Endometriosis

Endometrium, also called endometrial tissue, is the inner lining of the uterus. In response to hormones, the endometrium thickens every month in preparation for possible pregnancy. If pregnancy does not occur, the built-up lining is shed during the menstrual period.

Sometimes, the endometrial tissue grows outside the uterus. This is known as endometriosis. While no longer in the uterus, the tissues continue to react to hormones responsible for menstruation. Normally, the unused portion of the endometrium exits through the vagina during menstruation. However, when endometrial tissue builds up in unusual areas, it has no way to exit the body. This causes irritation and can lead to the formation of cysts and scar tissue. In some cases, bands of scar tissue, called adhesions, can even form a bridge between organs that should not be connected.

Endometriosis is a relatively common gynecological condition. The ovaries, the fallopian tubes, the outer surface of the uterus, the intestines and the abdominal wall are examples of areas that can be affected.

Causes

The causes of endometriosis are not well understood. Several hypotheses have been put forward but remain unproven. What we do know, however, is that those with family members who have endometriosis are more likely to develop the disease.

Symptoms

Symptoms vary from person to person. Some people may have few lesions but experience a lot of pain, while others have no symptoms at all. Depending on the location and extent of the scar tissue, endometriosis can make it more difficult to conceive. Other common symptoms include the following:

• Severe menstrual cramps
• Abdominal pain that changes with the menstrual cycle
• Abdominal bloating
• Nausea and vomiting
• Intestinal problems (diarrhea, constipation)
• Presence of blood in urine or stool
• Painful sexual intercourse
• Irregular or very heavy menstrual periods

Treatment

To manage endometriosis-related pain, pain relievers (e.g., Tylenol®) or anti-inflammatory medications (e.g., Advil, Aleve) can be used. Other medications can also be taken to reduce the effects of hormones linked to the menstrual cycle. In some cases, surgery is performed to remove endometriosis tissue. The type of surgery depends on the extent of the disease and whether the patient wishes to have children.

Some lifestyle changes may also help ease endometriosis symptoms. Indeed, following a balanced diet and staying physically active can be beneficial. Symptoms are often relieved during pregnancy and menopause.

For more information or support:

• The Endometriosis Network Canada