What is endometriosis?Endometriosis occurs when tissue that acts a lot like the lining of your uterus—called endometrium—starts growing outside of your uterus, where it doesn't belong.
Endometriosis pain levels can be affected by the depth and location of the lesions. Endometriosis is described as having four stages. Each stage is based on location, amount, depth, and size of lesions. The pain associated with endometriosis may not correlate with the stage of disease. For example, a women with Stage 1 endometriosis could have significant pain or very few symptoms.
Endometriosis causes and risk factors
The exact cause is unknown. Most scientists think that it happens because of a process called retrograde menstruation.
Retrograde menstruation happens when tissue that lines the inside of your uterus flows out in the wrong direction during the period—through the fallopian tubes. While this process can occur in many healthy women as well, women with endometriosis experience it differently. The out-of-place tissue can attach and start growing on surfaces and organs in the pelvic region. This can cause pain and inflammation.
Other possible theories on what causes endometriosis include:
The immune system not destroying endometrium cells outside of the uterus the way it should
Normal cells in the pelvic area changing into endometrial cells. This is called coelomic metaplasia
Endometrial cells forming outside of the uterus before birth, so that during puberty, those cells form endometrial lesions
Treatment optionsPainkillers:
Both prescription and over-the-counter painkillers can decrease inflammation and may help with endometriosis-associated pain.
Hormonal birth control:
Hormonal birth control can prevent estrogen fluctuation, which may reduce endometriosis-associated pain during the period. Hormonal birth control can be used in several ways. Some include:
Birth control pills (includes estrogen/progestin pills and progestin-only pills)
Hormonal IUDs (intrauterine devices)
Progestin injection
Implants
Laparoscopy (LAP-uh-RAHSK-uh-pee):
A laparoscopy is a minimally invasive surgery that can be used to diagnose endometriosis and remove lesions, which can relieve endometriosis pain. If you are considering a laparoscopy, ask your doctor about the different methods, including:
Ablation
– a procedure that destroys (ablates) the surface of endometriosis lesions
Excision
– a procedure that cuts out (excises) endometriosis lesions
Gonadotropin-releasing hormone (GnRh) antagonist medications:
These medications block GnRH receptors in the pituitary gland at the base of the brain. This leads to the body producing less estrogen. Lower estrogen levels can help relieve endometriosis pain.
Gonadotropin-releasing hormone (GnRH) agonist medications:
Usually taken as an injection or nasal spray, these medications stimulate GnRH receptors in the pituitary gland at the base of the brain. Over time, this makes the receptors less sensitive, causing the body to produce less estrogen. Lower estrogen levels can help relieve endometriosis pain.
Hysterectomy (HISS-ter-REKT-uh-mee):
A hysterectomy is the surgical removal of the uterus (and sometimes one or both ovaries), which can relieve pain. A hysterectomy is generally viewed as a last-resort treatment because of its complexity and irreversibility.