Endometriosis

Normally, endometrial tissue is found only inside the uterus. The uterus is the reproductive organ where a fetus develops. Hormones cause the tissue to form there, preparing the body for a fertilized egg. If you do not become pregnant, the tissue leaves the body during menstruation. In endometriosis, endometrial-like tissue is found outside the uterus. For example, it may be found on organs in the abdomen or pelvis. In these places, the tissue still responds to hormones. It swells, breaks down, and bleeds. But it is unable to leave when you menstruate. Surrounding tissue becomes inflamed. There is often scarring.

  • Causes

    Possible causes include:

    • Menstrual tissue backs up through the fallopian tubes and spills into the abdomen
    • Immune system may allow the tissue to implant on other organ surfaces and develop into endometriosis
    • Lymph system may carry endometrial cells from the uterus
    • Certain cells left behind on abdominal organs during embryonic development can turn into endometrial tissue

    Hormones and growth factors cause the disease to progress.

  • Definition

    Normally, endometrial tissue is found only inside the uterus. The uterus is the reproductive organ where a fetus develops. Hormones cause the tissue to form there, preparing the body for a fertilized egg. If you do not become pregnant, the tissue leaves the body during menstruation.

    In endometriosis, endometrial-like tissue is found outside the uterus. For example, it may be found on organs in the abdomen or pelvis. In these places, the tissue still responds to hormones. It swells, breaks down, and bleeds. But it is unable to leave when you menstruate. Surrounding tissue becomes inflamed. There is often scarring.

    Endometriosis
    Nucleus Medical Media Image
    Lesions were created by swelling and breakdown of endometrial tissue outside the uterus.
    Copyright © Nucleus Medical Media, Inc.

  • Diagnosis


    Your doctor will ask about your symptoms and medical history. A pelvic exam will be done. These are best done early in the menstrual period. Since you may not have any symptoms, diagnosis is usually confirmed with a
    laparoscopy
    . This test allows the doctor to see if there are patches of endometrial tissue and scar tissue.

  • Prevention

    There is no known way to prevent this condition.

  • Risk Factors

    Factors that may increase your risk of endometriosis include:

    • Family history—a mother or sister with endometriosis
    • Early onset of menstruation

    • Not having children—Pregnancy slows or stops the disease from progressing. The condition usually resolves at
      menopause
      . The symptoms may return with
      hormone replacement therapy
      .
    • Prolonged menstrual bleeding—more than 7-8 days
    • Abnormal development of the uterus, with a blocked segment

  • Symptoms

    Symptoms range from mild to severe. You may have many large growths with little pain. Or, you may have small areas with intense pain.

    Symptoms include:

    • Cramping and pelvic pain—especially just before and during menstrual bleeding

    • Pain during sex—
      dyspareunia
    • Heavy periods
    • Low back pain
    • Pain during bowel movements or urination
    • Infertility
    • Miscarriage

  • Treatment

    The goals of treatment are to:

    • Control pain
    • Slow endometrial growth
    • Restore or preserve fertility

    Treatment options depend on:

    • Severity of symptoms
    • Size, number, and location of growths
    • Degree of scarring
    • Extent of the disease
    • Age and whether you want to have a baby

    Treatment includes: