Adenomyosis

What is endometriosis?The uterus, or womb, is the place where a baby grows when a woman is pregnant. It is lined with tissue (endometrium). Endometriosis is a disease in which tissue that is similar to the lining of the uterus grows in other places in your body. These patches of tissue are called "implants," "nodules," or "lesions." They are most often foundOn or under the ovariesOn the fallopian tubes, which carry egg cells from the ovaries to the uterusBehind the uterusOn the tissues that hold the uterus in placeOn the bowels or bladderIn rare cases, the tissue may grow on your lungs or in other parts of your body.What causes endometriosis?Researchers don't know what causes endometriosis.Who is at risk for endometriosis?Endometriosis is most commonly diagnosed in women in their 30s and 40s. But it can affect any female who menstruates. Certain factors can raise or lower your risk of getting it.You are at higher risk ifYou have a mother, sister, or daughter with endometriosisYour period started before age 11Your monthly cycles are short (less than 27 days)Your menstrual cycles are heavy and last more than 7 daysYou have a lower risk ifYou have been pregnant beforeYour periods started late in adolescenceYou regularly exercise more than 4 hours a weekYou have a low amount of body fatWhat are the symptoms of endometriosis?The main symptoms of endometriosis arePelvic pain, which affects about 75 percent of women with endometriosis. It often happens during your period.Infertility, which affects up to half of all women with endometriosisOther possible symptoms includePainful menstrual cramps, which may get worse over timePain during or after sexPain in the intestine or lower abdomenPain with bowel movements or urination, usually during your periodHeavy periodsSpotting or bleeding between periodsDigestive or gastrointestinal symptomsFatigue or lack of energyHow is endometriosis diagnosed?Surgery is the only way to know for sure that you have endometriosis. First, however, your health care provider will ask about your symptoms and medical history. You will have a pelvic exam and may have some imaging tests.The surgery to diagnose endometriosis is a laparoscopy. This is a type of surgery that uses a laparoscope, a thin tube with a camera and light. The surgeon inserts the laparoscope through a small cut in the skin. Your provider can make a diagnosis based on how the patches of endometriosis look. He or she may also do a biopsy to get a tissue sample.What are the treatments for endometriosis?There is no cure for endometriosis, but there are treatments for the symptoms. Your health care provider will work with you to decide which treatments would be best for you.Treatments for endometriosis pain includePain relievers, including nonsteroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen and a prescription medicine specifically for endometriosis. Providers may sometimes prescribe opioids for severe pain.Hormone therapy, including birth control pills, progestin therapy, and gonadotropin-releasing hormone (GnRH) agonists. GnRH agonists cause a temporary menopause, but also help control the growth of endometriosis.Surgical treatments for severe pain, including procedures to remove the endometriosis patches or cut some nerves in the pelvis. The surgery may be a laparoscopy or major surgery. The pain may come back within a few years after surgery. If the pain is very severe, a hysterectomy may be an option. This is a surgery to remove the uterus. Sometimes providers also remove the ovaries and fallopian tubes as part of a hysterectomy.Treatments for infertility caused by endometriosis includeLaparoscopy to remove the endometriosis patchesIn vitro fertilizationNIH: National Institute of Child Health and Human Development