Endometriosis

Endometriosis is a disorder in women that can cause painful menstruation, chronic pelvic pain, painful intercourse, and possible infertility. The disorder may worsen over time, resulting in scarring to the ovaries and fallopian tubes and leading to decreased ability to get pregnant. In fact, 30% to 40% of patients with endometriosis are infertile. This is two to three times the rate of infertility in the general population.

What causes it?
No single theory seems to explain all cases of endometriosis. Several theories, however, have been suggested:

• The endometrial cells, which line the uterus, migrate from the uterus through the fallopian tubes into the pelvis. These cells implant on other pelvic organs and are stimulated by hormones released during menstruation. This can cause bleeding at these locations. Surrounding organs may then absorb the blood, leading to pain and inflammation. This theory fails to explain why women still have endometriosis after sterilization (sometimes called 'having their tubes tied') or after hysterectomy (removal of the uterus). It is possible that the endometrial tissue spreads from the uterus to the abdominal cavity through the lymphatic system or bloodstream instead of through the fallopian tubes.
• The cause may stem from an abnormality in the immune system that allows normally shed endometrial cells to attach and grow in other areas.
• The disease may be caused by a genetic birth defect as evidenced by its tendency to run in families.
• Tissue in the abdominal cavity may change into endometrial tissue as a result of repeated inflammation.