by Vikki McMahon

Created on: April 28, 2008   Last Updated: April 29, 2008

Endometriosis is a reproductive disease occurring in approximately 5-10% of women. It is diagnosed when endometrial tissue is found outside of the uterus, mainly in the pelvic cavity although it has been found in other areas of the body. Endometriosis causes adhesions and scar tissue to form on other organs, leading to prolonged periods of pain and discomfort.

Although not definitive, there are many studies as to what causes endometriosis. Metaplasia, where one type of tissue is replaced with reproductive tissue, is one theory. This is thought to occur in utero, when the reproductive organs are first forming. Another theory is retrograde menstruation. This is when the menstrual flow backs up into the pelvic cavity, usually through the Fallopian tubes, instead of passing out of the body. It attaches to other organs in the pelvic cavity, leaving adhesions and scar tissue. This theory has recently been disproved, as approximately 90% of women experience retrograde menstruation but not all develop endometriosis. Genetics may also play a role. Studies have shown a hereditary link, and are working to isolate the responsible gene. To a lesser degree, immunologic response and environmental concerns may also be a factor.

Symptoms of endometriosis can vary and do not always correlate to the severity of the disease. Pain is the most prevalent symptom. The pain can be felt at any time before, during, or after menstruation. It can manifest as ovulation pain, bowel or urinary pain, low back pain, or pain during sexual intercourse. It is also responsible for some hip joint pain as adhesions can form around the joint ligaments or the sciatic nerve. Other symptoms are diarrhea or constipation, heavy or irregular bleeding, excessive bloating, fatigue, and infertility. These symptoms can also overlap with those indicative of ovarian cancer. These symptoms should be discussed thoroughly with a physician. Although not conclusive, some studies show a slightly elevated risk of developing ovarian cancer in women diagnosed with endometriosis.

Treatment of endometriosis is dependent upon the severity of the diagnosis. For mild cases, over-the-counter or prescription painkillers taken as needed may be effective. Hormone treatments may also be prescribed. Endometriosis progresses due to the presence of estrogen. Hormones like those found in birth control pills or IUDs may slow the course of the disease, as can progestins and danazol, although this is seldom used anymore. Hormone treatments need to be closely reviewed as they provide temporary relief at best, and the side effects can be prohibitive. For more severe cases, surgery may be in order. The most common, laparoscopic surgery, removes the adhesions, cysts, and lesions using a laser or cutting. Among these more formal treatments, many patients are opting to take a more natural approach. Nutritional therapy, herbs, acupuncture, and traditional Chinese medicine have all been shown to alleviate symptoms and elevate energy levels in the patients.

Endometriosis is no longer a disease that one must "just live with". Although there is no cure, new advances are making pain management possible in most cases. All options should be thoroughly discussed with a physician in order to determine the best course of treatment. Please visit www.endometriosis.org for more information.

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