Endometriosis is a medical condition that occurs in women and affects the reproductive system, causing tissue that usually lines the inside of the uterus to grow outside the uterus. The two main symptoms of endometriosis are pain and infertility, and the tissue associated with the condition are usually referred to as endometriosis patches, implants, nodules, or lesions. The disease is often found on or under the ovaries, on the fallopian tubes, behind the uterus, on the tissues that hold the uterus in place, on the bowels or bladder, and in some rare cases on the lungs or in other parts of the body.
There is currently no cure for endometriosis, but there are treatments that ease the symptoms. In addition to pain and infertility, the symptoms of the disease include painful, even debilitating, menstrual cramps that can get worse over time, pain during or after sex, pain in the intestine or lower abdomen, painful bowel movements or painful urination during menstrual periods, heavy menstrual periods, premenstrual spotting or bleeding between periods, painful bladder syndrome, digestive or gastrointestinal symptoms, fatigue, tiredness, and lack of energy. The causes for the development of endometriosis are not fully understood, but there are theories about it.
Genetics as a Cause for Endometriosis
While between six and 10% of women who are of reproductive age suffer from endometriosis — the equivalent to five million women in the US alone — it has been noted that genetics are a risk factor for developing the condition. Women whose mother, sister, or daughter suffers from endometriosis is six times more likely to develop the disease as well, according to the National Institutes of Health (NIH). Since endometriosis runs in families, genes are related to the development of endometriosis to some degree, even though the correlation is yet to be understood.
Hormonal Impact on Endometriosis
Endometriosis is an estrogen-dependent and inflammatory disease, which means that the hormone estrogen is involved not only in the female reproductive cycle, but also in endometriosis. Similarly, the tissue inside the uterus, the endometrium, does not respond properly to progesterone in patients with endometriosis. Progesterone is another hormone involved in the female reproductive cycle and the endometrium is progesterone resistant, causing the growth of tissue outside the uterus.
Endometriosis Due to Retrograde Menstruation
Retrograde menstruation occurs when the menstrual blood makes a backward movement through the fallopian tubes and into the peritoneal cavity, rather than following its normal course out of the body. The menstrual fluids contain endometrial cells, which in the case of retrograde menstruation stick to the pelvic walls and surfaces of pelvic organs. Over time, the cells start to grow and continue to thicken and bleed over the course of each menstrual cycle. Retrograde menstruation is thought to be one of the main reasons for endometriosis.
Endometriosis Related to Immune System Dysfunction
In some cases, the problem that leads to endometriosis is based on a dysfunction of the immune system. The problem is that some women have an immune system incapable of recognizing and destroying endometrial tissue. The immune system plays an important role since it enables the sick cells to continue to grow outside the uterus.
Cell Implantation as Cause for Endometriosis
The cells in the abdominal and pelvic cavities are resultant from embryonic cells and in some cases they may turn into endometrial tissue. These endometrial cells can travel and attach due to different reasons. Following a surgery like a hysterectomy or a C-section, the endometrial cells can get connected to the surgical incision, while the lymphatic system is also capable of transporting endometrial cells to other parts of the body.
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