What are the Common Symptoms of Endometriosis

Endometriosis may be symptomatic or asymptomatic. There is poor correlation between the extent of the disease and the degree of symptoms. Pain is the main symptom. It may be periodic, before or during the periods, or it may be constant. It may cause painful intercourse, pain in the middle of the pelvis or on either or both sides, or rectal pain. There may be irregular uterine bleeding. Infertility is frequently associated with endometriosis. The rate of progression of endometriosis is highly variable among patients; even in the same patient it may vary at different time periods.



Symptoms

Symptoms of endometriosis typically occur in a cyclic fashion with menstrual periods. The most commonly reported symptoms are:

Pelvic pain and cramping before and during periods
Pain during intercourse
Inability to conceive
Fatigue
Painful urination during periods
Gastrointestinal symptoms such as diarrhea, constipation, and nausea
There are other medical conditions that have similar symptoms and should be considered prior to making a diagnosis of endometriosis. Conditions that may cause generalized pelvic pain include:

Pelvic inflammatory disease (PID)
Pelvic adhesions
Neoplasms (cancers), both benign or malignant
Ovarian torsion
Sexual or physical abuse
Other causes that are not gynecologic in nature
Endometriosis may place patients at a higher risk for developing endometriomas. These are ovarian cysts that are composed of endometrial cells that grow and bleed during menstruation. Sometimes they are called chocolate cysts, because they appear chocolate in color. Endometriomas may be painful, especially during active bleeding and/or ovulation.



What is Endometriosis

Endometriosis is the presence of endometrial tissue (tissue identical to the endometrium, the uterine lining) outside the uterus. Usually the endometriotic implants are located in the pelvis but endometriosis may also involve other parts of the abdominal cavity, the abdominal wall and, rarely, other locations such as the chest. The endometrial implants respond to ovarian hormonal changes in a fashion similar to the uterine endometrium. This results in local bleeding, irritation, inflammation, scarring and adhesion formation. In the ovaries, endometriosis may lead to the formation of cysts containing old blood (so-called chocolate cysts or endometriomas). These hormone-related changes are the basis for the symptoms of endometriosis. Approximately 19% of hysterectomies in the U.S. are performed because of endometriosis.




Causes and Symptoms

There are several theories on causes:

The first theory is known as retrograde menstruation, or the movement of sloughed endometrial tissue back through the fallopian tubes and into the abdominal cavity. This tissue can then attach itself to various internal organs or tissues outside of the uterus. Retrograde menstruation can occur in women with and without endometriosis, but it is thought that women with the disease have a deficiency in their immune system which is unable to destroy the ectopic implant.

This leads to the second theory:

Immune system dysfunction.

It is believed that certain women may develop endometriosis due to deficiencies in their immune system - the main system in the body that fights infection and other foreign "invaders". In women without endometriosis, the immune system destroys any ectopic implants that may develop. However, in women with endometriosis, there is an altered immune response and the body is unable to destroy the growth of the implants. Furthermore, some scientists believe that endometriosis is an autoimmune disorder. This means that the body makes antibodies to endometrial cells. These antibodies may destroy the healthy endometrium found in the uterus, but are ineffective in destroying ectopic implants.
Most likely, both of these theories play a role in the cause of endometriosis.

Endometriosis diet