Response to reader

Dear Dr Rainford,

I am 19 years old and a few months ago was diagnosed with endometriosis and ovarian cysts, after having severe abdominal pains. My menses are heavy and come with intense pain. It seems that I am infertile but, strangely, last month I had two periods, on the first of the month and then on the 18th of August, after continuous vomiting, loss of appetite and nausea. Is there any way I can be infertile, because it is causing extreme emotional and physical pain. Please, I would really like your help.

Dear Reader,

I am sorry to hear that you have formed that opinion at such a young age. You mentioned that you were diagnosed with endometriosis and ovarian cysts. How was this diagnosis made? As I mentioned in the article on this topic, unless the cysts were endometriomas, a laparoscopy is needed to confirm the diagnosis of endometriosis. It is true that this condition is associated with painful periods, but many women your age have painful menses (dysmenorrhoea) and do not have endometriosis.

By definition, a couple has infertility if they have one year of regular unprotected sex (about two to three times per week) without achieving pregnancy. About half the time the cause of infertility lies with the male. Many women with endometriosis do not have difficulty achieving pregnancy. In fact, although infertility is a very difficult problem, the majority of women are fertile. Even women who have carried a diagnosis of infertility for some time conceive and give birth to healthy children.

Unprotected sex is dangerous

Your behaviour of having unprotected sex and not taking contraception is dangerous for a number of reasons. One major reason is that it increases your exposure to sexually transmitted infections such as HIV, chlamydia, gonorrhoea and syphilis, just to name a few. Also you are raising your risk of acquiring pelvic inflammatory disease (PID), which carries its own set of problems as it can increase your risk of actually being infertile by scarring your tubes, and it can also increase your risk of having a pregnancy in your tubes (an ectopic pregnancy). You also raise your risk of having an unwanted pregnancy.

There are a number of reasons for irregular bleeding like you had in the month of August and they include those reasons I mentioned earlier - PID and pregnancy. Please get evaluated for this problem as soon as possible.

I strongly encourage you to discuss all your concerns with a doctor. While I cannot be certain about your current or future fertility, you certainly do not need to be carrying such a heavy burden when there are a number of treatment options available for you.

Dr Monique Rainford is a consulting obstetrician and gynaecologist; email: yourhealth@gleanerjm.com.