Endometriosis is a painful female disorder in which the lining of the uterus leaves the uterus through the Fallopian tube and begins to settle and grow in areas outside the uterus.  The most common areas involved include the ovaries, pelvic tissue lining, and bowel.  Endometrial tissue can spread beyond the pelvis rarely.

The displaced endometrial tissue acts as it would in the womb; it thickens during the growth phase of the menstrual cycle and breaks down and bleeds just like normal endometrial lining does.  When this happens, there is extreme pain in the pelvic area.  The surrounding tissue becomes irritated and can form a scar with adhesions.  The adhesions can be painful and can contribute to infertility.

Endometriosis causes its most pain during the menstrual period.  The primary symptom is pelvic pain, worse with menstruation.  Other signs and symptoms include pain during or after intercourse, excessive bleeding during the menstrual cycle, infertility and symptoms of fatigue, diarrhea, constipation, bloating or nausea, particularly during one’s menstrual period.


Endometriosis is sometimes mistaken for pain from other pelvic causes such as pelvic inflammatory disease, ovarian cysts or irritable bowel syndrome, which is a condition that causes constipation, diarrhea and abdominal pain.  A woman can have both irritable bowel syndrome and endometriosis, which complicates the diagnosis.

The exact cause of endometriosis is not clear although there are several possible explanations.  These include the following:

  • Embryonic cell growth. The cells lining the abdominal and pelvic cavities contain embryonic cells that can grow into endometrial tissue, the start of endometriosis.
  • Retrograde menstruation. Most doctors feel that this is the main reason why patients have endometriosis.    The menstrual blood flows back up into the Fallopian tubes and out to the ovaries, external uterus, and bowel area.  They stick to the walls of the pelvis and begin to grow nodules of tissue resembling the uterine lining.
  • Surgical scar implantation. Following a surgery, such as a cesarean section or hysterectomy, endometrial cells can attach to the incision and begin to grow on the inside of the scar.
  • Endometrial cell transport. The blood vessels or lymphatic fluid system may transport endometrial cells to other parts of the body.
  • Immune system problem. There could be a problem with the immune system so that the body can’t transport endometrial cells to other parts of the body.

People at greatest risk of developing endometriosis include those women who have never given birth, have a first order relative such as a mother or sister who has had endometriosis, have a medical condition that prevents the normal flow of menstrual blood out of the body, have a history of pelvic infections or a history of uterine abnormalities.

Complications of infertility include infertility.  About a third to a half of all women with endometriosis have problems getting pregnant and suffer from infertility issues.  Endometriosis can block or narrow the Fallopian tube or can settle on the egg, interfering with ovulation and with a connection between sperm and egg (fertilization).In addition, women with endometriosis tend to have higher than normal rates of ovarian cancer.

In order to treat endometriosis, the doctor needs to consider giving pain medication, especially nonsteroidal anti-inflammatory medications.  Supplemental hormones are sometimes given to thin the endometrium and endometrial tissue.  This includes birth control pills, gonadotropin-releasing hormone agonists and Depo-Provera.   Danazol is sometimes given as it suppresses the growth of endometrial tissue by blocking the production of ovarian-stimulating hormones.

If a couple is trying to get pregnant, the woman can undergo surgery to remove adhesions and any endometrial tissue found.  If this doesn’t work, then in vitro fertilization is the next best bet. For More Information Visit: Sydney Medical Claims

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