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Endometriosis
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Endometriosis

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Endometriosis is a condition in which the endometrium, tissue that normally lines the uterus, grows in other areas of the body, causing pain, irregular bleeding, and frequently infertility.

During your menstrual cycle, hormones signal the lining of your uterus to thicken to prepare for possible pregnancy. If a pregnancy doesn't occur, your hormone levels decrease, causing the thickened lining of your uterus to shed. This results in bleeding that exits your body through the vagina - your monthly period.

When endometrial tissue is located in other parts of your body, it continues to act in its normal way: it thickens, breaks down and bleeds each month as your hormone levels rise and fall. However, because there's nowhere for the blood from this mislocated tissue to exit your body, it becomes trapped, and surrounding tissue can become irritated.

Trapped blood may lead to the growth of cysts. Cysts, in turn, may form scar tissue and adhesions - abnormal tissue that binds organs together. This process can cause pain in the area of this misplaced tissue, usually the pelvis, especially during your period. Endometriosis can also cause fertility problems. In fact, scars and adhesions on ovaries or fallopian tubes can prevent pregnancy.

Signs and symptoms

Some women with endometriosis have no symptoms at all, and the disease is discovered only during an unrelated operation, such as a tubal ligation. Others may experience one or more of the following signs and symptoms:

  • Painful periods (dysmenorrhea). Pelvic pain and cramping may begin before and extend several days into your period and may include lower back and abdominal pain.

  • Occasional heavy periods or bleeding between periods (menometrorrhagia).

  • Pelvic pain during ovulation.

  • Sharp pain deep in the pelvis during intercourse.

  • Pain during bowel movements or urination.

  • Infertility. Endometriosis is first diagnosed in some women who are seeking treatment for infertility.

Some cramping during your period isn't abnormal. But women with endometriosis typically describe menstrual pain that's far worse than normal. They also tend to report that the pain has increased over time.

Pain is a common symptom of endometriosis. However, severity of pain isn't necessarily a reliable indicator of the extent of the condition. Some women with mild endometriosis have extensive pain, while others with more-severe scarring may have little pain or no pain at all.

Endometriosis is sometimes mistaken for other conditions that can cause pelvic pain, such as pelvic inflammatory disease (PID) or ovarian cysts. It may be confused with irritable bowel syndrome (IBS), a condition that causes bouts of diarrhea, constipation and abdominal cramping. IBS can accompany endometriosis, which can complicate a diagnosis.

See your physician if you have significant symptoms of endometriosis. The cause of chronic or severe pelvic pain may be difficult to pinpoint. But discovering the problem early may help you avoid unnecessary complications and pain.

Causes

The cause of endometriosis remains mysterious. Scientists are studying the roles that hormones and the immune system play in the condition. Several suggestions as to how endometrial tissue ends up outside the uterus have been made.

One theory holds that menstrual blood containing endometrial cells flows back through the fallopian tubes, takes root and grows. Another hypothesis proposes that the bloodstream carries endometrial cells to other sites in the body. Still another theory speculates that a predisposition toward endometriosis may be carried in the genes of certain families.

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This information is provided for general medical education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient's medical condition.
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