Endometriosis

What is the endometrium?

The endometrium is the mucous membrane lining of the inner surface of the uterus. Each month, the endometrium grows and becomes engorged with blood, and then is shed during the menstrual period.

What is endometriosis?

When fragments of the endometrium develop in other places, such as in the muscular wall of the uterus, ovaries, fallopian tubes, vagina, or intestine, the condition is called endometriosis. Each month, these fragments (sometimes referred to as endometrial implants, lesions, nodules, or growths) bleed just as endometrium does in the uterus, but the blood has no place to go. The blood becomes embedded in the tissue where it is located, forming blood blisters that may become surrounded by a fibrous cyst. The cause for this condition is not known.

Where are endometrial implants found?

Although endometrial implants are most-often found on the ovaries, they may also be found in other places, including the:

• fallopian tubes
• ligaments that support the uterus
• area between the vagina and rectum
• outer surface of the uterus
• lining of the pelvic cavity

Occasionally, the implants may also be found in other places, including the:

• intestines
• rectum
• bladder
• vagina
• cervix
• vulva

What are the symptoms of endometriosis?

The following are the most common symptoms for endometriosis, however, each individual may experience symptoms differently. Symptoms of endometriosis include:

• pain in the pelvic area, and possibly the abdomen and lower back
• change in menstrual periods
• infertility

However, some women with severe endometriosis may have no signs or symptoms, while others with minimal disease may have severe pain or other symptoms.

How is endometriosis diagnosed?

In addition to a complete medical history and physical examination, including a pelvic examination, your physician may perform a laparoscopy.

Laparoscopy is a minor surgical procedure in which a laparoscope (tube with lens and light) is inserted into an incision in the abdominal wall. Using the laparoscope to see into the pelvic area, the physician is able to locate the endometrial implants.

How may endometriosis be treated?

Specific treatment for endometriosis will be determined by your physician(s) based on:

• your overall health and medical history
• extent of the disease
• your tolerance for specific medications, procedures, or therapies
• expectations for the course of the disease
• your opinion or preference
• your desire for pregnancy

In general, treatment includes:

• medication to suppress function of the ovaries to stop the growth and activity of the endometrial implants
• hormone suppression therapy
• a combination of therapies
• laparotomy - surgery to remove as much of the displaced endometrium as possible without damaging healthy tissue
• hysterectomy - surgery to remove the uterus and possibly the ovaries