Endometriosis is a condition in which endometrial tissue (tissue that lines the inside of the uterus) grows outside the uterus. 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.
This 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 cyst called an endometrioma, which may interfere with ovulation.
Endometriosis is a progressive disease. It tends to get worse over time and can reoccur after treatment. It usually improves after menopause.
Symptoms of Endometriosis
You may experience painful menstrual periods, abnormal menstrual bleeding, or pain during or after sexual intercourse. However, you may not have any symptoms at all.
Causes of Endometriosis
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.
diagnostic tests for endometriosis
Your medical history and a pelvic exam may suggest the diagnosis of endometriosis. However, only a laparoscopy can confirm this. A laparoscopy is an outpatient surgical procedure. Your doctor uses 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.
treatment for endometriosis
Your doctor may want to treat your endometriosis surgically, with medications, or with a combination of both. Medications are mainly used to treat symptoms of endometriosis, shrinking the endometrial tissue and affecting estrogen production. A decrease in estrogen production stops the growth of the tissue; however, surgery is the best option. Surgery involves removing the endometrial tissue from your ovaries or Fallopian tubes and can usually be done during a laparoscopy. If, however, there is severe disease, then your physician may recommend in vitro fertilization (IVF).
Why is endometriosis classified by stages?
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.