What exactly is Endometriosis?

Endometriosis occurs when the cells lining the inside of the womb wander around the pelvis and abdomen.  There are many theories about how this happens. The most likely is that the menstrual flow spills out the fallopian tube instead of all coming out into the vagina. That flow could spread to the ovaries, the top, front and back of the womb, the bladder, or the intestines, or the peritoneum (the lining of the abdomen.)

When they stick to other areas, those lining cells act as if they are still inside the womb and grow, shed, and bleed in response to the normal hormones of estrogen and progesterone.  The problem is there is no place for the blood and tissue to go so it sits wherever it forms and sticks to more organs and forms scar tissue, adhesions. The adhesions can be tight bands like piano wire or they can just clump tissue and organs together in hard cement-like masses.

This can be extremely painful, usually worse during the time leading up to and including the menstrual cycle.  Depending on location and how far into the organs endometriosis invades, some women may have extreme pain with a relatively small amount of endometriosis, whereas other women have wide areas involved and have relatively little discomfort.

There is a tendency for this to run in families. The only way to diagnosis endometriosis is through surgery.  Doctors can make an educated guess however, based on the woman’s symptoms, her family history, or how she responds to treatment.

Current treatment is based on changing the hormone sequence affecting the endometriosis.  Doctors use birth control pills, anti-estrogen shots such as Lupron Depot, Depo-Provera injections, and if no relief, surgery.  Endometriosis can make it difficult for a woman to become pregnant, but is she has mild disease and is successful in becoming pregnant, the pregnancy hormone changes can wipe out the endometriosis.