Endometriosis is a chronic disease in which tissue similar to the lining of the uterus (endometrium) grows outside the uterus. This misplaced tissue causes inflammation, pain, and depending on the location, can interfere with fertility. It mainly affects pelvic organs such as the ovaries, fallopian tubes, and the lining of the pelvis but can rarely be found in other parts of the body.
Causes and Pathogenesis
The exact cause of endometriosis is unknown, but several theories exist. The most accepted one is retrograde menstruation, where menstrual blood containing endometrial cells flows backward into the pelvic cavity, allowing those cells to implant and grow outside the uterus. Other contributing factors include cellular metaplasia (cells transforming into endometrial-like cells), stem cell involvement, genetic predisposition, and immune system alterations. Estrogen plays a key role in promoting the growth and inflammation of endometrial tissue outside the uterus.
Symptoms
Symptoms vary widely; some affected individuals may be asymptomatic, while others suffer severe symptoms including:
- Pelvic pain, often worse during menstruation
- Pain during or after sex
- Pain with urination or bowel movements
- Heavy or irregular menstrual bleeding
- Infertility or difficulty conceiving
- Chronic fatigue, nausea, and sometimes depression or anxiety
Symptoms often improve after menopause but can persist in some cases.
Diagnosis and Treatment
Diagnosis is primarily through symptom assessment and imaging (ultrasound, MRI), but definitive diagnosis requires surgical visualization with biopsy (laparoscopy). Treatments depend on symptom severity and reproductive goals, including hormonal therapies to reduce estrogen effects, pain management, and surgical removal of lesions. There is no cure, but symptoms can be managed effectively for many.
Endometriosis significantly impacts quality of life and often requires a multidisciplinary approach for optimal management.
If further details on specific aspects of endometriosis are needed, more focused information can be provided.
