Endometriosis is a condition in which the tissues of the lining of the inside of the uterus, are found outside the uterus, up inside the abdomen and pelvis.

This can cause pain during and after periods, but it can also cause problems with fertility, pain during sex, heavy periods, pain during bowel movements or occasionally with a full bladder, and sometimes just dull aching or discomfort. It affects 1 in 10 women and can only be definitively diagnosed by a surgery called a laparoscopy. When the cells of the lining of the uterus implant outside the uterus, they are stimulated to grow by estrogen and can cause inflammation and scarring.

It can be treated by medications or surgery, depending on the situation. Endometriosis is most common in women in their 30s and 40s and is very uncommon in women under 20. If your periods are very painful, especially if they keep you from work or school, call and make an appointment to discuss these concerns with your doctor, you may be suffering from endometriosis.

Possible causes of endometriosis according to the Mayo Clinic:

Although the exact cause of endometriosis is not certain, 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.

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