Endometriosis is small deposits of the womb lining that are located outside of the womb cavity. The most common place to find it is on the ovary, the back of the uterus and the ligamentous supports that hold the uterus in its normal position (uterosacral ligaments). It can also be found on the thin lining of the pelvic organs (the peritoneum), on the tubes, between the vagina and rectum (rectovaginal septum), in or on the bladder, in abdominal scars from previous surgery and even as far away from the pelvis as the lung!
Each time that you have a normal period, it can lead to cyclical swelling, stretching of tissues, inflammation and scarring. Eventually all the scarring and inflammation can lead to symptoms even when you're not having a period.
It is more common in women whose relatives have endometriosis, in women who have cycles shorter than 28 days and those who typically have a period lasting longer than a week. Many cases occur in women without these associations, of course, and not all women who fit into the above categories necessarily get endometriosis, and this can make diagnosis sometimes difficult. Find out more about endometrosis awareness.
What Causes Endometriosis?
There are several theories behind this, one possible cause is called retrograde menstruation. Normally during a period the menstrual blood comes out of the cervix and into the vagina. In around 75% of women, a small amount of blood flows backwards down the fallopian tubes and into the pelvic cavity. This blood contains tiny seedlings of the lining of the womb - endometrium. It is not known why in some women this might implant and lead to endometriosis, but not in others - it may have something to do with a particular woman's immune response and ability to fight off & remove these seedlings.
The metaplasia theory suggests that because the uterus, tubes, peritoneum and part of the ovary are all developed from the same area in the fetus, endometriosis might be caused by some cells taking the wrong turn during development.
The vascular theory rests on the fact that endometrial tissue from the lining of the womb can be found in the blood stream. It might be that these small deposits end up in other areas far from the womb and grow from there. This would explain the rare finding of endometriosis in sites such as the lung.
Most likely there is no one simple answer to explain it, and the true cause is a composite of all these.
What Problems can Endometriosis Cause?
The most common problems experienced by those with endometriosis are:
- Pelvic pain
- Painful periods
- Pain during intercourse
The pelvic pain caused by endometriosis can be very variable. It may be like a dull ache located generally over the lower abdomen, or may be more severe. It can be more localised into the rectum (back passage) or cause urinary symptoms. Sometimes the degree of pain felt by a woman is not related to the extent of disease found when the endometriosis is diagnosed. Some women have very extensive endometriosis, but their pain & discomfort is minimal. Others have only a few spots noted yet their pain is disabling. In general, however, the more endometriosis that is present, the more likely you are to have symptoms. It is probably more to do with how deep the endometriosis is buried.
Painful periods are often the first sign a woman might have that endometriosis is present. The pain usually begins a few days before the period is due and continues throughout the period. It is typically located in the centre of the pelvis, but can be one-sided. It may go into the back or down the legs. Also find out the connection between frozen shoulder and endometrosis.
Pain on intercourse is often worse with a particular position and especially with deep penetration. Many women experience an aching in the pelvis after intercourse. Managing the pain of endometriosis and coping with this condition can sometimes be difficult.
The link between endometriosis and infertility is sometimes difficult to explain. When the disease is so bad that there is much scarring around the tubes, or there are ovarian cysts, it is not surprising that this might interfere with normal fertility. It is less clear how a few small spots of endometriosis might have a detrimental effect on attempts at pregnancy. Nevertheless, studies have found that endometriosis is more common in women who have difficulty conceiving, supporting the link. Also, another major study looking at treatment of mild to moderate endometriosis did find an improved fertility rate in women who received treatment. Also read up on PID and endometrosis.
Other Endometriosis Symptoms
Although the above problems are most common, some women experience other symptoms related to where endometriosis might have implanted:
- painful bowel movements or passing blood in the stools (known as dyschezia)
- painful pelvic exams
- painful and frequent urination, or bleeding when passing water during the time of the period
Its important to talk to your doctor if you have been diagnosed with endometriosis or if you think you may have this condition. Also read up on the possible connection between endometriosis and cancer and learn how to deal with you emotions regarding the condition.
Blood in your stool can also be a sign of an STD. Check out our forum for more inforation.