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The uterus, or womb, is where a fetus grows during pregnancy, and it is lined with tissue called the endometrium. Endometriosis is a disease in which tissue like that lining grows in other places in the body.
Where it grows
The patches of tissue are called implants, nodules or lesions. They are most often found:
- on or under the ovaries;
- on the fallopian tubes, which carry eggs from the ovaries to the uterus;
- behind the uterus;
- on the tissues that hold the uterus in place;
- on the bowels or bladder.
Rarely, the tissue grows on the lungs or elsewhere in the body.
Cause and risk
Researchers don't know what causes endometriosis. It can affect anyone who menstruates, and some factors change the risk:
| Higher risk | Lower risk |
|---|---|
| a mother, sister or daughter with endometriosis | having been pregnant before |
| periods that started before age 11 | periods that started late in adolescence |
| short monthly cycles (under 27 days) | breastfeeding |
| heavy periods lasting more than 7 days |
Symptoms
The main symptoms are:
- pelvic pain, often during a period;
- infertility.
Other possible symptoms:
- painful menstrual cramps that may worsen over time;
- pain during or after sex;
- pain in the intestine or lower abdomen;
- pain with bowel movements or urination, usually during a period;
- heavy periods, or spotting and bleeding between periods;
- digestive or gastrointestinal symptoms;
- fatigue or low energy.
Diagnosis
Surgery is the only way to know for certain. A health care provider will first ask about symptoms and medical history, do a pelvic exam, and may order imaging tests.
The most common diagnostic surgery is a laparoscopy: the surgeon inserts a laparoscope — a thin tube with a camera and light — through a small cut near the belly button. The provider can diagnose endometriosis from how the patches look, and may take a tissue sample (biopsy).
Treatment
There is no cure, but there are treatments for the symptoms, chosen with the provider.
For pain:
- Pain relievers, including nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, and a prescription medicine made specifically for endometriosis. Opioids are sometimes prescribed for severe pain.
- Hormone therapy, which stops the ovaries from making hormones. This may slow the growth of the tissue and may stop new areas from forming. Types include birth control pills, progestin therapy, and gonadotropin-releasing hormone (GnRH) agonists and antagonists. GnRH medicines cause a temporary menopause; once they are stopped, periods return and pregnancy is possible.
- Surgery for severe pain, to remove the patches or cut some nerves in the pelvis, either by laparoscopy or as major surgery.
For infertility caused by endometriosis:
- laparoscopy to remove the patches;
- in vitro fertilization.
Sources
- MedlinePlus, National Library of Medicine: "Endometriosis," with a summary from the National Institute of Child Health and Human Development, National Institutes of Health.
- A typing error in the source ("After your stop taking the medicines") is corrected here.
Лицензия: CC0 1.0 (общественное достояние) · По материалам medlineplus.gov
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