Endometriosis occurs when cells from the lining of the uterus (endometrium) appear and become established outside the uterine cavity, commonly on the peritoneum wall which lines the abdominal cavity. These endometrial-like cells are influenced by hormonal changes similar to the cells found inside the uterus and these symptoms usually worsen with the menstrual cycle.
The main symptom with endometriosis is recurring pelvic pain which can vary from mild to severe cramping in the pelvis, the lower back and sometimes down the legs.
The amount of pain often bears no relationship to the extent of endometriosis. Some women experience little or no pain while having extensive endometriosis, even including scarring, while other women may experience severe pain even though they have limited areas of endometriosis.
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Symptoms may include:
- Chronic pelvic pain – usually accompanied by lower back pain or abdominal pain
- Dysuria – urgency to urinate, frequency, sometimes with pain
- Dyspareunia – pain during sex
- Dysmenorrhea – painful, even disabling cramps during periods which may get worse over time along with lower back pain
- General pain - the pain areas and intensity often bears no relationship to the surgical diagnosis, and often the source of pain does not correlate to the sites of endometriosis.
- Endometriosis reacts to hormones and can "bleed" at menstruation time. The blood builds up locally, causing swelling, and sets off inflammatory responses once cytokines are activated. Pain can occur from adhesions (scar tissue) linking internal organs together, leading to organ dislocation. Fallopian tubes,the uterus, ovaries, the bladder and the bowels can be linked together leading to pain on a daily basis, as well as during menstrual periods.