About Endometriosis

Endometriosis is a chronic medical condition where tissue similar to the lining of the uterus (called the endometrium) grows outside the uterus. This tissue can be found on the ovaries, fallopian tubes, the outer surface of the uterus, and other organs in the pelvic area—and in rare cases, even beyond.

 

What Happens in Endometriosis?

• The endometrial-like tissue outside the uterus behaves like normal endometrial tissue: it thickens, breaks down, and bleeds during the menstrual cycle.

• However, unlike regular endometrial tissue, this displaced tissue has no easy way to exit the body.

• This leads to inflammation, pain, scar tissue (adhesions), and sometimes cysts (called endometriomas, especially on the ovaries).

 

Symptoms:

Symptoms can vary widely, but common ones include:

• Pelvic pain, especially during menstruation

• Pain during or after sex

• Pain with bowel movements or urination, especially during periods

• Excessive bleeding during periods (menorrhagia) or between periods

• Infertility

• Fatigue, bloating, nausea

Some women have mild endometriosis with severe symptoms, while others may have extensive disease with little pain.

 

Diagnosis:

• Often delayed (average delay is 7–10 years).

• Pelvic exam may detect masses or tenderness.

• Imaging (e.g., ultrasound or MRI) can sometimes show cysts.

• Laparoscopy (a minimally invasive surgery) is the definitive way to diagnose and stage endometriosis.

 

Treatment Options:

1. Medications:

• Pain relief: NSAIDs (e.g., ibuprofen)

• Hormonal therapies: birth control pills, GnRH agonists, progestins, etc., to reduce or stop menstruation and slow endometrial growth

2. Surgery:

• To remove or destroy endometrial lesions and scar tissue

• In severe cases, hysterectomy (removal of uterus) may be considered, though it's not always curative if endometrial-like tissue remains elsewhere.

3. Fertility Treatment:

• May be needed if endometriosis has caused scarring or other issues affecting fertility.

 

Causes (Still Not Fully Understood):

Some theories include:

• Retrograde menstruation (blood flows backward into the pelvis)

• Immune system dysfunction

• Genetics

• Cell transformation from other tissues (metaplasia)