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Endometriosis is a condition in which tissue that is usually found inside the uterus grows in places where it should not. Normally, the uterus is lined with tissue (called the endometrium) that grows and thickens every month to prepare for pregnancy. Hormones produced by the ovaries control this monthly process. If pregnancy does not occur, the blood and tissue is shed and leaves the body in the form of menstrual flow (the period).

However, problems arise if endometrial tissue grows outside the uterus, in places such as the ovaries; the fallopian tubes; the bladder, bowel or rectum; or in the tissue lining the pelvis. Hormones tell the tissue growing in the wrong place (called an implant) to fall out each month. But the blood and tissue have no way to leave the body (sacs that are often filled with old blood). Sometimes, large cysts break open.

Endometriosis can cause chronic pain and infertility. Approximately 30 to 40 percent of women with endometriosis have difficulty getting pregnant.

The exact cause is unknown. One possible cause is a process called retrograde menstruation. This happens when menstrual blood flow flows back through the fallopian tubes into the pelvis instead of out of the body. The uterine tissue then stays in the pelvis and grows. Another possible cause is inheriting a gene that increases the risk of endometriosis.

Women are more likely to have endometriosis if they:

  • Your mother, sister or daughter has it.
  • They have a disorder that prevents normal menstrual flow.
  • Have menstrual cycles of less than 27 days and flow lasts more than eight days

Symptoms of endometriosis?

In some cases, infertility is the first symptom of endometriosis. However, there are treatments that can help these women become pregnant. Some women have no symptoms at all. If symptoms occur, women may suffer from infertility in addition to infertility:

  • Pelvic pain and cramps before and during the menstrual period, often worsening over the years.
  • Abdominal or pelvic pain during ovulation
  • Lower back pain
  • Pain during and after intercourse
  • Pain when urinating or during bowel movements, especially during the period
  • Diarrhoea, constipation, nausea, bloating or fatigue.

The degree of pain a woman feels is not related to the level of endometriosis she has. However, severe or frequent pain can interfere with daily activities. Women with pain or infertility may feel worried, upset, depressed or frustrated.

What is the treatment for endometriosis?

Endometriosis is treated with medication, surgery or both. Over-the-counter pain relievers relieve menstrual cramps and other pain. Hormone treatments decrease or block the action of ovarian hormones that cause the implants to grow and bleed. Hormone treatments include

  • Birth control pills
  • Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • GnHR agonists
  • Progestins (including some IUD implants)