Endometriosis

What is endometriosis?

The tissue that lines the uterus is called the endometrium. In endometriosis, the endometrial tissue grows in different places outside of the uterus. Often, this disease only affects the ovaries, fallopian tubes, and the tissue lining the pelvis. However, the tissue may also be found on the intestine, the vagina, or other places in the abdominal cavity as well. The out of place endometrial tissue acts like normal endometrial tissue would during a menstrual cycle. The tissue will begin to build up, thicken, and then will be shed. Since the misplaced tissue is unable to leave the body, it becomes stuck inside the body. This can cause inflammation, swelling, adhesions, and scarring of the nearby normal tissue resulting in pelvic pain, intense menstrual cramping, and potential problems with fertility. Cases of this disease can range from mild to severe. In some instances, the formation of scarring and adhesions could result in nearby pelvic tissue and organs becoming stuck together. When endometrial tissue grows on the ovaries, an endometrioma can form. An endometrioma is a cyst that forms around a blood blister that has been embedded into the ovary tissue. 
 
Endometriosis stages have been identified by the American Academy of Reproductive Medicine based on the characteristics of the endometrial tissue. 
 
  • Stage 1: Minimal
  • Stage 2: Mild
  • Stage 3: Moderate
  • Stage 4: Severe 
 
 
Risk factors
 
  • Getting your period at an early age
  • Never giving birth 
  • Uterine abnormalities
  • Consuming alcohol 
  • Low body mass index (BMI)
  • One or more relatives that have endometriosis
  • Short menstrual cycles
  • Having a higher amount of estrogen in your body 
  • Having any medical condition that alters the normal passage of menstrual flow out of the body 
  • Giving birth for the first time after age 30
  • Race (endometriosis is more common in white women)
 
 
Diagnosis 
In order to diagnose endometriosis, your doctor will complete a medical history and physical exam. Your doctor will ask you to describe your symptoms, especially the characteristics of any pelvic pain you may be having. Common methods used to diagnose endometriosis include:
 
  • Pelvic exam: Your doctor may perform a pelvic exam to potentially feel for any cysts or scarring near your reproductive organs. This is not a definitive diagnosis because in most cases it is hard to feel areas of endometriosis during a pelvic exam. 
  • Laparoscopy and biopsy: Laparoscopy involves going under general anesthesia. During this procedure, a small incision on the abdomen is made. A scope is then inserted through the incision to look for any misplaced endometrial tissue. Doctors are also able to take a biopsy (sample) of the tissue during this procedure to later be looked at under a microscope to confirm that it is endometrial tissue.
  • Ultrasound, computerized tomography (CT) scan, or magnetic resonance imaging (MRI) scan: Any of these imaging scans may be ordered to identify any possible cysts that may have formed. 
 
 
Treatment
Less severe cases of this disease may not need any treatment. Some medications used for treating/relieving symptoms of endometriosis include:
 
  • Over the counter pain medications
  • Birth control pills
  • Progestin therapy
  • Gonadotropin-releasing hormone agonists and antagonists 
 
In some cases, surgery may be used to treat endometriosis. Surgeries used to treat endometriosis include:
 
  • Laparotomy 
  • Laparoscopic surgery
  • Hysterectomy 
 
 
 
# ENDOMETRIOSIS BY THE NUMBERS #
  • Endometriosis is most common in women ages 25-40
  • 2-10% of American women ages 25-40 have endometriosis 
  • It is estimated that approximately 6 ½ million women in the U.S. have endometriosis
  • Women affected by endometriosis are more likely to have more difficulty getting pregnant or be infertile
 
about endometriosis
 
 

Sources:
  • “Endometriosis.” Mayo Clinic. Mayo Foundation for Medical Education and Research, 20 Aug. 2016. Web. 3 Aug. 2017.
  • “Endometriosis.” Cleveland Clinic, 29 May. 2014. Web. 3 Aug. 2017. 
  • “Endometriosis.” John’s Hopkins Medicine. John’s Hopkins Medicine Health Library, n.d. Web. 3 Aug. 2017.
  • “Endometriosis.” John’s Hopkins Medicine. John’s Hopkins Medicine Gynecology and Obstetrics, n.d. Web 3 Aug. 2017.
  • “Endometriosis.” Office on Women’s Health, US Department of Health and Human Services. Womenshealth.gov, 10 Jul. 2017.   Web. 3 Aug. 2017. 

 

Endometriosis is a disorder of the uterus where the lining, endometrial tissue, grows abnormally outside the uterus. This inflicts pain in the individual, especially during the menstrual cycle. Even though the endometrial tissue is displaced, it still behaves as it normally would – growing, breaking down, and bleeding with each menstrual cycle. The tissue becomes trapped and can possibly irritate surrounding tissue.
 
an overview of endometriosis

 

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