Endometriosis

Endometriosis (EN-doh-mee-tree-OH-sis) is a condition in which endometrial tissue (tissue that lines the inside of the uterus) grows outside the uterus.

Endometriosis may be a cause of infertility. Endometrial tissue grows outside the uterus and attaches to other organs in your abdominal cavity such as the ovaries and fallopian tubes. The endometrial tissue inside and outside of your uterus responds to your menstrual cycle hormones in a similar way—it swells and thickens, then sheds to mark the beginning of the next cycle. Unlike the menstrual blood from your uterus that is discharged through your vagina, the blood from the endometrial tissue in your abdominal cavity has no place to go. Inflammation occurs in the areas where the blood pools, forming scar tissue. Scar tissue can block the fallopian tubes or interfere with ovulation. In addition, endometrial tissue growing inside the ovaries may form a type of ovarian mass called an “endometrioma”, which may interfere with ovulation. Endometriosis is a progressive disease. It tends to get worse over time and sometimes recurs after treatment. Endometriosis usually improves after menopause.

How endometriosis is diagnosed

Your medical history and a pelvic exam may suggest the diagnosis of endometriosis. However, only a laparoscopy can confirm this diagnosis. A laparoscopy is an outpatient surgical procedure. Your doctor will use a narrow fiber optic telescope inserted through an incision near your navel to look for and sometimes remove scar tissue and endometrial tissue attached to other organs.

Questions & Answers

Q. What are the symptoms of endometriosis?
A. You may experience painful menstrual periods, abnormal menstrual bleeding, or pain during or after sexual relations. However, you may not have any symptoms at all.

Q. Why do I have this disease?
A. The cause of endometriosis is still unknown. One theory suggests that during menstruation, some of the menstrual tissue backs up through the fallopian tubes into the abdomen, where it implants and grows. Another theory suggests that endometriosis is a genetic birth abnormality, in which endometrial cells develop outside the uterus during fetal development.

Q. What does stage 2 endometriosis mean?
A. Doctors classify endometriosis as minimal (stage 1), mild (stage 2), moderate (stage 3), or extensive (stage 4), based on the amount of scarring and diseased tissue found. Staging is important for determining which treatment will be best for you.

Q. What treatments are available?
A. Your doctor may want to treat your endometriosis surgically, with medications, or a combination of both. Surgery involves removing the endometrial tissue from your ovaries or fallopian tubes. It can usually be done during a laparoscopy. Treatments using medications may be used for a few months before attempting pregnancy. They include medications that shrink the endometrial tissue and those that stop or interfere with estrogen production. A decrease in estrogen production stops the growth of endometrial tissue.

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