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Endometriosis 

Introduction
Endometriosis is the abnormal growth of uterine-lining tissue outside of the uterus.  Endometriosis frequently develops on the outside of the uterus, fallopian tubes, ovaries, or pelvic lining.  It is a common problem that needs monitoring and treatment because complications may lead to pain and infertility.  Treatment for endometriosis involves medication or surgery.

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Anatomy
The internal female reproductive system includes the ovaries, fallopian tubes, uterus, cervix, and vagina.  The ovaries are two small organs that produce eggs (ova) and hormones.  An ovary typically releases one mature egg each month.  Two fallopian tubes extend from near the ovaries to the uterus.  The fallopian tubes transport the mature eggs to the uterus.

The uterus is a pear-shaped organ where a baby grows in during pregnancy.  The lining of the uterus undergoes cyclic changes to facilitate and maintain pregnancy.  Each month the uterine lining thickens as it builds up extra blood and tissue in preparation for a potential fertilized egg.  An egg that is fertilized by a sperm cell may implant itself in the nourishing uterine lining and develop into a baby.  An unfertilized egg or a fertilized egg that does not implant in the uterus passes through the reproductive system.  During menstruation the uterine lining sheds and the blood leaves the body through the vagina.  The uterus is joined to the vagina by the cervix.  The vagina is a muscular passageway that extends from the cervix to the external female genitalia.

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Causes
The exact cause of endometriosis is unknown.  Researchers suspect that hormones and the immune system may somehow contribute to the development of endometriosis.  Endometriosis occurs when the tissue that normally lines the uterus grows outside of the uterus.  Common sites for endometriosis include the outside of the uterus, fallopian tubes, ovaries, bowel, rectum, bladder, and tissue lining the pelvic region.  In response to monthly hormonal changes, the endometrial cells may bleed and cause pain or form cysts.  Overtime, this can lead to adhesion and scar tissue formation.  Endometriosis in the fallopian tubes and ovaries can cause infertility.

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Symptoms
Endometriosis may or may not cause symptoms.  Symptoms include lower abdominal pain or cramps that may begin a week or two before your period starts.  Pelvic or back pain may continue during your period. Y our periods may become increasingly painful.  The pain may feel dull or quite severe.  You may experience pain during or after sexual intercourse or bowel movements.  You may spot blood before your period begins.  You may bleed quite heavily during your period or bleed between periods. You may experience infertility, the inability to become pregnant after a year of trying.  Symptoms of endometriosis go away during pregnancy and after menopause.

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Diagnosis
You should contact your doctor if you have the signs and symptoms of endometriosis.  Your doctor will review your medical history and conduct a pelvic examination.  An ultrasound may be performed to create images of your reproductive organs.  A laparoscopy may be used to confirm the diagnosis and determine the extent of your condition.  A laparoscopy is a minimally invasive surgical procedure that uses a laparoscope to view the reproductive organs.  A laparoscope is a thin tube with a light and viewing instrument that is inserted through a small incision in your abdomen.  Images from the laparoscope are sent to a video monitor.

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Treatment
Treatment for endometriosis depends on several factors, including the extent of your condition and your desire to have children in the future.  Mild endometriosis may be monitored with regular examinations.  Your doctor may prescribe or recommend medication for pain relief.  You may find it helpful to use a heating pad or warm baths.  This can relax muscles and relieve pain.

Birth control pills may be used to stop menstruation and prevent the condition from getting worse.  Hormonal therapy may be used to prevent symptoms and the growth of endometriosis.  However, certain types of hormone medications may prevent pregnancy.  If you desire to get pregnant or have severe symptoms, you may consider surgical treatment.

Surgical treatment for endometriosis involves traditional or laparoscopic surgery to remove growth, scar tissue, or adhesions.  Laparoscopic surgery is minimally invasive and associated with short recovery times. I n severe cases of endometriosis, a total hysterectomy is performed to remove the uterus, both fallopian tubes, and both ovaries.  In some cases, just the uterus may be removed.  You will not be able to become pregnant after a hysterectomy.

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Prevention
There is no proven way to prevent endometriosis.  Birth control pills may help to prevent the onset or slow the growth of the condition.

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Am I at Risk

Endometriosis is a common condition.  Women with a family history of endometriosis have a higher risk of developing it.  Women that did not give birth to children may have a higher risk.  Women with periods that last longer than seven days or had their first period at an early age may be at risk for endometriosis.

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Complications
Endometriosis may cause infertility in some women.  Endometriosis may come back after surgical treatment, including hysterectomy.  Endometrial growths on the bladder or bowel may cause blockages or incontinence.

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This information is intended for educational and informational purposes only. It should not be used in place of an individual consultation or examination or replace the advice of your health care professional and should not be relied upon to determine diagnosis or course of treatment.

The iHealthSpot patient education library was written collaboratively by the iHealthSpot editorial team which includes Senior Medical Authors Dr. Mary Car-Blanchard, OTD/OTR/L and Valerie K. Clark, and the following editorial advisors: Steve Meadows, MD, Ernie F. Soto, DDS, Ronald J. Glatzer, MD, Jonathan Rosenberg, MD, Christopher M. Nolte, MD, David Applebaum, MD, Jonathan M. Tarrash, MD, and Paula Soto, RN/BSN. This content complies with the HONcode standard for trustworthy health information. The library commenced development on September 1, 2005 with the latest update/addition on April 13th, 2016. For information on iHealthSpot’s other services including medical website design, visit www.iHealthSpot.com.