Endometriosis is a benign disease that affects many patients of reproductive age. We want to help you learn more about it. This week we are answering the most frequently asked questions about endometriosis.
What is endometriosis?
Endometriosis is the appearance and growth of endometrial tissue (the tissue that lines the inside of the uterus) outside the uterus. It most often appears in the pelvic cavity (in the ovaries, tubes, behind the uterus, in the uterine ligaments, in the intestines or even in the urinary bladder). Less commonly, endometriosis occurs outside the abdomen (in the lungs or other parts of the body).
What causes endometriosis?
The causes of endometriosis are not fully understood. There are currently several theories as to why endometriosis occurs, including the following.
Retrograde menstruation:
During menstruation, part of the menstrual or endometrial tissue, instead of being expelled through the vagina, flows backward through the fallopian tubes into the abdominal cavity. According to this theory, viable endometrial tissue can implant on the ovaries and respond to each menstrual cycle in the same way as uterine endometrial cells—by growing and shedding with each period. However, this phenomenon occurs in many women who never develop endometriosis, which means this explanation does not fully account for the condition.
- The transformation of the cells of the peritoneum (the tissue that lines the inside of the abdomen) into endometrial cells.
- A defect in immunity that prevents endometrial cells, which are normally found only inside the uterus, from being recognised as foreign outside the uterus.
- Genetics: There may be a familial inheritance pattern, as the incidence of endometriosis is higher (6%) in first-degree relatives of women with endometriosis. A study has recently been published linking a gene to an increased risk of developing endometriosis.
- Endocrine: oestrogen may promote the growth of the disease.
- Why are endometriomas called chocolate cysts?
The content of endometriosis cysts or endometriomas is a thick, dark liquid that looks like chocolate.
- How is endometriosis diagnosed?
The diagnosis of endometriosis is sometimes made by chance during a routine examination.
The test that has proved most useful in diagnosing endometriosis is ultrasound. Other tests that can be performed to diagnose endometriosis are CT or MRI.
The only test that will give us a definitive diagnosis is direct visualisation and histological study of the area. However, this test is not used if the endometriosis is mild or if the endometriomas are small in size.
- What symptoms does endometriosis produce?
The appearance of symptoms in endometriosis is very variable, sometimes patients with large endometriomas have hardly any symptoms while in other cases small implants can cause a lot of symptoms and can be very disabling.
The most common symptom is pain, which usually intensifies during the menstrual period (dysmenorrhoea).
Other symptoms are menstrual disturbances, pain with sexual intercourse (dyspareumia or coitalgia), the occurrence of pain or intestinal disorders.
One of the symptoms that endometriosis can produce is sterility.
