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Endometriosis is a condition in which the endometrium – the tissue that lines the inside of the uterus – grows abnormally elsewhere. Common locations include the ovaries, fallopian tubes, outer surface of the uterus, and other pelvic organs and connective tissues. The endometrium may also grow into the muscular wall of the uterus, in which case, the condition is known as adenomyosis.
The endometrium is a special tissue, it undergoes periodic changes with each menstrual cycle. Each month, under the influence of estrogen, the lining of the uterus grows and thickens, in preparation for the possibility of pregnancy. If fertilization does not take place, the tissue breaks down and is shed in menstrual bleeding, and the cycle starts over.
In endometriosis, the displaced endometrial tissue behaves the same way, but the blood has nowhere to escape. It irritates the surrounding tissues, causing inflammation, scarring, and possibly adhesions. Depending on the location, endometriosis may cause a range of symptoms and problems, but the most common complaint is pelvic pain, which can be of various kinds. Symptoms can be very different from person to person.
Endometriosis is very common. It is estimated that about 10% of women of reproductive age have some degree of endometriosis. Higher risks are observed in women who have: never had children, started periods at an early age, heavy periods that last longer than usual, shorter cycles, relatives with endometriosis, or abnormalities in the reproductive organs.
Endometriosis usually develops several years after the start of menstruation. The condition may temporarily improve with pregnancy and may go away with menopause.
Diagnosis is usually based on symptoms, but because most symptoms are not specific, other conditions that may produce similar symptoms must be first ruled out. Pelvic exams and imaging tests also help, but only a biopsy, obtained by means of surgery, can give a definitive diagnosis.
While endometriosis is not a cancer and usually not life-threatening, it may cause infertility and/or unbearable symptoms in some women.
Treatment options include:
– Pain medication, such as ibuprofen.
– Hormone therapy, such as birth control pills, to help control endometrial growth and prevent new implants. This, however, only works for as long as the medication is taken, symptoms usually return after treatment is stopped.
– Surgery to remove endometrial implants may provide a definitive cure for severe endometriosis. It may also improve fertility provided that the reproductive organs remain intact.