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Endometriosis

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The endometrium is the lining of the womb (uterus) which proliferates every month before being shed during a woman's period. If a woman has endometrium outside the lining of the womb she has endometriosis. Whilst it can be symptomless, symptoms are caused by the tissues' response to the woman's monthly hormonal cycle, causing it to proliferate and bleed just like normal endometrium. However, there is no escape for the monthly bleed so it forms cysts and fibrous deposits. These endometriotic areas vary in size from a tiny pinhead to a large cyst with tarry material; the chocolate cyst.

The cause remains unproven but it is most likely to be caused by endometrial cells being pushed back towards the ovaries instead of out of the vagina during a woman's period. This would explain why the deposits are almost always in the pelvic cavity. Deposits within the ovaries, pelvic ligaments, large bowel (causing obstruction), bladder (causing bloody urine), and post-operative scars are common.

There can be any of three main symptoms: pain, infertility and menstrual disturbances. The pain is either severe before, and relieved by the period, severest at mid-cycle when the woman ovulates, or sometimes is severest during intercourse.

Endometriosis is a disease of women in the second half of their reproductive life between 30 and 45 and tends to fade away at the menopause or before.

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