Endometriosis is a medical condition that occurs when the tissue that normally lines the inside of the uterus — the endometrium — grows outside of the uterus. This tissue can grow on the ovaries, fallopian tubes, or other pelvic organs, and can cause inflammation, pain, and sometimes infertility. When someone has endometriosis, the affected tissue still thickens, breaks down, and bleeds during each menstrual cycle. However, because the tissue grows outside of the uterus, the blood cannot leave the body; this can lead to the formation of scar tissue, adhesions, and other complications. Endometriosis affects an estimated 10% of women and people with uteruses.

The following list includes some symptoms of endometriosis: 

• Painful periods (dysmenorrhea). Pelvic pain and cramping may begin before and extend several days into a menstrual period. You may also have lower back and abdominal pain.

• Pain with intercourse. 

• Pain with bowel movements or urination. 

• Excessive bleeding. You may experience occasional heavy menstrual periods or bleeding between periods (intermenstrual bleeding).

• Infertility. Sometimes, endometriosis is first diagnosed in those seeking treatment for infertility.

• Other signs and symptoms. You may experience fatigue, diarrhea, constipation, bloating or nausea, especially during menstrual periods.

Even though endometriosis is one of the most common gynecological diseases, people with the condition are commonly undiagnosed for years. This is due to the fact that the abdominal pain associated with the condition is often mistaken for menstrual cramps, or because there may be no symptoms. On average, women — and people with uteruses — in the United States will suffer from endometriosis for 10 years before receiving a proper diagnosis.

Although the exact cause of endometriosis is unknown, some possible explanations include:

• Retrograde menstruation. In retrograde menstruation, menstrual blood containing endometrial cells flows back through the fallopian tubes and into the pelvic cavity instead of out of the body. These endometrial cells stick to the pelvic walls and surfaces of pelvic organs, where they grow and continue to thicken and bleed over the course of each menstrual cycle.

• Transformation of peritoneal cells. In what's known as the "induction theory," experts propose that hormones or immune factors promote transformation of peritoneal cells — cells that line the inner side of your abdomen — into endometrial-like cells.

• Embryonic cell transformation. Hormones such as estrogen may transform embryonic cells — cells in the earliest stages of development — into endometrial-like cell implants during puberty.

• Surgical scar implantation. After a surgery, such as a hysterectomy or C-section, endometrial cells may attach to a surgical incision.

• Endometrial cell transport. The blood vessels or tissue fluid (lymphatic) system may transport endometrial cells to other parts of the body.

• Immune system disorder. A problem with the immune system may make the body unable to recognize and destroy endometrial-like tissue that's growing outside the uterus.

There are several treatment options for individuals with the condition. A person with endometriosis may also opt to have a hysterectomy if suggested by a doctor, which is the removal of the uterus. Besides a hysterectomy, some nonsurgical treatment options include: 

• Oral contraceptives with estrogen and progesterone to control hormones

• Progestins to stop menstrual periods and endometrial tissue growth

• Gonadotropin-releasing hormone antagonist to limit ovarian hormones

• Gonadotropin-releasing hormone agonist to stop ovarian hormones

Even if treatment successfully alleviates the symptoms of endometriosis, the tissue has the potential to grow back and cause symptoms to return. Because of this, it is important to schedule regular check-ups to monitor the status of this condition. 

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Sources:

https://www.mayoclinic.org/diseases-conditions/endometriosis/symptoms-causes/syc-20354656

https://my.clevelandclinic.org/health/diseases/10857-endometriosis

https://www.hopkinsmedicine.org/health/conditions-and-diseases/endometriosis

https://www.yalemedicine.org/conditions/endometriosis#:~:text=One%20of%20the%20most%20common,there%20may%20be%20no%20symptoms.

https://www.michiganmedicine.org/health-lab/endometriosis-9-facts-know-about-puzzling-disease

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