Endometriosis is a disease in which the endometrium (the tissue that lines the inside of the uterus or womb) is present outside of the uterus. Endometriosis most commonly occurs in the lower abdomen or pelvis, but it can appear anywhere in the body. Symptoms of endometriosis include lower abdominal pain, pain with menstrual periods, pain with sexual intercourse, and difficulty getting pregnant.
Endometriosis is seen in 12-32% of women having surgery for pelvic pain, and in up to 50% of women having surgery for infertility. Endometriosis is rarely found in girls before they start their period, but it is seen in up to half of young girls and teens with pelvic pain and painful periods.
- Superficial peritoneal lesion : This is the most common kind. You have lesions on your peritoneum, a thin film that lines your pelvic cavity.
- Endometrioma (ovarian lesion) : These dark, fluid-filled cysts, also called chocolate cysts, form deep in your ovaries. They don’t respond well to treatment and can damage healthy tissue.
- Deeply infiltrating endometriosis : This type grows under your peritoneum and can involve organs near your uterus, such as your bowels or bladder. About 1% to 5% of women with endometriosis have it.
The exact cause of endometriosis is unknown, but there are several theories that explain how and why endometriosis happens. Retrograde menstruation is one popular theory of its origin in which blood and tissue from a woman’s uterus travel through the fallopian tubes into the abdominal cavity during her period. Nearly all women have some degree of retrograde menstruation, but only a few women will get endometriosis. This may be due to differences in a woman’s immune system.
Another theory of endometriosis origin is called coelomic metaplasia, in which cells in the body outside of the uterus can undergo changes to become cells that line the uterus. This is a common explanation for endometriosis at unusual sites like the thumb or knee. Another possible explanation for endometriosis in locations far from the uterus is that cells from the lining of the uterus travel through blood vessels or the lymphatic system, thereby reaching other distant organs or body areas.
Endometriosis can also spread at the time of surgery. For example, a woman with endometriosis that undergoes a cesarean section could inadvertently have endometriosis implant in the abdominal incision so that she develops endometriosis in the scar from the surgery.
- Back pain during your period
- Severe menstrual cramps
- Pain when pooping or peeing, especially during your period
- Unusual or heavy bleeding during periods
- Blood in your stool or urine
- Diarrhea or constipation
- Painful sex
- Fatigue that won’t go away
- Trouble getting pregnant