In endometriosis, endometrial tissue is found in places in the body other than the lining of the uterus, including the ovaries, fallopian tubes, outer surface of the uterus, bowel, other pelvic structures or organs, and peritoneum. Rarely, it may also attach to places far from the pelvis. There are several theories about how this occurs:
– There may be a backward flow of blood through a fallopian tube.
– The endometrial cells may leave the pelvis through the blood or lymph vessels.
– Endometriosis may appear spontaneously.
Endometrial tissues outside the uterus respond to hormones like the endometrium does. During the menstrual cycle, hormones signal the lining of the uterus to grow and thicken to prepare for a pregnancy. If there is no pregnancy, hormone levels decrease and cause the endometrium to break down and bleed. This may be painful. Scar tissue may grow around the area. Scar tissues that bind organs together are called adhesions. In some cases, blood can be trapped in the ovary and build up into a benign tumor. This is called an endometrioma.
Endometriosis is most common in women in their 30’s and 40’s. After menopause, endometriosis usually is no longer active. To diagnose endometriosis, your doctor will usually look at your complete medical and menstrual background. He or she will perform a pelvic exam to check for anything abnormal. The diagnosis can be confirmed with a procedure called laparoscopy. This is done under general anesthesia. Treatment may consist of medical or surgical intervention. Your doctor will help you determine what treatment is best for you.