• Ovaries
• Peritoneum
• Fallopian Tubes
• Lymph Nodes

These tissues usually expel during menstruation; however, the displaced tissue can’t do it. The growing lesions can grow larger and lead to physical symptoms, such as pain, and affects bodily functions like the ability to work, etc.

Stages of Endometriosis

This condition has four stages:

Stage 1 (minimal): There are small implants, lesions or wounds. They are found in tissues or organs lining abdomen or pelvis. There is little to no scar tissue.

Stage 2 (mild): There are more implants compared to stage 1. These are also deeper within the tissue and also form scarring.

Stage 3 (moderate): There are deep implants with small cysts on one or both ovaries. There are thick scar tissues called adhesions.

Stage 4 (severe): It is the widespread stage of deep implants and thicker adhesions. There is the formation of large cysts on one or both ovaries.

Signs and Symptoms

The major symptom of endometriosis is severe pelvic pain that’s usually related to menstrual periods. This pain also increases over time.

General signs and symptoms of endometriosis are:

Painful periods (also called dysmenorrhoea): The cramping and pelvic pain may start early and remain even after the menstrual cycle. You may even feel abdominal and lower back pain.

Pain with intercourse: One feels pain during or after the intercourse.

Pain with urination or bowel movements: One experiences these symptoms at the time of the menstrual cycle.

Excessive bleeding: One may experience inter-menstrual bleeding or heavy menstrual periods.

Infertility: Sometimes, this condition can also be observed in women seeking infertility treatment.

Other symptoms include fatigue, constipation, diarrhoea, nausea or bloating especially during menstrual periods.

The severity of pain is not a reliable indicator of this condition. You may experience mild endometriosis with severe pain or you could experience advanced endometriosis with minimal or no pain.

Causes of Endometriosis

What exactly causes endometriosis is not known. However, there are various theories associated with the causes of this medical condition.

The oldest theory states that it occurs because of the retrograde menstruation. It happens when the menstrual blood begins to flow back through fallopian tubes into the pelvic cavity rather than leaving the body through the vagina.

Another theory states that hormones turn the cells outside the uterus into the cells equivalent to the lining within the uterus called endometrial cells.

Some also believe that this condition occurs in some areas of the abdomen and is converted into endometrial tissue. It happens when the abdominal cells start growing from embryonic cells that change their shape and start acting like endometrial cells.

Some also believe that endometriosis begins in the foetal period when misplaced cell tissues respond to puberty hormones. This is also known as the Mullerian theory. Endometriosis development is also linked to genetics or environmental toxins.

Risk Factors

There are several risk factors associated with the development of endometriosis, such as:

• Starting periods at an early age
• Not giving birth at all
• Getting menopause at an older age
• Having short menstrual cycles — for example, less than 26 or 27 days
• Having heavy menstrual periods, which last more than seven days
• Having higher oestrogen levels within the body or higher lifetime exposure to oestrogen
• Having lower body mass index
• Any medical condition that may prevent normal menstrual flow through your body
• Any family member (mother, sister or aunt) with the history of endometriosis
• Having one or more reproductive tract abnormalities

Treatment Options

For treating endometriosis, surgery is possible. However, it is considered only when other treatment options don’t work or are not effective. Other treatment options are:

Pain medications: The specialists may prescribe either nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Motrin IB, Advil, others) and over-the-counter (OTC) drugs or other prescription drugs for treating the painful menses.

Hormones: Endometriosis can also be treated with hormonal therapies, which include Gonadotropin-releasing hormone (Gn-RH) agonists and antagonists, hormonal birth control, Danazol and Medroxyprogesterone (Depo-Provera). Besides, the placement of the intrauterine device (IUD) could be suggested by the specialist for the treatment.

Surgery: The initial surgery may seek the removal of the areas of endometriosis. However, hysterectomy may be necessary with the removal of both ovaries.

Fertility treatment: In this case, the pregnancy is recommended through in-vitro fertilization (IVF).