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What is Endometriosis?

Endometriosis is the abnormal growth of endometrial tissue similar to that which lines the interior of the uterus, but in a location outside of the uterus. Endometrial tissue is shed each month during menstruation. Areas of endometrial tissue found in ectopic locations are called endometrial implants. These lesions are most commonly found on the ovaries, the Fallopian tubes, the surface of the uterus, the bowel, and on the membrane lining of the pelvic cavity.

They are less commonly found to involve the vagina, cervix, and bladder. Rarely, endometriosis can occur outside the pelvis. Endometriosis has been reported in the liver, brain, lung, and old surgical scars. Endometrial implants, while they may become problematic, are usually benign (i.e. non-cancerous).

What are the Symptoms of Endometriosis?

There are many symptoms of endometriosis, but not everyone will experience all, most or even any of the symptoms. Most commonly endometriosis patients experience pelvic pain. Pain usually coincides with menstruation, but some women may have symptoms throughout their entire cycle. Other symptoms include painful cramps, long periods, heavy menstrual flow, bowel and urinary disorders, nausea or vomiting, pain during intercourse and infertility.

Stages of Endometriosis

Endometriosis is classified into one of four stages (I-minimal, II-mild, III-moderate, and IV-severe) based upon the exact location, extent, and depth of the endometriosis implants as well as the presence and severity of scar tissue and the presence and size of endometrial implants in the ovaries. Most cases of endometriosis are classified as minimal or mild, which means there are superficial implants and mild scarring. Moderate and severe endometriosis typically results in cysts and more severe scarring. The stage of endometriosis is not related to the degree of symptoms a woman experiences, but infertility is common with stage IV endometriosis.

What Causes Endometriosis?

The cause of endometriosis is unknown. One theory is that the endometrial tissue is deposited in unusual locations by the retrograde flow of menstrual debris through the Fallopian tubes into the pelvic and abdominal cavities. The cause of this retrograde menstruation is not clearly understood. It is clear that retrograde menstruation is not the only cause of endometriosis, as many women who have retrograde menstruation do not develop the condition. Another possibility is that areas lining the pelvic organs possess primitive cells that are able to develop into other forms of tissue, such as endometrium.

  • Endometriosis affects 176 million women worldwide, and 1 in 10 girls and women in the US.
  • Endometriosis usually causes symptoms during reproductive years (~12-60 years old), however many women and girls are undiagnosed.
  • Endometriosis affects women equally across all racial/ethnic and socioeconomic backgrounds.
  • On average in the U.S., it takes 10 years from symptom onset to receive an accurate diagnosis of endometriosis.
  • Women who have a close female relative with endometriosis are five to seven times more like to have it themselves.

There is no proven way to prevent endometriosis. One study, however, indicated that girls who begin participating in aerobic exercise at a young age are less likely to develop the condition. Anyway, make sure to educate yourself, notice the symptoms on time and get a consultation with your doctor right away!