Endometriosis: a painful condition

Savitri is distraught. She has been having painful periods for many years but the pain has been getting worse for the past few months. She and her husband have been trying for a pregnancy for the past year but without any success. She has had an ultrasound today and she has been told she has endometriosis leading to an endometrioma in her right ovary. She wants to know if it is a serious condition.

What is endometriosis?

The lining of the uterus is called the endometrium. Sometimes, this tissue grows outside the uterus, and can be present in the pelvis. When this happens it is called endometriosis. Most often it affects the ovaries where it may cause a cyst (also known as an endometrioma). It can also affect the fallopian tubes, the surface of the uterus and the cul-de-sac (the space behind the uterus).  Less often, it can affect the bowel, bladder and the rectum.

Endometriosis can cause pain before and during the menstrual period. For some women, the pain is mild. For others, it can be severe. Severe endometriosis also may lead to infertility. Endometriosis is found in about one third of infertile women.

Endometrial tissue outside the uterus responds to changes in hormones. It also breaks down and bleeds like the lining of the uterus during the menstrual cycle. This bleeding can cause pain, especially before and during the period. This process each month also can cause scar tissue, called adhesions. Sometimes adhesions bind organs together. Adhesions also can cause pain. 

What causes endometriosis?

Though there are several theories about the cause of endometriosis, there is no specific way of preventing it from occurring. For most women, a small amount of blood and cells flow through the fallopian tubes into the abdomen during their period. For women with endometriosis, the cells in the blood that flows through the tubes attach to other places and grow.