertility doctor to ensure a safe and effective treatment plan.
Let us know which of these topics you’d like us to explore further—and remember, your symptoms are valid. Your care should be too.
About Dr. Prati Sharma
Dr. Prati A. Sharma, M.D. F.A.C.O.G (OB/GYN, REI) is an American Board Certified Reproductive Endocrinologist who has been in clinical practice for over 10 years. She has an excellent, consistent record of focused practice in Reproductive Endocrinology and Infertility (REI), excelling in Infertility Management, treatment of Reproductive Endocrine disorders and utilizing Assisted Reproductive techniques to help her patients.
