THEendometrial is the mucous membrane that lines the inside of theuterus. At the end of the menstrual cycle, if there has not been fertilization, part of the endometrium (which is constantly renewing itself) is evacuated with the menstruation.

THEendometriosis is characterized by training, outside the womb, tissue formed from endometrial cells. As a result, endometrium begins to form elsewhere in the body.

Endometrial tissue, no matter where it is in the body, responds to hormonal fluctuations in the menstrual cycle. So, just like the lining of the uterus, it forms and then “bleeds” every month. However, when this tissue is located outside the uterus, as is the case in women with endometriosis, bleeding has no outlet to the outside of the body. The blood and loose endometrial cells can irritate nearby organs and the peritoneum (the membrane that encloses the organs in the abdomen). It can also lead to the formation of cysts (the size of a pin to that of a grapefruit), scar tissue, as well as adhesions that connect organs to each other and cause pain.

Where do endometrial tissues form?

Most of the time :

– on the ovaries;

– on the fallopian tubes;

– on the ligaments supporting the uterus;

– on the outer surface of the uterus.

More rarely, they can develop on nearby organs, such as the intestines, bladder or kidneys. Finally, exceptionally, they are found in places very far from the uterus, such as the lungs, arms or thighs.

This gynecological disorder is among the most frequent: from 5% to 10% of women of childbearing age are affected. Endometriosis is usually discovered around the age of 25 to 40, due to pain abnormally intense in the lower abdomen or a probleminfertility. Indeed, 30% to 40% of women with endometriosis are infertile. But in many cases, endometriosis is not accompanied by pain and does not impact fertility. It is then detected by chance, for example during a laparoscopic procedure in the abdomen.

Causes

Currently, no one can explain why some women haveendometriosis. It is possible that a malfunction of the immune system and certain genetic factors are involved. here is some hypotheses advances.

The most accepted hypothesis involves the notion of retrograde flow. During menstruation, blood and the outer layers of the endometrium are normally forced outward through muscle contractions. Occasionally, blood flow may reverse (hence the name retrograde flow) and blood containing endometrial cells may be directed to the pelvic cavity through the fallopian tubes (see diagram ). This reflux would occasionally occur in most women, but it would not be accompanied by a rooting endometrial cells than in some of them.

Another hypothesis is that endometrial tissue could migrate out of the uterus through lymph or through blood.

Finally, it is also possible that certain cells normally located outside the uterus transform into endometrial cells under the influence of genetic and environmental factors.

Evolution

The degrees of severity of endometriosis vary. This disorder usually tends to get worse over time if left untreated.

On the other hand, 2 situations have the effect of reducing its symptoms: menopause, which most often provides permanent relief, and pregnancy, which relieves them temporarily.

Possible complications

The main risk associated withendometriosis is theinfertility. About one in three women who have trouble getting pregnant has endometriosis. Moreover, the diagnosis of endometriosis is often made during exploratory tests (by laparoscopy) carried out due to infertility problems.

The adhesions endometrial tissue can decrease fertility by preventing the egg from being released or by preventing it from passing through the fallopian tubes to the uterus. However, we observe that 90% of women with mild or moderate endometriosis succeed in becoming pregnant within 5 years. However, the more time passes, the more fertility is likely to be compromised. Also, better not to delay a desired pregnancy.