Endometriosis : Part 2

by National Institute of Health

(Page 2 of 4)

Researchers are exploring other possible causes, as well. Estrogen, a hormone involved in the female reproductive cycle, appears to promote the growth of endometriosis. Therefore, some research is looking into endometriosis as a disease of the endocrine system, the body's system of glands, hormones, and other secretions. Or, it may be that a woman's immune system does not remove the menstrual fluid in the pelvic cavity properly, or the chemicals made by areas of endometriosis may irritate or promote growth of more areas. So, other researchers are studying the role of the immune system in either stimulating, or reacting to endometriosis.

Other research focuses on determining whether environmental agents, such as exposure to man-made chemicals, cause endometriosis. Additional research is trying to understand what, if any, factors influence the course of the disease. We just don't have answers on the causes yet.

Another important area of NICHD research is the search for endometriosis markers. These markers are substances made by or in response to endometriosis that health care providers can measure in the blood or urine. If markers are found, health care providers could diagnose endometriosis by testing a woman's blood or urine, which might reduce the need for surgery.

How do I know that I have endometriosis?

Currently, health care providers use a number of tests for endometriosis. Sometimes, they will use imaging tests to produce a "picture" of the inside of the body, which allows them to locate larger endometriosis areas, such as nodules or cysts. The two most common imaging tests are ultrasound, a machine that uses sound waves to make the picture, and magnetic resonance imaging (MRI), a machine that uses magnets and radio waves to make the picture.

The only way to know for sure that you have the condition is by having surgery. The most common type of surgery is called laparoscopy. In this procedure, the surgeon inflates the abdomen slightly with a harmless gas. After making a small cut in the abdomen, the surgeon uses a small viewing instrument with a light, called a laparoscope, to look at the reproductive organs, intestines, and other surfaces to see if there is any endometriosis. He or she can make a diagnosis based on the characteristic appearance of endometriosis. This diagnosis can then be confirmed by doing a biopsy, which involves taking a small tissue sample and studying it under a microscope.

Your health care provider will only do a laparoscopy after learning your full medical history and giving you a complete physical and pelvic exam. This information, in addition to the results of an ultrasound or MRI, will help you and your health care provider make more informed decisions about treatment.

Why does having endometriosis cause pain?

How endometriosis causes pain is the topic of much research. Because many women with endometriosis feel pain during or related to their periods, some researchers are focusing on the menstrual cycle in their search for answers about pain.

Normally, if a woman is not pregnant, her endometrial tissue builds up inside her uterus, breaks down into blood and tissue, and is shed as her menstrual flow or period. This cycle of growth and shedding happens every month or so.

The endometriosis areas growing outside the uterus also go through a similar cycle; they grow, break down into blood and tissue, and are shed once a month. But, because this tissue isn't where it's supposed to be, it can't leave the body the way a woman's period normally does. As part of this process, endometriosis areas make chemicals that may irritate the nearby tissue, as well as some other chemicals that are known to cause pain.

Over time, in the process of going through this monthly cycle, endometriosis areas can grow and become nodules or bumps on the surface of pelvic organs, or become cysts (fluid-filled sacs) in the ovaries. Sometimes the chemicals produced by the endometriosis can cause the organs in the pelvic area to scar, and even to scar together, so they appear as one large organ.

Is there a cure for endometriosis?

Currently, we have no cure for endometriosis. Even having a hysterectomy or removing the ovaries does not guarantee that the endometriosis areas and/or the symptoms of endometriosis will not come back.

Are there treatments for endometriosis?

There are a number of treatments for both pain and infertility related to endometriosis.

First, let's focus on the treatments for endometriosis pain. They include:

Pain medication - Works well if your pain or other symptoms are mild. These medications range from over-the-counter remedies to strong prescription drugs.

Hormone therapy - Is effective if your areas are small and/or you have minimal pain. Hormones can come in pill form, by shot or injection, or in a nasal spray. Common hormones used to treat endometriosis pain are progesterone, birth control pills, danocrine, and gonadatropin-releasing hormone (GnRH).

Surgical treatment - Is usually the best choice if your endometriosis is extensive, or if you have more severe pain. Surgical treatments range from minor to major surgical procedures. Go to the What are the surgical treatments for endometriosis pain? section for more information about these options.

About the Author

NIH is the nation's medical research agency - making important medical discoveries that improve health and save lives. The National Institutes of Health (NIH), a part of the U.S. Department of Health and Human Services, is the primary Federal agency for conducting and supporting medical research.