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How does a woman get endometriosis

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It occurs when endometrial implants, comprised of tissue normally found within the uterus, are present in other areas of the body. As the tissue continues to thicken, break down, respond to menstrual cycle hormones, and bleed during the menstrual cycle, endometriosis forms deep inside the body. Endometriosis is thought to affect around 11 percent of women in the United States aged between 15 and 44 years. Endometrial tissue consists of gland, blood cells, and connective tissue. It normally grows in the uterus, to prepare the lining of the womb for ovulation.

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Endometriosis symptoms usually subside after menopause, but not always. And they are sometimes related to other health problems. Crippling menstrual cramps, gastrointestinal problems, and pain during sex are among the most common and distressing symptoms of endometriosis, a gynecological disorder that affects as many as 1 in 10 women.

The disease occurs when tissue similar to the lining of the uterus the endometrium shows up on the walls of the abdominal cavity and the outer surfaces of the uterus, ovaries, fallopian tubes, bowel, bladder, and nearby organs.

Rarely, endometriosis appears in the heart, lungs, and brain. Like the endometrium, this wayward tissue builds up and sheds monthly in response to the menstrual cycle. But unlike menstrual fluid, which exits through the vagina, the blood and tissue from endometriosis lesions remain trapped, triggering inflammation and adhesions weblike scar tissue that binds organs together. Endometriosis can also distort the large intestine, ovaries, and fallopian tubes, causing bowel problems and infertility.

Traditional treatments include surgery to remove the misplaced tissue and drugs that suppress or regulate menstruation. Many women say that they get some relief from dietary changes avoiding red meat, caffeine, alcohol, and refined flour and sugar , acupuncture, massage, and relaxation techniques such as yoga or meditation. However, these are unproven approaches to treating endometriosis.

Although endometriosis symptoms are most troublesome during the reproductive years, they don't necessarily disappear once a woman stops menstruating. Martha K. Tissue similar to the uterine lining appears on the outer surfaces of organs in the abdominal cavity. Adhesions weblike scar tissue may also be present. Fluctuating hormone levels during perimenopause the years leading up to menopause can cause erratic periods and heavier-than-usual flow.

Some women with endometriosis who suffer gut-wrenching pain during menstruation may benefit from eliminating their periods altogether through the use of continuous low-dose birth control pills. Others take birth control pills for three months followed by a week off, so they have a period only four times a year.

Another option is an intrauterine device called Mirena that releases levonorgestrel a progestin and has been shown in a few small studies to ease menstrual cramps. The Mirena device can be left in place for up to five years.

Periods eventually become lighter and may disappear completely after one year. Estrogen fuels the growth of endometriosis lesions, so in theory, dwindling estrogen levels at menopause should lessen the symptoms. But even after periods have ceased, the ovaries continue to produce small amounts of the hormone, so endometriosis may continue to cause trouble. Women bothered by menopausal symptoms such as hot flashes and night sweats are often concerned that taking hormone therapy to quell them could reactivate any previous endometriosis.

To reduce this possibility, many clinicians recommend using hormone preparations such as Estrace, Vivelle, Climara, or Estraderm patches and micronized progesterone Prometrium and Crinone vaginal gel rather than synthetic or animal-derived hormones such as Premarin and Provera.

Women with severe endometriosis who've gotten no relief from various medical and surgical treatments often resort to hysterectomy—sometimes in their 30s or 40s, or even earlier. Most also have their ovaries removed, which results in "surgical menopause. Hysterectomy and ovariectomy do reduce the risk of ovarian cancer, but evidence suggests that removing the ovaries before age 65 has a downside.

Ovariectomy may increase the risk of heart disease and osteoporosis, which are far more common than ovarian cancer. This is one reason why doctors say that ovary removal should be decided on a case-by-case basis. Most experts agree that women with endometriosis who undergo surgical menopause should probably take hormone therapy until natural menopause around age 51 to avoid the risks of osteoporosis and heart disease.

Some recommend waiting three to nine months after surgery before starting hormone replacement, to give the endometriosis a chance to die out. Women may be at increased risk for osteoporosis if they've been taking medications that lower estrogen levels in order to reduce endometriosis growth. These medications, called GnRH agonists Lupron, Synarel, Zoladex, and others , induce a temporary "pseudomenopause" that eases endometriosis symptoms but may also weaken bones.

Women who take GnRH agonists may be given small amounts of hormones or bisphosphonate drugs to prevent bone loss. They also should be diligent about bone density testing, bone-healthy habits, and follow-up with their clinicians.

According to a study in the journal Human Reproduction , women with endometriosis have a higher-than-average risk of autoimmune and related disorders. Researchers found that, compared with American women in general, women who had endometriosis were times more likely to have chronic fatigue syndrome, 7 times more likely to have hypothyroidism, and twice as likely to have fibromyalgia.

These findings support the theory that the immune system plays a role in endometriosis. They also suggest that women who have endometriosis should be alert to new symptoms that could signal the onset of one of these conditions.

The reasons are unclear. Ovarian cancer can mimic endometriosis, with symptoms including abdominal pain, swelling, fatigue, back pain, and a frequent need to urinate. Women who have had endometriosis should be alert to this possibility, especially if symptoms recur after menopause, when most ovarian cancers develop. Several reports also suggest an association between endometriosis and an increased risk for breast cancer, non-Hodgkin's lymphoma, and melanoma.

If you have endometriosis, be sure to have annual checkups and any tests recommended by your clinician. Be aware that abdominal adhesions—a common result of repeated surgeries for endometriosis—can make colon cancer screening with sigmoidoscopy or colonoscopy more painful or difficult. Alert the physician performing the procedure; you may also want additional sedation and pain medication. Some studies suggest that genes play a role in the development of endometriosis. Researchers have identified several gene variants that appear to be involved, some of which code for enzymes that detoxify unwanted substances.

This discovery is consistent with research suggesting that endometriosis is associated with exposure to dioxin and estrogen-like compounds in the environment, although a connection has not been proved.

Young women with endometriosis whose mothers also have the disease are fortunate in having someone close to them who understands their pain.

Too often it has not been taken seriously enough. Endometriosis was once characterized as a disease of "career women" meaning women who chose career over childbearing , and it's still sometimes dismissed as "bad cramps.

But today greater awareness is leading to earlier diagnosis and treatment, and research holds the promise of a better understanding of the disease. Endometriosis Association www. Disclaimer: As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review or update on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.

Harvard Women's Health Watch. Published: February, E-mail Address. First Name Optional. Anatomy of endometriosis Tissue similar to the uterine lining appears on the outer surfaces of organs in the abdominal cavity.

Selected resources Endometriosis Association www.

Symptoms & causes

Anne had never had problems with her periods the way some of her friends did. But over time her periods started getting so painful that she dreaded their arrival. Every month for a few days she would curl up on the couch with a heating pad and take a pain reliever. The cramps eventually became so bad that she was missing school a couple of days a month, and the pain even started happening between periods. The most common locations for these growths — called endometrial implants — are the outside surface of the uterus, the ovaries, the fallopian tubes, the ligaments that support the uterus, the intestines, the bladder, the internal area between the vagina and rectum, and the lining of the pelvic cavity.

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Endometriosis symptoms usually subside after menopause, but not always. And they are sometimes related to other health problems. Crippling menstrual cramps, gastrointestinal problems, and pain during sex are among the most common and distressing symptoms of endometriosis, a gynecological disorder that affects as many as 1 in 10 women. The disease occurs when tissue similar to the lining of the uterus the endometrium shows up on the walls of the abdominal cavity and the outer surfaces of the uterus, ovaries, fallopian tubes, bowel, bladder, and nearby organs. Rarely, endometriosis appears in the heart, lungs, and brain.

Endometriosis

Endometriosis is a condition in some women that occurs when the cells that normally line the inside of the uterus endometrial cells are found in other parts of the body. Since they are the same type of cells that are usually just on the inside of the uterus, they respond to estrogen and grow a little each month and sometimes bleed slightly. The small amount of growth and bleeding each month causes endometriosis. Women who have endometriosis may experience significant endometriosis symptoms including pain, infertility or both. It is unclear however, why many women may have no endometriosis symptoms at all and find out they have endometriosis because they develop a cyst on their ovary or they have surgery for another reason. There are a wide range of endometriosis symptoms. Usually these symptoms occur at regular times that are often before, during or after monthly periods. Currently, the only way to diagnose endometriosis is through laparoscopy—a minor surgical procedure that is done under general anesthesia while the patient is asleep. There is no cure for endometriosis nor one perfect endometriosis treatment.

Myths and misconceptions in endometriosis

Endometriosis is a common gynecological condition affecting an estimated 2 to 10 percent of American women of childbearing age. The name of this condition comes from the word "endometrium," which is the tissue that lines the uterus. During a woman's regular menstrual cycle, this tissue builds up and is shed if she does not become pregnant. Women with endometriosis develop tissue that looks and acts like endometrial tissue outside of the uterus, usually on other reproductive organs inside the pelvis or in the abdominal cavity.

It occurs when tissue from the uterine lining implants outside the uterus but grows and acts like the uterine lining and sheds during the menstrual cycle.

Endometriosis is a disorder in which tissue similar to the tissue that forms the lining of your uterus grows outside of your uterine cavity. The lining of your uterus is called the endometrium. Endometriosis occurs when endometrial tissue grows on your ovaries, bowel, and tissues lining your pelvis. Endometrial tissue growing outside of your uterus is known as an endometrial implant.

How common is endometriosis?

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What is the link between infertility and endometriosis? What medications are used to treat endometriosis? What if I still have severe pain that does not go away even after I have had treatment? Endometriosis is a condition in which the type of tissue that forms the lining of the uterus the endometrium is found outside the uterus. Endometriosis occurs in about 1 in 10 women of reproductive age. It is most often diagnosed in women in their 30s and 40s.

Endometriosis 101

All A-Z health topics. View all pages in this section. The javascript used in this widget is not supported by your browser. Please enable JavaScript for full functionality. Endometriosis happens when tissue similar to the lining of the uterus womb grows outside of the uterus. Several different treatment options can help manage the symptoms and improve your chances of getting pregnant.

Does endometriosis increase a woman's risk of getting cancer? Some studies have postulated that women with endometriosis have an increased risk for  ‎Facts · ‎What Is · ‎Stages · ‎Signs & Symptoms.

Endometriosis occurs when cells similar to those that line the uterus are found in other parts of the body, commonly a woman's pelvic and reproductive organs. Endometriosis, pronounced end-o-me-tree-oh-sis or just endo , is a progressive, chronic condition where cells similar to those that line the uterus the endometrium are found in other parts of the body. It most commonly occurs in the pelvis and can affect a woman's reproductive organs.

It affects these women and girls during the prime of their lives and through no personal failing in lifestyle choices. About half of women with endometriosis will also suffer from pain associated with sexual intercourse. Access to timely diagnosis and treatment for this large population of women and girls should not be impacted by the myths and mis-conceptions that, unfortunately, remain at large.

Endometriosis occurs when bits of the tissue that lines the uterus endometrium grow on other pelvic organs, such as the ovaries or fallopian tubes. Outside the uterus, endometrial tissue thickens and bleeds, just as the normal endometrium does during the menstrual cycle. Endometriosis en-doe-me-tree-O-sis is an often painful disorder in which tissue similar to the tissue that normally lines the inside of your uterus — the endometrium — grows outside your uterus. Endometriosis most commonly involves your ovaries, fallopian tubes and the tissue lining your pelvis.

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