Topics: Endometriosis, Menstrual cycle, Endometrium Pages: 16 (5236 words) Published: April 26, 2013
Endometriosis is a gynecological medical condition in which cells from the lining of the uterus (endometrium) appear and flourish outside the uterine cavity, most commonly on the membrane which lines the abdominal cavity. The uterine cavity is lined with endometrial cells, which are under the influence of female hormones. Endometrial-like cells in areas outside the uterus (endometriosis) are influenced by hormonal changes and respond in a way that is similar to the cells found inside the uterus. Symptoms often worsen with the menstrual cycle. Endometriosis is typically seen during the reproductive years; it has been estimated that endometriosis occurs in roughly 6–10% of women. Symptoms may depend on the site of active endometriosis. Its main but not universal symptom is pelvic pain in various manifestations. Endometriosis is a common finding in women with infertility. There is no cure for endometriosis, but it can be treated in a variety of ways, including pain medication, hormonal treatments, and surgery. Contents

1 Signs and symptoms
o1.1 Pelvic pain
o1.2 Fertility
o1.3 Other
o1.4 Complications
2 Risk factors
o2.1 Environmental toxins
o2.2 Genetics
o2.3 Aging
3 Pathophysiology
o3.1 Formation of ectopic endometrium
3.1.1 Retrograde menstruation
3.1.2 Other theories of endometrial formation
o3.2 Localization
4 Diagnosis
o4.1 Staging
o4.2 Markers
o4.3 Histopathology
5 Prevention
6 Management
o6.1 Hormonal medication
o6.2 Other medication
o6.3 Surgery
o6.4 Comparison of medicinal and surgical interventions
o6.5 Treatment of infertility
7 Prognosis
8 Epidemiology
9 History
10 References
11 Further reading
12 External links

Signs and symptoms
Pelvic pain
A major symptom of endometriosis is recurring pelvic pain. The pain can range from mild to severe cramping that occurs on both sides of the pelvis, in the lower back and rectal area, and even down the legs. The amount of pain a woman feels correlates poorly with the extent or stage (1 through 4) of endometriosis, with some women having little or no pain despite having extensive endometriosis or endometriosis with scarring, while other women may have severe pain even though they have only a few small areas of endometriosis. Symptoms of endometriosis-related pain may include: •dysmenorrhea – painful, sometimes disabling cramps during menses; pain may get worse over time (progressive pain), also lower back pains linked to the pelvis •chronic pelvic pain – typically accompanied by lower back pain or abdominal pain •dyspareunia – painful sex

dysuria – urinary urgency, frequency, and sometimes painful voiding Throbbing, gnawing, and dragging pain to the legs are reported more commonly by women with endometriosis. Compared with women with superficial endometriosis, those with deep disease appear to be more likely to report shooting rectal pain and a sense of their insides being pulled down. Individual pain areas and pain intensity appears to be unrelated to the surgical diagnosis, and the area of pain unrelated to area of endometriosis. Endometriosis lesions react to hormonal stimulation and may "bleed" at the time of menstruation. The blood accumulates locally, causes swelling, and triggers inflammatory responses with the activation of cytokines. This process may cause pain. Pain can also occur from adhesions (internal scar tissue) binding internal organs to each other, causing organ dislocation. Fallopian tubes, ovaries, the uterus, the bowels, and the bladder can be bound together in ways that are painful on a daily basis, not just during menstrual periods. Also, endometriotic lesions can develop their own nerve supply, thereby creating a direct and two-way interaction between lesions and the central nervous system, potentially producing a variety of individual differences in pain that can, in some women, become independent of the disease itself. Fertility...
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