by Eric Lannak

Created on: April 27, 2008   Last Updated: April 29, 2008

The endometrium lines the womb, becoming either a placenta or a woman's menstrual discharge. Every 28 days or so it is rebuilt again in preparation for conception.

Sometimes endometrial cells migrate to other parts of the body and multiply. Unlike cancer, where native cells mutate and destroy healthy tissue, endometriosis is a proliferation of healthy cells. But they grow in inappropriate areas and interfere with the body's functions, most commonly in the abdomen or fallopian tubes. This causes discomfort and pain because endometrial tissues swell during increases in a woman's estrogen level. The swelling can create blockages and lesions, press on nerves and blood vessels, and even cause scarring.

A widely held theory suggests the cause is "menstrual reflux", which forces endometrial cells up the fallopian tubes and into the abdominal cavity during menstruation. However, 90% of women have this reflux, but only about 5% have endometriosis.

Other theories suggest blood and lymph systems transport the cells, or that they were "misplaced" during fetal development. Environmental chemicals have been implicated, but this is unlikely; a percentage of all women in the child-bearing ages, regardless of race, status, heritage, or lifestyle, will suffer from endometriosis.

The symptoms usually include pain in the pelvic area. If the pain increases every few weeks, then reduces or goes away after her period, a woman may indeed have endometriosis.

Other symptoms include: diarrhea, painful bowel movements, or other intestinal distress during menstruation; bloating and swelling in the belly; fatigue, exhaustion, or a generally "tired" feeling; very heavy or irregular menstrual bleeding; and pain during or after sex. Hip pain is common where endometriosis affects the sciatic nerve, or where adhesions affect the ligaments. The pain typically becomes worse during menstruation.

A tentative diagnosis can be made from symptoms, and tests like ultrasound. But proof requires a biopsy, a surgical removal of a tissue sample for testing.

There is no cure, but endometriosis can be treated with hormones, drugs, and surgery.

Hormones and drugs are used most often, and can control the symptoms. These therapies focus on reducing a woman's estrogen level to reduce the swelling of endometrial tissues, but they also have side effects that include preventing conception.

The surgical removal of endometrial tissues may allow an infertile woman to conceive, and is the preferred strategy where conception is the goal. Surgery also has a high success rate in relieving symptoms, but poses obvious risks.

Endometriosis must be monitored. A recent study found it increased the risk of ovarian cancer, endocrine tumors, kidney cancer, and thyroid cancer by over 30%. As many as 1 in 5 may also suffer from rheumatoid arthritis, lupus, chronic fatigue syndrome, and osteoporosis.

Endometriosis is a serious ailment. It is rarely life-threatening, but it can cause serious pain that will only grow more severe without medical management. If you or someone you know might suffer from endometriosis, consult a doctor.

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