Women's Health

Endometriosis

Endometriosis (en-doe-me-tree-O-sis) is an often painful uterine disorder affecting women of reproductive age. The tissue that normally lines the inside of your uterus – endometrial cells – grows outside your uterus.

  • Implants (growths) from endometriosis are often benign (noncancerous) and may be found anywhere in the pelvic cavity, including on other organs, such as ovaries or fallopian tubes.
  • Hormones impacting your menstrual cycle cause the growths to enlarge over time.
    • Up to 10% of women have endometriosis in their reproductive years, but many don't have symptoms.328
  • Endometriosis is one of the most common causes of pelvic pain and infertility in women:
    • 30% to 50% of women may experience infertility from endometriosis.329
Endometriosis

Symptoms of Endometriosis

Pain is the most common symptom of endometriosis, which may or may not correlate to the menstrual cycle.

  • Chronic pain in the lower abdomen or lower back
  • Very painful menstrual cramps; pain may get worse over time
  • Distorted pelvic anatomy caused by scar tissue and adhesions
  • Pain during or after sex
  • Intestinal pain
  • Painful bowel movements or painful urination during menstrual periods
  • Spotting or bleeding between menstrual periods
  • Infertility or not being able to get pregnant
  • Fatigue
  • Diarrhea, constipation, bloating, or nausea, especially during menstrual periods

Causes of Endometriosis

Experts agree there is no clear cause of endometriosis, but possible explanations include:

  • Retrograde Menstruation: This is the most widely accepted explanation for endometriosis. Instead of menstrual blood (which contains endometrial cells) flowing out of the body, it flows into the fallopian tubes and into the pelvic cavity. The endometrial cells may stick to the pelvic walls or surfaces of pelvic organs, where they continue to grow during each menstrual cycle.
  • Heredity: Endometriosis runs in families so may be carried in the genes.
  • Estrogen: The hormone, estrogen, appears to promote the growth of endometriosis.
  • Embryonic Cell Growth: The cells lining the abdominal and pelvic cavities come from embryonic cells, which can develop into endometriosis.
  • Surgical Scar Implantation: After a pelvic surgery, such as a hysterectomy or Csection, endometrial cells may attach to scar tissue.
  • Endometrial Cell Transport: The blood vessels or tissue fluid (lymphatic) system may transport endometrial cells to other parts of the body.
  • Immune System Disorder: Problems with the immune system make the body unable to recognize and destroy endometriosis growing outside the uterus.
Female Pelvic Anatomy with Text

Diagnosing Endometriosis

After a discussion about your symptoms and medical history, your doctor will perform a pelvic exam. Additional procedures may be requested:

  • Vaginal Ultrasound: An imaging test to see if there are ovarian cysts from endometriosis. Sound waves will make pictures of your reproductive organs.
  • Magnetic resonance imaging (MRI) is another common imaging test that may be used. This test is non-invasive and involves the use of magnetic fields to develop images.
  • Laparoscopy (lap-ar-OS-ko-pee): Laparoscopy is a minimally invasive surgical procedure that allows for direct visualization of the pelvic cavity and reproductive organs, such as ovaries and fallopian tubes. In addition to enabling diagnosis, the surgeon may also remove or destroy the remaining endometriosis at the same time.
    • The procedure is an outpatient procedure performed under general anesthesia.
    • To perform the procedure, your surgeon will make a small incision (approx. 1cm) near your navel (belly button), and insert a lighted scope (laparoscope) into your abdomen to look for endometriosis tissue. A small tissue sample (biopsy) may be taken. Your surgeon may also remove or destroy the remainder of the endometriosis.

If you have symptoms of endometriosis, speak with your doctor or your obstetrician/gynecologist (OB/GYN) to understand the best way to manage your symptoms.

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