Endometriosis | Disease Information

Endometrial cells that are found outside the uterus respond to hormones released during the menstrual cycle in the same way as endometrial cells that are located in the uterus. 1 At the beginning of the normal menstrual cycle, when the lining of the uterus is shed and menstrual bleeding begins, the sites of these abnormally located cells (implants) may swell and bleed.

The body responds to the swelling and bleeding by surrounding the cells with scar tissue. During the menstrual cycle, this scar tissue may become red, swollen, and painful. As the scar tissue increases, it can form adhesions that cover and bind the abdominal organs. Adhesions can interfere with an organ's normal function.

Endometriosis is an ongoing (chronic) and usually progressive disease. The rate of progression varies widely from woman to woman. Infertility or pain may be the only symptoms. Pain from endometriosis may start as mild discomfort a few days before the menstrual period or be unrelated to the menstrual cycle.

Symptoms may remain stable, decrease without treatment, or suddenly increase. Symptoms may resolve with treatment and then return later. Often symptoms decrease during pregnancy, and they usually disappear after menopause.

The exact cause of endometriosis is not known. Endometrial cells may be carried up through the uterus into the pelvis during menstruation or they may travel to other parts of the body in the circulatory system.

Diagnosis of endometriosis starts with a history of your symptoms and menstrual periods and a routine pelvic exam.

Additional exams and tests will be needed if symptoms are severe, treatment is being considered, or other conditions are suspected. Other tests may include:

Endometriosis is more difficult to treat when it is causing moderate to severe pain or infertility. Treatment may vary depending on whether you are treating pain or infertility. You may need to try several different treatments to find one that works best for you. Treatment may include medications to shrink the implants, laparoscopy to destroy implants, or surgery to remove the uterus and ovaries.

Endometriosis that causes only mild symptoms usually does not require medical treatment. Home treatment, such as taking a nonprescription pain medication or using a heating pad, may be all that is needed. When severe pain or infertility are present, treatment options include medications and surgery.

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