Endometriosis is a condition where the cells that line the uterus, the endometrial tissue, grow outside of the uterus in the pelvic cavity. This tissue is actively growing and functioning. Approximately 10% of women of reproductive age are affected by endometriosis. It is diagnosed by a procedure called a laparoscopy, which can determine the location, type of endometrial tissue and extent of spread. The patches of endometrial tissue are commonly located on the uterine wall, uterine ligaments, fallopian tubes, ovaries, bowel and bladder. It can attach either deeply into the membrane or more superficial. The three types of patches of endometrial tissue, each with a different appearance and behaviour are; Brown or pigmented, Chocolate cyst and Pale pink, white or non-pigmented.
The main symptom associated with Endometriosis is painful periods, which can be quite severe and debilitating in many cases. The pain usually starts 1-2 days before the period and lasts throughout it. There may also be lower back pain, possibly radiating pain down the thighs, rectal pressure and pain on bowel movement, pain during intercourse, premenstrual spotting, depression, anxiety and infertility (in some cases). Fertility is affected in a number of ways. Scarring and adhesions can cause damage to the tubes and ovaries or prevent release of the egg and passing through the tube. Substances released from the inflamed areas can have a harmful effect on the embryo, egg or sperm. Local hormones may be altered; uterine lining and implantation of the embryo can also be affected.
The cause of endometriosis is unclear. Theories include:
Retrograde menstruation: Menstrual blood flows backwards and is forced out along the fallopian tubes into the pelvic cavity where the endometrial cells can then implant and grow.
Coelomic Metaplasia: Cells lining the pelvic organs change their structure and function to become endometrial cells.
Immunologic factors: The immune system is unable to recognize the presence of endometrial tissue in abnormal locations and eliminate it.
Women more likely to be affected are those with a family history, delayed childbearing age, early onset of puberty & menarche (before age 11), and those who have undergone elective tubal sterilization surgery.
Western medical treatment includes removal of endometrial tissue during a laparoscopy if possible. Alternatively drugs are used to halt menstruation to prevent bleeding from the endometrial tissue and give it an opportunity to recede. Painkillers and anti-inflammatories are also used.
From a Chinese Medicine perspective Endometriosis is considered Blood Stagnation, in combination with underlying patterns of Kidney Yang deficiency, Phlegm Damp, Liver Qi stagnation, Spleen Qi deficiency, Heat or Cold.