Overview

Endometriosis is a chronic disease involving endometrial tissue. Normally endometrial tissue is found only inside the uterus, the reproductive organ where a fetus develops. Hormones direct the tissue to accumulate there, in preparation for a fertilized egg. If conception does not occur, the tissue passes out of the body during menstruation. In endometriosis, endometrial-like tissue is found outside the uterus. It may be found on organs in the abdomen, pelvis or another location. Outside the uterus, the tissue continues to respond to hormones.

Title
Endometriosis

Types

Endometriosis has four stages or types. It can be any of the following:

- Stage 1: Minimal

In minimal endometriosis, there are small lesions or wounds and shallow endometrial implants on ovary.

- Stage 2: Mild

Mild endometriosis involves light lesions and shallow implants on an ovary and the pelvic lining.

- Stage 3: Moderate

Moderate endometriosis involves deep implants on ovary and pelvic lining. There can also be more lesions.

- Stage 4: Severe

The most severe stage of endometriosis involves deep implants on the pelvic lining and ovaries. There may also be lesions on fallopian tubes and bowels.

Symptoms

Symptoms of endometriosis include cramping, pelvic pain, pain during sex, pain just before and during the menstrual period, heavy periods, low back pain, pain during bowel movements or urination, pain when urinating, infertility or miscarriage.

Causes

The cause of endometriosis is unknown. Possible causes include menstrual tissue backs up through the fallopian tubes and spills into the abdomen, immune system allowing the tissue to implant and develop into endometriosis, lymph system carrying endometrial cells from the uterus, or certain cells that cover organs in the abdomen transforming into endometrial tissue. Whatever the cause, the disease progresses due to the release of hormones and growth factors.

Diagnosis

Diagnosis is based on symptoms and medical history, and a pelvic exam. The history and exam is best done early in the menstrual period. Since most women with endometriosis have no symptoms, diagnosis is usually confirmed with a laparoscopy. Laparoscopy allows to see if there are patches of endometrial tissue. Knowing the size, number and location of growths affects treatment decisions.

Treatment

The goals of treatment are to control the pain, to slow endometrial growth, and to restore or preserve fertility.

Treatments include pain medication, hormonal therapy and/or surgery.

Prevention

There are no known preventative measures against endometriosis.

Complications

Having issues with fertility is the most serious complication. Medications don’t improve fertility. Some women have been able to conceive after having endometrial tissue surgically removed.

Risks

Precise risk factors for endometriosis have not been well established. However, there is some evidence that endometriosis is associated with

  • Family history, a mother or sister with endometriosis
  • Early onset of menstruation
  • Delayed pregnancy (pregnancy slows or stops the disease from advancing.
  • Prolonged menstrual bleeding (more than 7-8 days)

Abnormal development of the uterus, with a blocked segment