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Endometriosis is a condition in which tissue that is structurally and functionally similar to endometrium becomes present and attaches itself outside the uterine cavity.



Endometriosis occurs after one has reached reproductive age. It does not occur before menarche (menses) and regresses after menopause. This suggests that menopause is dependent on estrogen levels which are affected by menses and menopause. The primary age for the development of endometriosis is 30 to 45 years of age.

Endometriosis is more prevalent in white females; females in higher social classes and patients with infertility or low parity as well as in females who delay their first pregnancy.

The incidence of endometriosis also increases in those whose first degree relatives have had or are currently suffering with the condition and can thus be linked to genetics (hereditary).




Sites of Endometriosis

Endometriosis can develop anywhere in the body but is most commonly seen in the pelvis.

Pelvic organs which are mostly affected include the ovaries, the Pouch of Douglas, the fallopian tubes, serosal uterine surface and broad ligament of the uterus.

Endometriosis can also involve the lower genital tract such as the vagina, cervix, recto-vaginal septum and scar of episiotomy and can occur in the bowel, urinary tract and different other sites.


Causes of Endometriosis

The true cause of endometriosis is not yet known. There are however some theories that describe its formation. These include:

  • The retrograde menstruation and implantation theory
  • The composite theory
  • Lymphatic and vascular dissemination/ Halban theory


Signs and Symptoms of Endometriosis

The symptomatology of endometriosis depends upon the organ involved.

    1. Pelvic organs
      • Pain
        • Dysmenorrhea
        • Dull lower abdominal and pelvic pain
        • Dyspareunia
        • Low back pain
      • Infertility
      • Irregularities of menstruation
    2. Gut
      • Dyschesia
      • Diarrhea
      • Rectal bleeding
      • Colonic obstruction
    3. Urinary tract
      • Ureteric obstruction
      • Cyclical obstruction
    4. Surgical scar or umbilicus
      • Bleeding and cyclical pain


Diagnosing Endometriosis

Endometriosis is diagnosed with a speculum and by bimanual examination.

Other investigations include:

A laparoscopy which can be used to diagnose it.

An ultrasound detects the presence of chocolate cysts, but it is of no value in detecting the disease early.

Serum CA-125: These are moderately raised in patients with endometriosis.

A CT scan and MRI can pick up early lesions but cannot establish the nature of lesion.


Treatment of Endometriosis

Endometriosis can be treated by both medical and surgical intervention. The treatment selected depends on the extent of the disease, the reproductive needs of the client and severity of symptoms. Whatever treatment option is taken, the aim is to provide relieve from the pain and allow satisfactory coitus; to promote chances of conception in infertile patient and to control abnormal bleeding.


Medical Treatment

Drugs used to treat endometriosis include danazol, the oral contraceptive pills, progestin-only regimens and gestinon. Prostaglandin synthetase inhibitors can also provide symptomatic relief.

When to seek Surgical Treatment

Surgical treatment of endometriosis is indicated under following indications:

    1. Pelvic adhesions
    2. Endometriomas
    3. A blockage of the fallopian tubes
    4. Incapacitating and intractable pain
    5. Involvement of other organs such as ureter and bowel.

Surgical treatment of endometriosis can be conservative or radical.

The conservative approach keeps the reproductive capabilities intact while radical surgery involves the removal of endometrial implants, bilateral oophorectomy and a possible hysterectomy.


 Natural Treatments


Endometriosis - Bella EndoMet  

For the treatment of excess pain/discomfort prior to menses, a decrease in PMS & irregular menstrual symptoms, the expulsion & removal of irregular endometrial linings & improves reproductive health.

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Address: Healing Innovation LLC
501 Silverside Rd, Suite 105,

Wilmington, DE, 19809



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