Endometriosis is an inflammatory condition in which cells similar to those of the endometrium, the type of tissue that forms uterine lining, are found outside the uterus.
Implants mostly occur in the following places:
- Peritoneum;
- Ovaries;
- Fallopian tubes;
- Outer surfaces of the uterus, bladder, ureters, intestines, and rectum; and
- Cul-de-sac.
Additionally, many women and individuals assigned female at birth with endometriosis have no symptoms. Those without symptoms often learn they have endometriosis when they cannot get pregnant or when they are having surgery for something else.
Endometriosis is characterized by non-menstrual pelvic pain as well as pain during menstruation. Endometriosis forms when the cells that normally line the uterus begin to grow outside of the uterus. These cells depend on a hormone called estrogen.
Endometriosis tissue grows and bleeds like the uterine lining does during the menstrual cycle. Tissue surrounding endometriosis tissue can become irritated, inflamed, and swollen.
The breakdown and bleeding of endometriosis tissue each month can also cause scar tissue to form. This scar tissue is called adhesions. Sometimes adhesions can cause organs to stick together making getting pregnant difficult. The bleeding, inflammation, and scarring can cause pain, especially before and during menstruation.
An obstetrician-gynecologist (OB-GYN) first may do a physical exam, including a pelvic exam, and order an ultrasound. An ultrasound can detect some kinds of endometriosis but may not detect other types.
The only way to certainly diagnose endometriosis is through a surgical procedure called laparoscopy. Access to ultrasound and laparoscopy are time-consuming and expensive processes.
Almost 4 in 10 individuals assigned female at birth with infertility have endometriosis.
Inflammation caused by endometriosis may damage the sperm, the egg, or interfere with their movement through the fallopian tubes and uterus. In severe cases of endometriosis, the fallopian tubes may be blocked by scar tissue (adhesions).
