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How To Explain Endometriosis Pain | 2020 | Good Advice For Endometriosis Pain

General description

Endometriosis is an often painful disorder in which the tissue-like tissue that normally lines the inside of the uterus - the endometrium - grows outside the uterus. Endometriosis most commonly affects the ovaries, the fallopian tubes, and the tissue that lines the pelvis. Seldom, endometrial tissue can spread past the pelvic organs.
With endometriosis, endometrial-like tissue acts like endometrial tissue would: it thickens, breaks down, and bleeds with each menstrual cycle. But because this tissue has no way of leaving the body, it becomes trapped. When endometriosis affects the ovaries, cysts called endometriomas can form. The surrounding tissue can become irritated and eventually develop scar tissue and adhesions, that is, abnormal bands of fibrous tissue that can cause the pelvic tissues and organs to stick together.

How To Explain Endometriosis Pain | 2020 | Good Advice For Endometriosis Pain
Endometriosis can cause pain, sometimes intense, especially during menstrual periods. Fertility problems can also occur. Fortunately, there are effective treatments available.


The main symptom of endometriosis is pelvic pain, often associated with menstrual periods. Although many have colic during their menstrual periods, women with endometriosis often describe menstrual pain that is much worse than usual. Pain can also increase over time.

Common signs and symptoms of endometriosis include the following:

  • Painful periods (dysmenorrhea). Pelvic pain and colic can start earlier and continue for several days during the menstrual period. You may also have pain in your lower back and abdomen.
  • Pain when having sex. Pain during or after sexual intercourse is common with endometriosis.
  • Pain when defecating or urinating. You are more likely to have these symptoms during a menstrual period.
  • Excessive bleeding You may have sporadic heavy menstrual periods or bleeding between periods (breakthrough bleeding).
  • Sterility. Sometimes endometriosis is diagnosed first in those seeking treatment for infertility.
  • Other signs and symptoms You may experience fatigue, diarrhea, constipation, bloating, or nausea, especially during menstrual periods.

Pain intensity is not necessarily a reliable indicator of the extent of the condition. You could have mild endometriosis with severe pain, or you could have advanced endometriosis with little or no pain.

Endometriosis is sometimes confused with other conditions that can cause pelvic pain, such as pelvic inflammatory disease (PID) or ovarian cysts. It can be mistaken for irritable bowel syndrome (IBS), a condition that causes episodes of diarrhea, constipation, and abdominal cramps. IBS can accompany endometriosis, which can complicate the diagnosis.

When should you see a doctor

If you have signs and symptoms that may indicate endometriosis, see your doctor.

Endometriosis can be a difficult condition to treat. Control of symptoms may improve with early diagnosis, a multidisciplinary medical team, and understanding of the diagnosis.


Although the exact cause of endometriosis is unclear, possible explanations include the following:

  • Retrograde menstruation. In retrograde menstruation, menstrual blood containing endometrial cells return through the fallopian tubes to the pelvic cavity instead of leaving the body. These endometrial cells adhere to the pelvic walls and to the surfaces of the pelvic organs, where they grow and continue to thicken and bleed throughout each menstrual cycle.
  • Peritoneal cell transformation. In what is known as the "induction theory," experts postulate that hormones or immune factors promote the transformation of peritoneal cells - the cells that line the inner side of the abdomen - into cells similar to those of the endometrium.
  • Embryonic cell transformation. Hormones such as estrogen can transform embryonic cells - cells in the early stages of development - into cell implants similar to those of the endometrium during puberty.
  • Implantation of surgical scars. After surgery, such as a hysterectomy or cesarean section, endometrial cells can adhere to a surgical incision.
  • Endometrial cell transport. Blood vessels or the the interstitial (lymphatic) fluid system can transport endometrial cells to other parts of the body.
  • Immune system disorder. A problem with the immune system can render the body unable to recognize and destroy endometrial tissue that is growing outside the uterus.

Risk factor's 
There are factors that put you at greater risk of developing endometriosis, such as the following:

  •  Never give birth
  • Start period at a young age
  • Go through menopause at an advanced age  
  • Short menstrual cycles, p. eg less than 27 days
  • Intense menstrual periods lasting more than seven days
  • Having higher levels of estrogen in the body or increased lifetime exposure to estrogen produced by your body
  •  Low body mass index
  • One or more relatives (mother, aunt or sister) with endometriosis
  • Any medical condition that prevents the normal passage of menstrual flow out of the body
  • Reproductive system abnormalities

Endometriosis usually develops several years after the onset of menstruation (menarche). The signs and symptoms of endometriosis may temporarily improve with pregnancy and may disappear entirely with menopause unless you are taking estrogen.



The main complication of endometriosis is impaired fertility. Between a third and a half of women with endometriosis have difficulty getting pregnant.

For pregnancy to occur, an ovary must release an egg, which must travel through the neighboring fallopian tube, be fertilized by a sperm, and adhere to the uterine wall to begin development. Endometriosis can block the tube and prevent the egg and sperm from coming together. But the condition also appears to affect fertility in less direct ways, such as by damaging the sperm or egg.

Still, many people with mild to moderate endometriosis can conceive and carry a pregnancy to term. Doctors sometimes advise people with endometriosis not to delay having children because the condition can get worse over time.


Ovarian cancer occurs at higher rates than expected in women with endometriosis. However, first, the overall lifetime risk of ovarian cancer is low. Some studies suggest that endometriosis increases that risk, but it is still relatively low. Although rare, another type of cancer, adenocarcinoma associated with endometriosis, can develop later in life in people who have had endometriosis.

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