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Endometriosis: Causes, Symptoms & Treatments

Endometriosis is a women's medical condition that occurs when the lining of the uterus, called the endometrium, grows in other places, such as the fallopian tubes, ovaries or along the pelvis. When that lining breaks down, like the regular lining in the uterus that produces the menstruation, it has nowhere to go. This causes cysts, heavy periods, severe cramps and even infertility. More than 5 million women in the United States are affected by this condition, according to the National Institute of Child Health and Human Development.

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Credit: Piotr Marcinski | Shutterstock

Causes & Symptoms

The cause of endometriosis is unknown, but researchers have several theories. One theory is that during menstruation, blood with endometrial cells flows back into the fallopian tubes, according to the Mayo Clinic. The cells are rooted there and grow a new lining. Another theory is that the bloodstream carries endometrial cells throughout the body, while it's also theorized that endometriosis is a genetic condition. Yet another theory, according to the Mayo Clinic, is that abdominal cells that were present since a woman's embryonic state retain their ability to become endometrial cells.

The most common symptom of endometriosis is extreme cramping during menstruation. This is due to internal bleeding from the lining being shed inside the body, and can also lead to scar tissue formation and bowel problems, according to the Endometriosis Association.

Women with the condition may also experience pain while having sex, fatigue, painful urination or bowel movements during menstruation and gastrointestinal upset according to the Endometriosis Association.

However, some women don't experience any symptoms at all, but realize they have the condition when they are unable to get pregnant, according to the National Institutes of Health.

Diagnosis & Tests

The only way for endometriosis to be diagnosed for certain is through laparoscopy, which is a minor surgical procedure that involves your doctor putting a thin scope into your abdomen to view your pelvic organs, according to the American Congress of Obstetricians and Gynecologists. If the doctor sees the extra endometrial tissue during the laparoscopy, he or she can also remove it right there to treat the condition.

A basic pelvic exam, where the doctor manually feels for abnormalities, is another way of testing for endometriosis. If all other causes of pelvic pain can be ruled out, the doctor can choose to treat the condition surgically or with medicine, according to the American Congress of Obstetricians and Gynecologists.

Vaginal or abdominal ultrasound can't test for endometriosis, but it can test for ulcers that may be caused by the condition, according to the Mayo Clinic.

 

Risks & Complications

There are several risk factors for endometriosis, according to the Mayo Clinic, none of which can really be helped. They include: never having given birth, having a mother with endometriosis, having menstrual cycles that are shorter than 27 days and bleeding that lasts longer than eight days, being white or Asian, having a medical condition that makes the passage of menstrual flow irregular, and having previous damage to cells that line the pelvis.

The biggest complication with endometriosis, the Mayo Clinic said, is fertility problems. The clinic estimates that a third to a half of women with endometriosis have difficulties getting pregnant. Infertility can occur because the condition can create adhesions that trap the egg near the ovary, making it difficult for it to travel down the fallopian tube to be fertilized by sperm.

However, that doesn't mean all women with endometriosis can't get pregnant – it just might take them a little longer, the Mayo Clinic said. However, the longer you go without having had a child, the worse endometriosis gets. Thirty to 40 percent of women with endometriosis are infertile, according to the National Institute of Child Health and Human Development.

Treatments & Medications

Treatment for endometriosis is usually limited to pain medication (for the severe cramping), hormone therapy to slow growth of the endometrial tissue and surgery to remove the tissue, according to the National Institute of Child Health and Human Development.

Some common hormones prescribed include oral contraceptives, or birth control pills, a gonadotropin-releasing hormone, which essentially turn off the ovaries to lower estrogen levels, or the progestin hormone, which shrinks the endometrial tissue, according to the American College of Obstetricians and Gynecologists. However, some of these hormones come with side effects.

Laparoscopy and laparotomy are common forms of surgery used to treat endometriosis that require going in through the abdominal region to remove the endometrial tissue. However, if symptoms keep coming back after these surgical procedures, a hysterectomy, or total removal of the uterus, could be an option, according to the American College of Obstetricians and Gynecologists. Often, medications and surgery are used together to treat women with endometriosis.

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