Endometriosis is when uterine lining ("endometrium") grows outside the uterus, commonly in the abdomen.

It affects 1 in 10 reproductive-age women, or 200 million people with a uterus worldwide. That's about as prevalent as diabetes!

During menstruation, endometrium builds up and breaks down in response to hormonal changes. Endometrial tissue within the pelvis and abdominal cavity is also responsive to these hormonal changes, causing small bleeding within the pelvic cavity. This bleeding causes inflammation, swelling, and scarring of the normal tissue surrounding the endometriosis.
When endometriosis involves the ovary, blood can surround the normal tissue, creating a "blood blister" surrounded by fibrotic tissue, called an endometrioma.

MOST COMMON:
• Ovaries
• Fallopian Tubes
• Uterosacral Ligaments
• Posterior Cul-de-Sac (between uterus and rectum)
• Anterior Cul-de-Sac (between uterus and bladder)
• Outer surface of uterus
• Lining of pelvic cavity

OTHER:
• Intestines
• Rectum
• Bladder
• Vagina
• Cervix
• Vulva
• Abdominal Surgery Scars

Signs & Symptoms:
• Painful* menstrual cramps in abdomen and lower back
• Pain during intercourse
• Abnormal or heavy menstrual bleeding
• Infertility**
• Painful urination or bowel movements during menstruation
• GI symptoms (diarrhea, constipation, nausea)

DIAGNOSIS:
Laparoscopic biopsy is confirmatory.
Other helpful modalities include ultrasound, CT scan, and MRI scan.

TREATMENT:
Watch & wait can be used to observe course, staging, and severity of disease
Pain medication: NSAIDs
Hormone therapy: combined oral contraception, progestins alone, GnRH agonist, Danazol
Surgery: laparoscopic removal of endometrial growths, hysterectomy