The inner lining of the uterus is called the endometrium. During
a menstrual period, the lining of the endometrium is shed through the vagina. In
endometriosis, fragments of endometrium develop in places other than the inner
lining of the uterus. These fragments may develop on the ovaries, or sometimes
on the fallopian tubes, the vagina, the peritoneum, or the intestine.
Mild forms of endometriosis are common and may not require
treatment. Endometriosis can make it difficult for a woman to become pregnant.
Who can get endometriosis?
Any woman who has menstrual periods can get endometriosis.
Endometriosis occurs most often between the ages of 25 and 40, but it also can
occur in younger women. This condition may also persist after menopause in some
women, but such an occurrence is very uncommon.
What causes endometriosis?
The cause of endometriosis is unknown. Some experts believe that
pieces of endometrium travel back through the fallopian tubes and pass out into
the pelvic cavity (space inside the pelvis that holds the reproductive organs).
Tiny pieces of tissue may lodge on surfaces of the reproductive organs. During
menstruation, the tissue bleeds, just like the endometrium inside the uterus.
Surrounding tissue may become inflamed. Over time, scar tissue and cysts can
form.
What are the symptoms of endometriosis?
Many times, endometriosis has no symptoms. When symptoms are present, they may include:
- Very painful menstrual cramps
- Painful sex
- Difficulty becoming pregnant
- Abnormal or heavy bleeding during periods
- Abdominal cramps or back pain during menstruation
- Painful bowel movements
There is no connection between the symptoms and severity or
extent of endometriosis. In other words, patients with very mild disease may
have very severe symptoms while those with significant disease may not
experience significant symptoms.
How do you find out if you have endometriosis?
If you have any of the symptoms mentioned previously, see your
physician. You may need to undergo a surgical procedure called a laparoscopy to
confirm the diagnosis. In this procedure, a small scope is inserted through a
small incision in the abdomen so the physician can look for endometrial
implants. Many times, the physician will biopsy these implants in order to
confirm the diagnosis. Once the diagnosis is clear, he or she will attempt to
remove the implants during this surgery.
What is the treatment for endometriosis?
There is no known cure for endometriosis. However, there are
treatments to reduce the size of tissue growth and to relieve painful symptoms.
Treatment for endometriosis symptoms may include:
- Birth control pills
- Non-steroidal anti-inflammatory drugs (NSAIDs)
- Mirena®
- Danazol® (Danocrine)
- Gonadotropin-releasing hormone (GnRH agonist)
- Progestins
Although medical therapy will relieve pain, it will not increase
fertility rates. On the other hand, surgery may improve the pregnancy rate as well as relieve pain.
For severe cases, both medical and surgical treatment will
improve the symptoms of pain. As with mild disease, surgery will improve
pregnancy rates. In cases of mild and severe endometriosis, infertility
treatment options like artificial insemination and/or in vitro fertilization (IVF)
may be considered if pain is not a primary concern.
© Copyright 1995-2009 The Cleveland Clinic Foundation. All rights reserved.
Can't find the health information you’re looking for?
Ask a Health Educator, Live!
Know someone who could use this information?...send them this link.
This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 2/23/2009...#10857
