Endometriosis is a chronic condition where the layer of tissue that covers the inner side of the uterus, the endometrium, is found on other sites of the body besides the uterus. This tissue is often found on the fallopian tubes, ovaries, and tissues surrounding them. In rare cases, it can also be found in further parts of the body.
While the cause of endometriosis is not clear, some of the risk factors for endometriosis include having a family history (increased by 7 to 10 times), increased exposure to menstruation (early start of menstruation, heavy bleeding during menses, having short menstrual cycles, or increased duration of menses), conditions that interfere with normal menstrual flow (i.e. fibroids, polyps, structural abnormalities of the uterus), immunologic disorders, and a history of abdominal surgery. Since the affected sites proliferate and bleed (much like intrauterine endometrium) according to the menstrual cycle, they can cause inflammation and fibrosis or adhesions in the surrounding areas. These processes are responsible for the clinical consequences of the condition.
The diagnosis of endometriosis is usually achieved based on symptoms, medical imaging, and biopsy. While there is no cure, management of endometriosis includes pain medication, hormonal treatments, and surgery. It is estimated that approximately 10.8 million women were affected worldwide as of 2015.
Symptom #1: Dysmenorrhea
Dysmenorrhea is a medical term that refers to pain during menstruation or menstrual cramps. It usually starts around the time when menstruation begins and usually lasts no longer than three days. The pain is located in the lower abdomen and may also include back pain (lumbago), nausea and diarrhea. There are two types of dysmenorrhea. Primary dysmenorrhea is menstrual pain without an underlying condition, while secondary dysmenorrhea refers to menstrual pain associated with an underlying disease. Endometriosis is one of the main causes of secondary dysmenorrhea.
Unlike primary dysmenorrhea, secondary dysmenorrhea is more common among women older than 30 years, and gradually worsens with aging. Secondary dysmenorrhea is usually associated with endometriosis, adenomyosis, and uterine fibroids. The mechanism of pain in endometriosis is associated with primary endometriotic lesions (i.e. lesions of the peritoneum that induce inflammatory reactions or ruptured cysts) or secondary lesions (i.e. scar, fibrosis and adhesions may reduce mobility of organs and cause pain).