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Endometriosis

A benign condition in which tissue that looks like endometrial tissue grows in abnormal places in the abdomen.

PubMed Health Glossary
(Source: NIH - National Cancer Institute)

About Endometriosis

Endometriosis is one of the most common medical conditions affecting the lower abdomen (lower belly) in women. In endometriosis, the kind of tissue that normally lines the inside of the womb (endometrial tissue) also grows outside of it. This can happen without the woman being aware of it. But in other women endometriosis is a chronic disease, associated with severe pain and fertility problems.

It often takes years for endometriosis to be diagnosed as the cause of these problems. Until the diagnosis is made, many women try to cope with their pain somehow. They believe that the pain — even really bad pain — is a normal part of their menstrual period.

There is currently no cure for endometriosis. But there are many things that can be done to relieve the symptoms. And if treatment is adapted to suit women's personal circumstances and the severity of their endometriosis, many can cope quite well with the disease.

Like with other chronic conditions, it is important to get to know your own body and how it reacts, in order to find ways to manage the symptoms. Getting hold of good information and consulting experienced, supportive doctors can help... Read more about Endometriosis

What works? Research summarized

Evidence reviews

Danazol for pelvic pain associated with endometriosis

Danazol reduces the painful symptoms of endometriosis but has androgenic effects. Endometriosis is a painful condition where endometrial tissue grows outside the uterus. It can cause cysts and infertility. Danazol is a hormone that produces male characteristics as well as weight gain and acne. It does, however, relieve the painful symptoms of endometriosis, although the side effects can be unacceptable. The improvement was still present six months after treatment was stopped. There was some evidence that women who took danazol were satisfied with the treatment compared with women who had inactive treatment.

Pentoxifylline for premenopausal subfertile women with endometriosis

Endometriosis is a painful condition where endometrial tissue grows outside the uterus, which potentially affects a woman's ability to conceive. Recent studies support the influence of the immune system on this disease. Pentoxifylline is an immunomodulator drug (used for effects on the immune system) which may relieve the symptoms of the disease without inhibiting ovulation. It may improve blood flow through blood vessels and, therefore, help with blood circulation because of its anti‐inflammatory activity. However, this systematic review of four trials found there was not enough evidence upon which to draw conclusions about the effectiveness and safety of pentoxifylline in terms of fertility and pain relief outcomes in women with endometriosis. At this update in 2011, there was still no evidence of an increase in pregnancy events in the pentoxifylline group compared with placebo.

Ovulation suppression for endometriosis

This review of 23 trials involving 3043 women with endometriosis has shown that there no evidence of benefit with the use of ovulation suppression for women with endometriosis and infertility. Endometriosis is caused by the lining of the uterus (endometrium) spreading to a site outside the uterus. It is associated with subfertility and can cause pain during both sexual intercourse and menstruation. The hormone oestrogen stimulates the growth of endometriosis. For many years, the use of drugs such as danazol to stop ovulation and the production of oestrogen has been standard practice in the treatment of pain and subfertility caused by endometriosis. This works well for pain, but does not appear to improve fertility. In fact, as ovulation and periods are stopped for the time of treatment, fertility may be reduced by this approach.

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Summaries for consumers

Endometriosis symptoms

Endometriosis causes serious pain and cramps in some women, while others only have a little discomfort or notice nothing at all. Women usually have endometriosis symptoms during their menstrual period, but may also experience them at other times. The severity of symptoms does not always depend on things like the extent of endometrial tissue growth a woman has in her body.Endometriosis is a condition where the kind of tissue that normally lines the womb (endometrial tissue) grows in other parts of a woman’s body too. These “growths” are known as endometrial implants. They do not always cause pain. Endometriosis can lead to various symptoms, depending on things like how many endometrial implants a woman has, and where they are in her body. The most common symptoms are:Very painful menstrual periods (dysmenorrhea): When a woman has her period (menstruation), the muscles in the wall of her womb repeatedly tighten and squeeze in order to shed the lining of the womb. This can cause period pain. Women who have endometriosis may have particularly severe pain and cramping during their period. Many girls and women think this is normal because things have always been that way for them. It never crosses their mind that their severe period pain might be caused by a medical condition like endometriosis.Pain during sex (dyspareunia): This pain is usually described as burning or cramp-like pain. Sometimes women only feel it after they have finished having sex.Abdominal (lower belly) pain: Various degrees of pain may be felt in different parts of the abdomen, sometimes radiating to the back or legs. The pain is not necessarily associated with women’s menstrual period. Permanent (chronic) abdominal pain tends to be rare.Gastrointestinal (stomach and bowel) problems: If endometriosis affects a woman’s bowel, she might feel full or have painful bowel movements. If it affects her bladder, passing urine might hurt.General exhaustion: Severe and frequent endometriosis symptoms often lead to general exhaustion. This makes women less able to cope with physical and mental strain.All of these symptoms can be caused by other things too, so endometriosis cannot be clearly diagnosed based on these symptoms alone.

Danazol for pelvic pain associated with endometriosis

Danazol reduces the painful symptoms of endometriosis but has androgenic effects. Endometriosis is a painful condition where endometrial tissue grows outside the uterus. It can cause cysts and infertility. Danazol is a hormone that produces male characteristics as well as weight gain and acne. It does, however, relieve the painful symptoms of endometriosis, although the side effects can be unacceptable. The improvement was still present six months after treatment was stopped. There was some evidence that women who took danazol were satisfied with the treatment compared with women who had inactive treatment.

Pentoxifylline for premenopausal subfertile women with endometriosis

Endometriosis is a painful condition where endometrial tissue grows outside the uterus, which potentially affects a woman's ability to conceive. Recent studies support the influence of the immune system on this disease. Pentoxifylline is an immunomodulator drug (used for effects on the immune system) which may relieve the symptoms of the disease without inhibiting ovulation. It may improve blood flow through blood vessels and, therefore, help with blood circulation because of its anti‐inflammatory activity. However, this systematic review of four trials found there was not enough evidence upon which to draw conclusions about the effectiveness and safety of pentoxifylline in terms of fertility and pain relief outcomes in women with endometriosis. At this update in 2011, there was still no evidence of an increase in pregnancy events in the pentoxifylline group compared with placebo.

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Terms to know

Endometriotic Tissue (Endometriotic Lesion)
Tissue that normally grows inside the uterus, grows outside the uterus.
Endometrium
The layer of tissue that lines the uterus.
Estrogen
A type of hormone made by the body that helps develop and maintain female sex characteristics and the growth of long bones. Estrogens can also be made in the laboratory. They may be used as a type of birth control and to treat symptoms of menopause, menstrual disorders, osteoporosis, and other conditions.
Fallopian Tubes
A slender tube through which eggs pass from an ovary to the uterus. In the female reproductive tract, there is one ovary and one fallopian tube on each side of the uterus.
Hormones
A messenger molecule that helps coordinate the actions of various tissues; made in one part of the body and transported, via the bloodstream, to tissues and organs elsewhere in the body.
Ovarian Cysts
An ovarian cyst is any collection of fluid, surrounded by a very thin wall, within an ovary. Any ovarian follicle that is larger than about two centimeters is termed an ovarian cyst. The vast majority of ovarian cysts are harmless (benign). Some ovarian cysts cause problems, such as bleeding and pain.
Pouch of Douglas
A sac or recess formed by a fold of the peritoneum.
Progesterone
A type of hormone made by the body that plays a role in the menstrual cycle and pregnancy. Progesterone can also be made in the laboratory. It may be used as a type of birth control and to treat menstrual disorders, infertility, symptoms of menopause, and other conditions.
Tissue
A group of cells that act together to carry out a specific function in the body. Examples include muscle tissue, nervous system tissue (including the brain, spinal cord, and nerves), and connective tissue (including ligaments, tendons, bones, and fat). Organs are made up of tissues.
Uterus (Womb)
The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a fetus develops. Also called womb.

More about Endometriosis

Photo of a young adult woman

Also called: Endo

See Also: Dysmenorrhea, Menstruation

Other terms to know: See all 10
Endometriotic Tissue (Endometriotic Lesion), Endometrium, Estrogen

Related articles:
Causes of Endometriosis
Information for Partners of Women with Endometriosis

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