Endometriosis

Endometriosis is a chronic gynecological condition where tissue similar to the endometrium (the lining of the uterine cavity) begins to grow outside the uterus, most commonly on the ovaries, fallopian tubes, and other organs in the pelvic cavity.

Most often this occurs on the ovaries, fallopian tubes, the outer side of the uterus, and other organs in the pelvic cavity. Similar to normal endometrium, this ‘ectopic’ tissue responds to monthly hormonal changes, swells, and bleeds during menstruation. Since this blood has no way out of the body, it causes inflammation, adhesion formation, and pain.

Symptoms and Consequences

The main symptom is severe pelvic pain, often associated with menstruation (dysmenorrhea), which can begin before and continue after the period. The pain may be chronic and can also occur during sexual intercourse (dyspareunia), urination, or bowel movements. Another significant consequence is reduced fertility or infertility, as adhesions can disrupt the function of the ovaries and fallopian tubes. Depending on the location of the implants, specific ovarian cysts known as endometriomas or ‘chocolate cysts’ may also form.

Diagnosis and Treatment

Initial suspicion of endometriosis arises based on complaints and examination. Ultrasound may detect endometriomas, but a definitive diagnosis is traditionally made via laparoscopy, which allows direct visualization of the pelvic organs. Treatment focuses on pain relief and improving fertility. Pain relievers and hormonal therapy (e.g., birth control pills or progestins) are used to suppress the growth of endometrial tissue. Surgical treatment (laparoscopy) is employed to remove implants, adhesions, and endometriomas, especially when the disease is severe or affects fertility.

 Synonyms: Chocolate cyst, Chronic pelvic pain, Laparoscopy