Endometriosis

• Endometriosis is a condition in which the tissue that behaves like the cells lining the uterus (endometrium) grows in other areas of the body, causing pain, irregular bleeding, and possible infertility

• The tissue growth (implant) typically occurs in the pelvic area, outside of the uterus, on the ovaries, bowel, rectum, bladder, and the delicate lining of the pelvis. However, the implants can occur in other areas of the body, too.

• Each month a woman's ovaries produce hormones that stimulate the cells of the uterine lining (endometrium) to multiply and prepare for a fertilized egg. The lining swells and gets thicker.

• If these cells (called endometrial cells) grow outside the uterus, endometriosis results. Unlike cells normally found in the uterus that are shed during menstruation, the ones outside the uterus stay in place. They sometimes bleed a little bit, but they heal and are stimulated again during the next cycle

• This ongoing process leads to symptoms of endometriosis (pain) and can cause scars (adhesions) on the tubes, ovaries, and surrounding structures in the pelvis.

• The cause of endometriosis is unknown, but there are a number of theories. One theory is that the endometrial cells loosened during menstruation may "back up" through the fallopian tubes into the pelvis. Once there, they implant and grow in the pelvic or abdominal cavities.

• This happens in many women, but there may be something different about the immune system in women who develop endometriosis compared to those who do not get the condition.

• Endometriosis is a common problem. Sometimes, it may run in the family. Although endometriosis is typically diagnosed between ages 25 - 35, the condition probably begins about the time that regular menstruation begins.

• A woman who has a mother or sister with endometriosis is six times more likely to develop endometriosis than women in the general population.

Other possible risk factors include:• Starting menstruation at an early age• Never having had children• Frequent menstrual cycles• Periods that last 7 or more days• Problems such as a closed hyman, which block the flow of

menstrual blood during the period

Symtomps

• Pain is the main symptom for women with endometriosis.

This can include:• Painful periods• Pain in the lower abdomen or pelvic cramps that

can be felt for a week or two before menstruation

• Pain in the lower abdomen felt during menstruation (the pain and cramps may be steady and dull or severe)

• Pain with bowel movements• Pelvic or low back pain that may occur at any

time during the menstrual cycle• Pain during or following sexual intercourse

Exams and Test

Test that are done to diagnose endometrosis include:

• Pelvic exam• Transvaginal ultrasound• Pelvic laparoscopy

Treatment

• Treatment options include:• Medications to control pain• Medications to stop the endometriosis from

getting worse• Surgery to remove the areas of endometriosis• Hysterectomy with removal of both ovaries