Endometriosis is a painful medical condition in which endometrial implants, comprised of tissue normally found within the uterus, are present in other areas of the body.1-3
This becomes problematic as the tissue continues to act as though it was within the uterine cavity and continues to thicken, break down and bleed during a woman's menstrual cycle and becomes trapped within the area of the body affected.1
Scar tissue and adhesions form when irritation of the surrounding tissues occur causing organ fusion and anatomical changes.1,3
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You will also see introductions at the end of some sections to any recent developments that have been covered by MNT's news stories. Also look out for links to information about related conditions.
Fast facts on endometriosis
Here are some key points about endometriosis. More detail and supporting information is in the main article.
- Worldwide 176 million women are affected by the disease,3 with 5 million women affected in the United States.2
- Data shows that endometriosis can be present in a developing fetus; pubertal estrogen levels are thought to trigger the disease.3
- Symptoms of endometriosis are generally present during the reproductive years most commonly during a woman's 30s-40s and can occur with the onset of a girls menses.2,3
- Most women are undiagnosed, taking approximately 10 years to receive a diagnosis in the United States.3
- Endometriosis is not contagious.3
- Allergies, asthma, chemical sensitivities, autoimmune diseases, chronic fatigue syndrome, fibromyalgia, breast and ovarian cancer are linked to women and families with endometriosis.2
What is endometriosis?
Endometrial implants can be found in various areas of the body including the vagina, vulva, cervix, uterus, fallopian tubes, ovaries, ureterosacral ligaments, peritoneum, pelvic cavity, bladder, bowel, intestines, appendix and or rectum.3
In more rare situations, endometrial implants can also be present in the lungs, brain and on the skin.2
The disease not only causes physical symptoms such as pain, but also can affect other areas of a woman's life including their professional and financial lives, relationships and quality of life.3
Causes of endometriosis
The exact cause of endometriosis is not currently fully understood. However, there are some explanations for development of the disease and include:
Endometriosis is a long-term (chronic) condition that causes painful periods or heavy periods.
- Retrograde menstruation: this condition causes menstrual blood to back up into the fallopian tubes and pelvis instead of normal expulsion.1-3 Additional research in this area is needed to determine why only some women manifest endometriosis during retrograde menstruation3
- Embryonic cell growth: at times embryonic cells lining the abdomen and pelvis develop into endometrial tissue within those cavities1
- Fetal development: data show that endometriosis can be present in a developing fetus; pubertal estrogen levels are thought to trigger the disease3
- Surgical scar: endometrial cells can attach to an incision made for a procedure such as a hysterectomy or c-section1,2
- Endometrial cell transport: the lymphatic system can transport endometrial cells to various parts of the body1
- Genetics: there is possibly an inherited component to endometriosis.2 There is a 5-7x increased risk for a girl to develop endometriosis if she has a close female relative with the disease3
- Hormones: endometriosis is stimulated by the hormone estrogen2
- Immune system: problems with the immune system can prohibit destruction of extrauterine endometrial tissue.1-3
Symptoms of endometriosis
Other medical conditions such as pelvic inflammatory disease (PID), ovarian cysts and irritable bowel syndrome (IBS) can mimic the symptoms of endometriosis.1 Concerning symptoms should be evaluated by your health care provider so an accurate diagnosis can be made.
The most common symptoms of endometriosis include painful or heavy periods, pain in the lower abdomen, pelvis or lower back pain and bleeding between periods.
Symptoms of endometriosis include:1-3
- Severe menstrual cramps unrelieved with NSAIDS
- Long-term lower back and pelvic pain
- Longer than average periods lasting more than 7 days in duration
- Heavy menstrual bleeding causing the need to change your pad or tampon every 1-2 hours
- Bowel and urinary problems including pain, diarrhea, constipation and bloating
- Bloody stool or urine
- Nausea and vomiting
- Painful sex
- Intermenstrual spotting/bleeding
- Infertility can be experienced in 30-40% of those with endometriosis.
While pain is the most common indication of endometriosis, the severity of the pain itself does not always correlate with the extent of the disease, as some women will experience excruciating pain and only exhibit mild disease or vice versa.1
Often, pain will resolve following menopause when estrogen production is over however if hormone therapy is used during menopause, symptoms may persist.1,2 Pregnancy may provide temporary relief to symptoms.1
Risk factors and complications
While anyone can develop endometriosis, there are certain risk factors placing some women at a higher risk of developing endometriosis and include:1,2
- Age: most commonly experienced in women ages 30-40
- Null parity: never giving birth
- Genetics: one or more relatives with the disease (mother, aunt, sister, etc.)
- Medical history: having a condition preventing expulsion of menstrual blood, pelvic infection or uterine abnormalities
- Menstrual history: menses lasting more than 7 days or menstrual cycles <27 days.
Complications of endometriosis include infertility, increased risk of developing ovarian cancer or endometriosis-associated adenocarcinoma, ovarian cysts, inflammation, scar tissue and adhesion development and intestinal and bladder complications.1,2
On the next page we look at tests and diagnosis of endometriosis, prevention and the available treatment options for the condition.