What is endometriosis?
Endometriosis is a chronic disorder in which the endometrium, or the tissue that normally lines the inside of your uterus, grows outside of your uterus. Endometriosis commonly involves the ovaries, fallopian tubes and tissue lining your pelvis. In rare occurrences, endometrial tissue may spread beyond the pelvic organs. In individuals with endometriosis, the endometrial tissue acts as it is supposed to. It thickens, breaks down and bleeds with the menstrual cycle.
However, because the displaced tissue has no way to exit the body, it becomes trapped. When endometriosis involves the ovaries, cysts called endometriomas can form. The surrounding tissue can become irritated and, eventually, form scar tissue and adhesions that cause pelvic tissue and organs to stick to each other. Endometriosis is sometimes confused for other illnesses and disorders that cause pelvic pain such as:
- Pelvic inflammatory disease (PID)
- Polycystic ovarian syndrome (PCOS)
- Irritable bowel syndrome (IBS)
Symptoms of endometriosis
Symptoms of endometriosis usually occur around the menstrual period, but can also occur when not on the menstrual cycle. Symptoms include:
- Painful periods (dysmenorrhea)
- Pain during or after sexual intercourse
- Pain with bowel movements or urination
- Excessive bleeding
- Ovarian cysts
Possible causes of endometriosis
The exact cause of endometriosis is unknown, however some possible explanations include:
- Retrograde menstruation: Menstrual blood containing endometrial cells flow back through the fallopian tubes and into the pelvic cavity instead of out of the body. The displaced endometrial cells stick to the pelvic walls and surfaces of the pelvic organs. They then grow and continue to thicken and bleed over the course of each menstrual cycle.
- Transformation of peritoneal cells: Some scientists have proposed the “Induction Theory” which suggests that hormones or immune factors promote the transformation of peritoneal cells into endometrial cells.
- Embryonic cell transformation: Hormones such as estrogen may transform embryonic cells into endometrial cells during puberty.
- Surgical scar implantation: After a surgery such as a hysterectomy or C-section, endometrial cells may attach to a surgical incision.
- Endometrial cells transport: The blood vessels or lymphatic system may transport endometrial cells to other parts of the body.
- Immune system disorder: A problem with the immune system may make the body unable to recognize and destroy endometrial tissue that’s growing outside of the uterus.
Endometriosis cannot be cured, but there are a variety of treatment options available. Over-the-counter pain medications, such as ibuprofen, naproxen or acetaminophen may help ease the pain of menstrual cramps. Hormone therapy may also help reduce or eliminate the pain of endometriosis. Therapies include hormonal contraceptives such as birth control pills; gonadotropin-releasing hormone (Gn-RH) agonists and antagonists; progestin therapy; and danazol. Surgery to remove inappropriate endometrial tissue is sometimes considered if you are trying to become pregnant or if you have severe and unrelenting pain from endometriosis. In severe cases, a total hysterectomy (removal of the cervix, uterus and both ovaries) may be the best treatment option, although it is also considered the last resort.