Endometriosis: Causes, Complications and Prevention

Endometriosis is the development of uterine-lining tissue outside the uterus. The tissue that normally lines the inside of your uterus, grows outside your uterus.

Updated: June 16, 2022

Endometriosis is the development of uterine-lining tissue outside the uterus. The tissue that normally lines the inside of your uterus, grows outside your uterus. Endometriosis most commonly involves your ovaries, fallopian tubes and the tissue lining your pelvis. Rarely, endometrial tissue may spread beyond pelvic organs.

Causes of Endometriosis:

The exact cause of endometriosis is not certain. However, the possible causes could be

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 displaced 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.
Retrograde menstruation is not the only cause of endometriosis, as many women who have retrograde menstruation do not develop the condition.

Embryonic cell transformation:

During puberty hormones such as estrogen may transform the cells in the earliest stages of development called embryonic cells into endometrial cell implants.

Transformation of peritoneal cells:

Hormones or immune factors promote transformation of the cells that line the inner side of your abdomen called peritoneal cells into endometrial cells.

Endometrial cells transport:

The blood vessels or tissue fluid system may transport endometrial cells to other parts of the body.

Surgical scar implantation:

After a surgery, such as a hysterectomy or C-section, endometrial cells may attach to a surgical incision. The direct transfer of endometrial tissues at the time of surgery may be responsible for the endometriosis implants occasionally found in surgical scars.

Immune system disorder:

A problem with the immune system may make the body unable to recognize and destroy endometrial tissue that is growing outside the uterus.

Complications of Endometriosis:

Endometriosis affects women during their reproductive years. The complications include:

Infertility:

Endometriosis is more common in infertile women, as compare to those who have conceived a pregnancy. However, many women with confirmed endometriosis are able to conceive without difficulty, particularly if the disease is mild or moderate. Women with endometriosis should not delay having children because the condition may worsen with time.
An egg must be released from an ovary, travel through the neighboring fallopian tube, become fertilized by a sperm cell and attach itself to the uterine wall to begin development for pregnancy to occur. The presence of endometriosis may trigger significant scar  formation within the pelvis which can distort normal anatomical structures. Endometriosis may obstruct the tube and keep the egg and sperm from uniting. It can also damage to the sperm or egg. Endometriosis may affect fertility through the production of inflammatory substances that have a negative effect on ovulation, fertilization of the egg, and implantation of the embryo.

Ovarian cancer:

Women with endometriosis have an increased risk for development of certain types of ovarian cancer, known as epithelial ovarian cancer (EOC). This risk is highest in women with both endometriosis and primary infertility . The presence of endometriosis may be related to other genetic or environmental factors that serve to increase the risk of developing ovarian cancer in women.
The endometriosis implants themselves undergo malignant transformation to cancer. The risk can be reduced by using oral contraceptive pills (OCPs), which are sometimes used in the treatment of endometriosis.
A common complication of endometriosis is the development of a cyst on an ovary called as ovarian endometrioma or an endometrial cyst. The symptoms of an ovarian cyst may be the same as those of endometriosis. The size of the cyst could be 1 mm or more than 8 cm.

Prevention of Endometriosis:

Dietary modifications can either prevent or reduce the symptoms of endometriosis. A diet rich of green vegetables and fruit is associated with a lower risk of developing endometriosis, while a higher intake of red meats is associated with a higher risk.
Milk or coffee does not effect endometriosis.


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