• Endometriosis is the abnormal growth of cells (endometrial cells) outside of the uterus. Endometriosis is most commonly found on other organs of the pelvis.
• The exact cause of endometriosis has not been identified.
• Endometriosis is more common in women experiencing infertility than infertile women, but the condition does not necessarily cause infertility.
• Most women with endometriosis have no symptoms. However, when women do experience signs and symptoms of endometriosis, they may include:
○ Pelvic pain that may worsen during menstruation
○ Painful intercourse
○ Painful bowel movements or urination
• Pelvic pain during menstruation or ovulation can be a symptom of endometriosis, but may also occur in normal women.
• Endometriosis can be suspected based on the woman’s pattern of symptoms, and sometimes during a physical examination. But the definite diagnosis is usually confirmed by surgery, most commonly by laparoscopy.
Treatment of endometriosis includes medication and surgery for both pain relief and treatment of infertility if pregnancy is desired.
Most women who have endometriosis do not have symptoms. Of those who do, the most common symptoms include:
• Pain (usually pelvic) that generally occurs just before menstruation and lessens after menstruation
• Painful sexual intercourse
• Cramping during intercourse
• Cramping or pain during bowel movements or urination
• Pain with pelvic examinations
The intensity of the pain can vary from month to month and can vary significantly among affected individuals. Some women experience progressive worsening of symptoms, while others can have a resolution of pain without treatment.
Pelvic pain in women with endometriosis depends partly on where endometrial implants location.
• Deeper implants and implants in areas of high nerve density are more apt to produce pain.
• The implants may also release substances into the bloodstream, which are capable of eliciting pain.
• Pain can result when endometriotic implants incite scarring of surrounding tissues. There appears to be no relationship between the severity of pain and the amount of anatomical disease present.
• Endometriosis can be one of the reasons for infertility for otherwise healthy couples. When laparoscopic examinations are performed during evaluations for infertility, implants are often found in totally asymptomatic individuals. Endometriosis may incite scar tissue formation within the pelvis. If the ovaries and Fallopian tubes are involved, the mechanical processes involved in the transfer of fertilized eggs into the tubes may be altered. Alternatively, the endometriotic lesions may produce inflammatory substances, which adversely affect ovulation, fertilization, and implantation.
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