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Endometriosis is one of the most common gynecological diseases, affecting more than 5.5 million women in North America
alone. The two most common symptoms of endometriosis are pain and infertility. Some women have pain before and
during their periods, as well as during or after sex. This pain can be so intense that it affects a woman’s quality of life, from
her relationships, to her day-to-day activities. Some women don’t have any symptoms from endometriosis. Others may not
find out they have the disease until they have trouble getting pregnant.
Endometriosis occurs when tissue like that which lines the inside of uterus grows outside the
uterus, usually on the surfaces of organs in the pelvic and abdominal areas, in places that it is
not supposed to grow.
The word endometriosis comes from the word “endometrium”—endo means “inside” and
metrium (pronounced mee-tree-um) means “mother.” Health care providers call the tissue that
lines the inside of the uterus (where a mother carries her baby) the endometrium.
Health care providers may call areas of endometriosis by different names, such as implants,
lesions, or nodules.
One of the most common symptoms of endometriosis is pain, mostly in the abdomen, lower
back, and pelvic areas. The amount of pain a woman feels is not linked to how much
endometriosis she has. Some women have no pain even though their endometriosis is
extensive, meaning that the affected areas are large, or that there is scarring. Some women,
on the other hand, have severe pain even though they have only a few small areas of
General symptoms of endometriosis can include (but are not limited to):
* Extremely painful (or disabling) menstrual cramps; pain may get worse over time
* Chronic pelvic pain (includes lower back pain and pelvic pain)
* Pain during or after sex
* Intestinal pain
* Painful bowel movements or painful urination during menstrual periods
* Heavy menstrual periods
* Premenstrual spotting or bleeding between periods
In addition, women who are diagnosed with endometriosis may have gastrointestinal
symptoms that resemble a bowel disorder, as well as fatigue.
Endometriosis can affect any menstruating woman, from the time of her first period to
menopause, regardless of whether or not she has children, her race or ethnicity, or her socio-
economic status. Endometriosis can sometimes persist after menopause; or hormones taken
for menopausal symptoms may cause the symptoms of endometriosis to continue.
Current estimates place the number of women with endometriosis between 2 percent and 10
percent of women of reproductive age. About 30 percent to 40 percent of women with
endometriosis are infertile, making it one of the top three causes of female infertility. Some
women don’t find out that they have endometriosis until they have trouble getting pregnant.
What are the causes for endometriosis?
Endometriosis may result from something called “retrograde menstrual flow,” in which some
of the tissue that a woman sheds during her period flows into her pelvis. While most women
who get their periods have some retrograde menstrual flow, not all of these women have
endometriosis. Researchers are trying to uncover what other factors might cause the tissue to
grow in some women, but not in others.
Another theory about the cause of endometriosis involves genes. This disease could be
inherited, or it could result from genetic errors, making some women more likely than others to
develop the condition. If researchers can find a specific gene or genes related to
endometriosis in some women, genetic testing might allow health care providers to detect
endometriosis much earlier, or even prevent it from happening at all.
Researchers are exploring other possible causes, as well. Estrogen, a hormone involved in
the female reproductive cycle, appears to promote the growth of endometriosis.
Why does having endometriosis cause pain?
Normally, if a woman is not pregnant, her endometrial tissue builds up inside her uterus,
breaks down into blood and tissue, and is shed as her menstrual flow or period. This cycle of
growth and shedding happens every month or so.
The endometriosis areas growing outside the uterus also go through a similar cycle; they
grow, break down into blood and tissue, and are shed once a month. But, because this tissue
isn’t where it’s supposed to be, it can’t leave the body the way a woman’s period normally
does. As part of this process, endometriosis areas make chemicals that may irritate the
nearby tissue, as well as some other chemicals that are known to cause pain.
Over time, in the process of going through this monthly cycle, endometriosis areas can grow
and become nodules or bumps on the surface of pelvic organs, or become cysts (fluid-filled
sacs) in the ovaries. Sometimes the chemicals produced by the endometriosis can cause the
organs in the pelvic area to scar, and even to scar together, so they appear as one large
Is there a cure for endometriosis?
Currently, we have no cure for endometriosis. Even having a hysterectomy or removing the
ovaries does not guarantee that the endometriosis areas and/or the symptoms of
endometriosis will not come back.
Are there treatments for endometriosis?
There are a number of treatments for both pain and infertility related to endometriosis- pain
medication, hormone therapy and surgical treatment.