Endometriosis is a condition in which the endometrium, the lining of the uterus, grows outside of the uterus. The tissue can be found on any part of the reproductive system, to include the ovaries, fallopian tubes, or the intestines. Despite growing in an unintended place, the tissue continues to act as it would in the uterus–thickening, breaking down, and bleeding with each menstrual cycle. This tissue may also cause cysts (endometriomas), development of scar tissue, and adhesions (organs that stick together).
Risk factors. While the exact cause of endometriosis remains uncertain, there
are several known risk factors such as: having never birthed a child; starting menstruation at an early age; going through menopause at a later age; having shorter periods; regular alcohol consumption; low body mass index; and a family history of endometriosis.
Symptoms. A woman with endometriosis may experience abdominal, pelvic, rectal, or vaginal pain; painful intercourse; irregular, heavy, or painful menstruation; constipation; nausea; abdominal cramping; and infertility.
Complications. Infertility and ovarian cancer are the two most concerning complications of endometriosis. Approximately 1/3 – 1/2 of women who suffer from the condition have fertility issues, yet pregnancy is still possible. Fortunately, the rates of associated ovarian cancer are much lower.
Diagnosis. Possible diagnostic tools when endometriosis is suspected are a pelvic exam, transvaginal ultrasound, or laparoscopy.
Once diagnosed, endometrosis can be classified into 4 different stages based on their severity. Stage I (minimal) and II (mild) are most common. Stage III (moderate) typically means that cysts and severe scarring are present. Stage IV (severe) indicates that the damage has caused infertility.
Treatment. Self-care can help to improve minor symptoms. Warm baths and heating pads can reduce pain and cramping by relaxing the pelvic muscles. OTC pain medications can also help to alleviate muscle cramps.
Hormonal therapy, such as birth control medications, can be effective in relieving the pain associated with endometriosis. It is the rise of fall of hormones as a part of the menstrual cycle that causes the tissue to thicken, break down, and bleed. Hormone medications help to slow tissue growth, and prevent new tissue from building.
If hormonal therapy fails, conservative surgery may be used to remove the displaced tissue. This option removes only the abnormal tissue and leaves the female reproductive organs intact. In the most severe cases, a hysterectomy may be required.
