Endometriosis

A common gynecological problem in women occurs when cells that are supposed to form in the uterus of a woman, attach themselves to tissue in other places of the body, causing pain, irregular bleeding, and problems with getting pregnant, or infertility. Let's talk about endometriosis in a little more detail.

Every month, a woman's ovaries produce hormones that tell the cells lining the uterus, or womb, to swell and thicken. The body removes these extra cells from the womb lining, or endometrium, when you get your period.

But if these cells, called endometrial cells, implant and grow outside the uterus, endometriosis results. The growths are called endometrial tissue implants. Women with endometriosis typically have tissue implants on the ovaries, or bowel, rectum, bladder, or on the lining of the pelvic area.

We don't know what causes endometriosis. One theory is that the endometrial cells that shed when you get your period travel backwards through the fallopian tubes into the pelvis, where they implant and grow. This is called retrograde menstruation. This backward menstrual flow occurs in many women, but many think the immune system may also be different in women with endometriosis.

Symptoms of endometriosis include painful periods, pain in your lower belly before and during menstruation, cramps before and during menstruation, pain during sex, painful bowel movements, as well as pelvic or lower back pain.

To treat endometriosis. . .

The goal of treatment is to improve pelvic pain, reduce pelvic masses, or improve fertility. If you have mild symptoms and do not want to have children, you may choose to have regular exams every 6 to 12 months so your doctor can make sure the disease isn't getting worse.

Treatment options also include pain medicines, hormone medicines to stop the disease from getting worse, or surgery to remove the area of endometriosis or even the entire uterus and ovaries if you have severe pain that does not get better with other treatments.

Hormone therapy doesn't cure endometriosis, but it can relieve some or all of your symptoms. Unfortunately, removal of the uterus, fallopian tubes, and both ovaries may eliminate symptoms, but it also eliminates fertility. A combination of limited surgery and assisted reproduction techniques may improve fertility. So, if you have any questions about endometriosis, please see your doctor.

Endometriosis

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Review Date: 4/1/2023

Reviewed By: John D. Jacobson, MD, Professor Emeritus, Department of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda, CA. Internal review and update on 02/06/2024 by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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