Endometriosis

Endometriosis is a progressive and often debilitating condition affecting approximately 10 percent of women of reproductive age. It is also present in 40 percent of women with infertility, making it one of the most common causes of infertility.

This often painful condition occurs when endometrial cells develop outside of their normal location inside the uterus. These misplaced cells still respond to hormonal changes in the same way as those lining the uterus so the tissue grows and sheds blood at the same time as the woman's menstrual period. But instead of flowing out of the body through the vagina, the blood shed by the misplaced cells has no way of leaving the body and the resulting internal bleeding can lead to chronic inflammation and the formation of adhesions and scar tissue. Areas commonly affected by these endometrial lesions include the ovaries, fallopian tubes, the ligaments that support the uterus, the area between the vagina and rectum, near c-section scars, on the outer surface of the uterus, and on the lining of the pelvic cavity. In rare cases, endometrial growths may even be found in the lung, arm, thigh, and other locations.

Endometriosis most often affects women between the ages of 25 and 44, but can also strike teenagers. Women who have given birth after the age of 30 may be at greater risk to develop it, as are Caucasian women, although it can affect women of any race; and it is more common in first-degree relatives (mothers, sisters, daughters), suggesting a possible genetic link.

Some women with endometriosis are symptom-free, while others have the condition for many years before experiencing any painful symptoms. But for many others, it can cause severe pain that interferes with daily life and, because it is a progressive disease, lesions and symptoms tend to worsen over time. Symptoms may include:

• Pelvic tenderness

• Pain during sexual intercourse

• Fatigue

• Abdominal bloating

• Premenstrual spotting

• Heavy periods

• Pain during ovulation as well as during menstrual periods

• Painful urination and bowel movements during periods

• Diarrhea

• Constipation

• Nausea and vomiting

• Endometriosis can also affect women emotionally, causing them to feel depressed, frustrated, confused, and develop a poor self-image.

Diagnosis is often made by taking a history of symptoms and using transvaginal ultrasound to locate lesions. However, a definite diagnosis is usually made using laparoscopy that shows the precise location, size, and extent of the growths. A woman is usually diagnosed as having mild, moderate, or severe endometriosis, based on the amount of scarring and diseased tissue found.

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