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The Basics of Endometriosis

Endometriosis is a condition in which cells from the endometrium - or uterine lining - grow outside the uterus and adhere to other structures in the pelvis, most commonly the ovaries, bowel, fallopian tubes or bladder. It is a benign (noncancerous) condition. According to the American College of Obstetricians and Gynecologists (ACOG), endometriosis is a common condition affecting 10 to 15 percent of reproductive-age women. It rarely causes symptoms following natural or surgical menopause.

The most common symptoms of endometriosis are painful menstrual periods or non-cyclic pelvic pain. However, the type and intensity of symptoms vary greatly among women with endometriosis. Symptoms may be completely disabling or mild. Sometimes the condition is present and causes few to no symptoms. Chronic pelvic pain is common in women with endometriosis. Other symptoms may include:

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  • diarrhea and painful bowel movements especially during menstruation
  • painful intercourse
  • abdominal tenderness
  • severe cramping

Endometriosis with scarring that distorts the anatomy of the pelvic organs may impair fertility. When there is no distortion of the pelvic organs or blockage of the fallopian tubes, endometriosis is less likely to impair fertility.

Researchers are not clear what causes endometriosis. Many theories exist. One theory suggests that retrograde menstruation — or "reverse menstruation" may be the predominant cause. Instead of flowing out of the cervix (opening of the uterus to the vagina) each month some menstrual blood containing endometrial tissue is pushed backward and out of your uterus through the fallopian tubes into the pelvic cavity.

Copyright 2003 National Women's Health Resource Center Inc. (NWHRC)

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Endometrial tissue also may grow abnormally in the abdominal area or, more rarely, migrate far from the pelvic region — it may be found in the lungs, skin, and other regions of the body, for example. Wherever it is — in the uterus or elsewhere — endometrial tissue continues to respond to hormonal signals produced by the ovaries each month. But unlike the tissue lining the uterus, which is shed with menstruation and leaves your body, misplaced endometrial tissue is trapped. With no place to go, the tissue bleeds, causing an inflammatory response which can lead to scar tissue formation (adhesions). This inflammation and the resulting scar tissue causes pain and other symptoms typical of endometriosis, if left untreated.

Since most women experience some amount of retrograde menstruation without it developing into endometriosis, some researchers believe something else may contribute to the development of the condition. Other theories suggests that endometriosis is an immune system problem or hormonal imbalance that enables the endometrial tissue to take root and grow after it is pushed out of the uterus into the pelvic cavity or elsewhere. Environmental factors may also play a role, some theories suggest. Others believe that in patients with endometriosis, the endometrium itself is abnormal, leading to the abnormal implants.

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Endometriosis occurs only after the onset of regular menstruation and can sometimes strike girls in their teens. Around 10 to 15 percent of all reproductive-age are thought to suffer from endometriosis. Endometriosis has a reputation for causing infertility, but most women with this condition do not have trouble getting pregnant.

There is some evidence that a family history of endometriosis may contribute to your likelihood of developing this disease. If you have a mother or sister who is battling endometriosis or has been diagnosed with it, there is a seven-fold increase in the chance that you may develop the disease.

Medical research indicates that daughters of women who took the drug diethylstilbestrol (DES), during the years 1938 through 1971 to prevent miscarriage, have an increased risk of developing this disease.

Copyright 2003 National Women's Health Resource Center Inc. (NWHRC)

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