Endometriosis is a gynecological condition in which the tissue that normally lines the woman’s uterus grows outside of the uterus, often causing pain. Learn more about endometriosis ›

The Mystery and Misery of Endometriosis

Pelvic pain, disabling cramps, extreme fatigue, painful sex, or infertility--all can warn of endometriosis.

This poorly understood disease devastates millions of women with no regard to race or income. It's a leading cause of infertility.

No one's sure what causes endometriosis. Some doctors believe it occurs when menstrual fluid backs up through a woman's fallopian tubes (which move eggs from the ovaries to the womb) and falls into the pelvis behind the womb. Others blame heredity, immune disorders, or cellular changes. But it's not an infection or cancer, says Ellen E. Wilson, M.D., a reproductive endocrinologist in Dallas.

A highly vascular tissue called the endometrium lines the uterus. In endometriosis, that tissue appears outside the uterus. It can grow on the outside of the uterus, fallopian tubes, ovaries, bowels, bladder, rectum, and surgical scars, or almost anywhere on the peritoneum, the lining of the abdominal cavity. In rare cases, it turns up in the lungs.

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Finding the Cause When Sex Hurts

Sex is supposed to be one of the most pleasurable experiences there is. Unfortunately, for millions of women, it's exactly the opposite: Painful. Irritating. Uncomfortable. In fact, as many as 75 percent of women will experience painful intercourse at some point during their lives.

If sex is more likely to make you furrow your brow than curl your toes, keep reading to find out what could be causing your pain. It's the first step in finding your way to treatment.

Pelvic inflammatory disease (PID). Sexually transmitted diseases (STDs) such as chlamydia and gonorrhea are often to blame for PID. It occurs when bacteria associated with these STDs cause an infection in your uterus, fallopian tubes, and other reproductive organs. As a result, you may experience pain in your lower belly, fever, painful urination, irregular periods, and pain during sex.

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Dysmenorrhea is a menstrual condition characterized by severe and frequent menstrual cramps and pain associated with menstruation. Dysmenorrhea may be classified as primary or secondary.

  • Primary dysmenorrhea - from the beginning and usually lifelong; severe and frequent menstrual cramping caused by severe and abnormal uterine contractions.

  • Secondary dysmenorrhea - due to some physical cause and usually of later onset; painful menstrual periods caused by an another medical condition present in the body (i.e., pelvic inflammatory disease, endometriosis).

The cause of dysmenorrhea depends on whether the condition is primary or secondary. In general, women with primary dysmenorrhea experience abnormal uterine contractions as a result of a chemical imbalance in the body (particularly prostaglandin and arachidonic acid - both chemicals which control the contractions of the uterus). Secondary dysmenorrhea is caused by other medical conditions, most often endometriosis (a condition in which tissue that looks and acts like endometrial tissue becomes implanted outside the uterus, usually on other reproductive organs inside the pelvis or in the abdominal cavity - often resulting in internal bleeding, infection, and pelvic pain). Other possible causes of secondary dysmenorrhea include the following:

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Living with Endometriosis

Once you know you have endometriosis, you can think about your options for treatment. Even after treatment, most women have symptoms off and on until menopause. Then, when monthly periods are over for good, symptoms tend to subside or disappear. In the meantime, there is a lot you can do to help yourself feel better.

Along with cycles of pain, you may have emotional cycles or mood swings. You may feel frustrated, or depressed. Don’t suffer in silence. Talking to someone you trust can really help. Also, spend time doing things you enjoy.

Heat can help limit pain. Soak in a hot bath or use a heating pad. You may also find relief with yoga, meditation, or acupuncture. Aspirin and ibuprofen may also help. Those work best if taken just as pain begins. If needed, you may be given prescription medications to reduce cramping and pain during periods. Keep track of your symptoms to help you anticipate and cope with the pain.

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What is Endometriosis

Endometriosis is a common gynecological condition, particularly among women of childbearing age, affecting an estimated 2 to 10 percent of American women in this age group. Endometriosis can be a debilitating disease for some women who experience ongoing pain, while others may be asymptomatic. It is also a factor in infertility. According to the American Society for Reproductive Medicine, endometriosis can be found in 24 percent to 50 percent of women who experience infertility.

The name comes from the word "endometrium," which is the tissue that lines the uterus. During a woman's regular menstrual cycle, this tissue builds up and is shed if she does not become pregnant. Women with endometriosis develop tissue that looks and acts like endometrial tissue outside the uterus, usually on other reproductive organs inside the pelvis or in the abdominal cavity. Each month, this misplaced tissue responds to the hormonal changes of the menstrual cycle by building up and breaking down just as the endometrium does, resulting in internal bleeding.

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Your Guide to Endometriosis

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