Endometriosis is a medical condition in which the tissue that lines the uterus (endometrium) grows outside the uterus, resulting in pain and/or fertility issues. This tissue is similar in structure to the endometrium found inside the uterus. It is a chronic condition that can cause severe pain during menstruation, sexual activity, bowel and bladder movements, chronic pelvic discomfort, abdominal bloating, nausea, and exhaustion. It can also lead to feelings of depression, anxiety, and fertility problems. This can have a negative impact on a person’s quality of life.
Endometriosis causes a chronic inflammatory response that can result in the formation of scar tissue (adhesions, fibrosis) in the pelvis and other areas of the body. There is a lack of correlation between the size of endometrial lesions and the severity or duration of symptoms. Some individuals with a large number of visible lesions may experience mild symptoms, while others with fewer lesions may have severe symptoms. Symptoms of endometriosis often improve after menopause, but in some cases, painful symptoms may continue. This chronic pain may be caused by changes in the brain’s pain centres, known as central sensitization, which can occur at any stage of endometriosis and may persist even if the endometriosis lesions are no longer visible. Endometriosis may not always cause symptoms.
Elevated levels of oestrogen and stress hormones and low levels of progesterone can exacerbate the inflammation associated with endometriosis. Common triggers for flare-ups include stress, poor sleep, and pro-inflammatory foods such as caffeine, alcohol, and red meat.
Endometriosis is a condition that can have significant impacts on society, public health, and the economy. It can significantly affect the quality of life due to the severe pain, fatigue, depression, anxiety, and fertility issues it is associated with. For some people with endometriosis, the pain caused by the condition can be so severe that it prevents them from going to work or school. Endometriosis-related pain during sexual activity can lead to a reduction or avoidance of sexual intercourse, which can impact the sexual health of those affected by the condition and their partners. Other, less common but more serious risks include:
Possible complications of endometriosis include damage to organs such as the womb, bladder, or bowel, as well as severe bleeding inside the abdominal or pelvic cavity.
The development of a blood clot in the leg, known as deep vein thrombosis (DVT), or in the lungs, known as a pulmonary embolism, can be a potential complication of endometriosis.
Infertility may be caused by the potential effects of endometriosis on the pelvic cavity, ovaries, fallopian tubes, or uterus. It is not fully understood how endometriosis impacts the reproductive system in women, but it is likely that endometriosis plays a significant role in fertility issues. Endometriosis can affect the uterus, ovaries, and potentially even fallopian tubes, leading to fertility problems through various mechanisms.
The likelihood of endometriosis returning after surgery is approximately 20-30%. The recurrence of endometriosis after surgery is influenced by a number of factors, including the type of surgery. Factors that increase the risk of endometriosis returning include:
Endometriosis is a condition in which tissue that is similar in structure to the endometrium (the lining of the uterus) grows outside of the uterus. To understand it more clearly, endometriosis is the abnormal growth of endometrial tissue in areas of the body other than the uterus (usually in the pelvic region). Normally, endometrial tissue lines the uterus.
Endometriosis is thought to be fueled by oestrogen, which promotes the inflammation, growth, and pain associated with the condition. This means that oestrogen itself cannot cause the growth of endometrial tissue outside of the uterus, but it can worsen the pain and inflammation associated with endometriosis. However, the connection between oestrogen and endometriosis is complicated because the absence of oestrogen does not always prevent the development of endometriosis.
There is currently no known method for preventing endometriosis. However, increasing awareness, followed by early diagnosis and treatment, may slow or stop the progression of the condition and reduce the long-term impact of its symptoms, including possibly the risk of central nervous system pain sensitization. Unfortunately, endometriosis cannot currently be cured.