Expert advice: Endometriosis, breast care

Q:I’ve suffered from endometriosis for most of my life and have learnt to deal with it as best I can, so it doesn’t affect how I live too much.

But I got married recently, and we are keen to start a family. How does my condition affect my chances of falling pregnant naturally?

Is there anything I can do to improve my chances?

A:Dr Koll answers: Endometriosis is a condition that doesn’t follow any rules. We can never predict when it will flare up and when it will resolve. The extent of the endometriosis also doesn’t correlate well with the symptoms. Some people with severe endometriosis have minimal symptoms, and milder forms can present severe symptoms. Similarly, its effect on falling pregnant is also somewhat unpredictable. Some patients with a fairly mild form have difficulty falling pregnant and require surgery, while in others, who had no problem falling pregnant, we find severe endometriosis unexpectedly at the time of caesarean section.

My best advice is to firstly make sure you are up to date with your gynae check-ups and PAP smear, then, stop contraception, start folic acid supplements and don’t try to fall pregnant. Just allow nature to take its course. If you are not pregnant in six months, see your gynaecologist for an assessment.

To maximise your chances, initially simple lifestyle adjustments for both partners are important. Follow a healthy diet, get moderate exercise every day, stop smoking, limit alcohol and manage your stress levels.