Endometriosis is a well known and common cause of pelvic pain in women. It is a condition where endometrial tissue typically found in the uterus (womb) is found in other parts of the body, commonly on the ovaries, bladder and pelvic floor. It is sometimes found in the lungs, and can occur anywhere in the body. This tissue produces an inflammatory response to hormone changes which manifests as pelvic pain, pain with intercourse and bowel movements, urinary symptoms and infertility. It is estimated that about 10% of women have endometriosis however, some women can have endometriosis but do not have pain.
The origination of endometriosis is still not well understood. There are three main theories surrounding how it occurs. One is that when women have their periods, that there is backflow of menstrual blood containing endometrial tissue that ends up in the pelvis, on the ovaries, bladder and bowel. Another possible cause is through cells floating through the blood vessels and lymphatic system and ending up in other places. Lastly, it is possible that these cells/tissue somehow differentiated into endometrial type during pregnancy or some time after. People with endometriosis also have altered immune systems that allows the tissue to implant and grow outside the uterus.
Pain occurs with hormone changes that cause the endometrial tissue to produce prostaglandins and bleed. This causes irritations and inflammation which leads to scar tissue formation that in turn causes further pain.
The only definitive way to diagnose this is through laparoscopy, pelvic washings and tissue sampling which allows a pathologist to evaluate the cells for evidence of it. There is a clinical assessment component to diagnosing endometriosis based on symptoms.
Treatment for it may require surgery, medications and dietary or lifestyle changes. It’s important to discuss your symptoms, life plans and goals in order to formulate a care plan that fits your problem and needs.