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Endometriosis
is a condition where the cells from the lining of the uterus called
the endometrium grow other places within the abdominal region. It can produce these
symptoms: incapacitating pain in the uterus, lower back pain, and pain
in the organs in the pelvic area, intermittent pain during menstrual
cycles, painful sexual intercourse, excessive bleeding and passing of
large clots and tissue during the menstruation, nausea, vomiting,
constipation, and
infertility. Because
menstruation is typically heavy, iron deficiency anemia is common.
Women with cycles shorter than 27 days and those with periods lasting
over a week are at increased risk of anemia. Endometriosis is a
condition that often passes from mother to daughter.
Growths of endometrial tissue outside of the uterine
cavity occur most often around the ovaries, the fallopian tubes, the urinary bladder, the bowel, the pelvic floor,
and/or the pentoneum which is the membrane that lines the walls of the abdominal cavity, and
within the uterine muscles. The most common site of endometriosis is believed to be the deep pelvic
peritoneal cavity, or the cul-de-sac. The presence of endometrial implants outside the pelvic area of the
body is not very common.
During a normal menstrual cycle, a continually
changing hormonal environment stimulates the endometrium to grow in preparation for a possible pregnancy. This same cycle
causes a follicle within one of the ovaries to ripen, and an egg is released. Fingerlike tissues on the fallopian
tube grasp the egg, and the tiny, hair like cilia inside the
tube transport it toward the uterus, the lining of which is now spongy
and well supplied with blood. If the egg is not fertilized within
around 24 hours of being released, the uterine lining proceeds to
“die,” to be sloughed off, and to pass through the vagina during the
menstruation
Though not inside the uterus, the abnormal
implants of endometriosis also respond to the hormonal changes
controlling menstruation. Like the uterine lining, these pieces build
tissue every month, then break down and bleed. Unlike blood from the
uterine lining, the blood from the implants has no way to leave the
body. Instead, it must be absorbed by surrounding tissue, which is a
fairly
slow process. In the meantime, the blood accumulates in body cavities. The
whole sequence, from bleeding through absorption, can be painful.
As
the menstrual cycle recurs month after month, the implants may get bigger. They may seed new implants and form localized
scar tissue and adhesion scar tissue that attaches to pelvic organs and binds them together.
This adds to the pain of endometriosis, and it may cause extreme pain in pregnancy later on, as the uterus
enlarges and the organs within the abdomen are pushed into different positions. Sometimes blood collects
and a sac or cyst forms. Endometrial or “chocolate” cysts are common on the ovaries. These
are usually found to contain moderate amounts of oxidized blood,
which looks something like chocolate syrup. If a cyst ruptures,
it can cause severe pain
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