Sinclair Community College

What is Endometriosis?

Ana Neal
Bio 1107
Dr. Sloan
20 November 2019
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Endometriosis is a condition where the innermost layer of the uterus called the
endometrium, begins to grow on the outside of the uterus or in other places in the body. The
tissue can grow on structures surrounding the uterus including the ovaries, fallopian tubes,
the structures holding the uterus in place and even on the outside of the uterus. These spots of
tissue are known as “implants,” “nodules,” or “lesions.”(MedlinePlus 2019).Although it is
uncommon, the tissue can also grow on the bowels, the pelvic tissues, and event the bladder.
This research paper will cover the causes, treatments, and outcomes of endometriosis.

What is the function of the endometrium? In the uterus, the endometrium is the inner
layer of the uterus. It is composed of the two layers the first being the stratum basalis, which
attaches to the smooth muscle of the uterus called the myometrium. This layer also serves as
a base for the endometrium. The next layer is called the stratum functionalis, which is
forever changing in relation to hormones in the body. During ovulation, the stratum
functionalis will change.

“...the functional layer of the endometrium goes through specific changes. Structures
called uterine glands become longer and tiny blood vessels proliferate—a process called
vascularization. As a result, the endometrial lining becomes thicker and enriched with blood
so that it's ready to receive a fertilized egg and also support a placenta—the organ that
develops during pregnancy to supply a fetus with oxygen, blood, and nutrients.”(Cornforth,
2019). If there is no conception the endometrium will shed, this is the menstrual cycle. With
endometriosis, the endometrium can become thick and may travel to parts of the body that
are not the uterus. The tissue will spread and cover the bowels, ovaries, bladder and pelvic
area. Because the tissue is not where it is supposed to be, it has nowhere to go once it breaks
down. As a result, the tissue has no way to leave the body and is trapped in the body.

Because these “implants” of tissue are unable to leave the body they will continue to
function as endometrial tissue. The tissue will respond to the hormones affected by the
menstrual cycle, and break down inside the body and cause internal bleeding in the pelvic
area. This bleeding leads to scarring, inflammation, and swelling of the tissues surrounded by
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the “implants” of endometrial tissues. In cases where the ovaries are also affected, fibrous
cysts, known as endometrioma, will form.

There is no specific cause of endometriosis. Possible causes may include immune

disorders and hormones that transform cells outside of the uterus. The lymphatic system may
transport endometrial cells throughout the body, this is known as Endometrial cell transport.
Another possible cause is surgical scar implantation. This is when endometrial cells attach to
incisions after surgeries like c-sections and hysterectomies. Retrograde menstruation is
another possible cause; this happens when a backflow of endometrial cells make their way
into the fallopian tubes. There these cells will stick to the surfaces of pelvic organs and the
pelvic wall where they continue to continue to function as endometrial cells and thicken and
bleed with every menstrual cycle.

There are various degrees of this condition that affects the severity which relates to
the number, size and overall location of the “ implants” of endometrial tissue. Graded in four
stages, the least severe is Stage 1. In this stage, there is inflammation in the pelvic area along
with shallow implants and tiny wounds on the ovary. The second stage involves lesions on
and shallow implants on the pelvic lining and ovaries. The third and fourth stages are very
similar. Both feature deep deep implants on pelvic lining and ovaries but, in the fourth stage,
the lesions could be on the bowels and fallopian tubes.

Symptoms of endometriosis include painful abdominal cramping and back pain

during periods, heavy and abnormal menstrual flow. Symptoms also related to the menstrual
cycle are bloating, nausea, fatigue and painful urination and bowel movements. Infertility,
painful intercourse, G.I. issues like constipation and diarrhea may also occur. These
symptoms are not always dependent on the degree of the condition. More severe cases may
experience no pain or very small amounts.

Serious complications of this condition are infertility and cancer. Being that this
condition gets worse with time, doctors will advise that patients with this condition have
children as soon as possible. This can lead to infertility. Infertility is caused by a blockage in
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the fallopian tube which keeps the egg and sperm from coming together. It can also cause
damage to the sperm and egg. Ovarian cancer is also a possibility associated with
endometriosis. The general risk of ovarian cancer is low but, persons with this condition are
at a greater risk for developing this form of cancer. Adenocarcinoma is another form of
cancer endometriosis patients are at risk for.

Even though the condition is progressive, there are many ways to treat and manage it.
This condition must be diagnosed by a doctor because it shows similar symptoms to pelvic
inflammatory disease and ovarian cysts. In order to be correctly diagnosed with
endometriosis, a pelvic exam feeling for cysts and scars around the uterus, transvaginal and
abdominal ultrasounds showing images of the reproductive organs, looking for tissue related
to endometriosis. For treating pain, hormone therapy including birth control progestin
therapy and gonadotropin-releasing hormone which causes helps with the growing tissues by
causing temporary menopause. There are also surgical options that aid with pain depending
on the severeness. Hysterectomy for more severe pain and laparoscopic removal of patches
of endometrial tissue for less serious cases. Infertility can also be treated with laparoscopic
procedures and in-vitro fertilization.

Since endometriosis is a chronic condition, there is no way to cure it and it can only
be treated and managed. In the United States, only about “... 2 to 10 percent of childbearing
women in the United States between the ages of 25-40 have endometriosis.”(Riggins Nwadike,
MD, MPH, Valinda, et al., 2019). Keeping track of menstrual and family history, can help with
understanding and knowing if you are at risk for this condition.
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Works Cited

Cornforth, Tracee. “The Role the Endometrium Plays in Your Reproductive Health.”
Verywell Health, Verywell Health, 12 Nov. 2019, www.verywellhealth.com/what-
is-the-endometrium-2721857.

“Endometriosis | Endo.” MedlinePlus, U.S. National Library of Medicine, 19 Nov. 2019,

medlineplus.gov/endometriosis.html.

“Endometriosis.” Johns Hopkins Medicine, www.hopkinsmedicine.org/health/conditions-

and-diseases/endometriosis.

“Endometriosis.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 16
Oct. 2019, www.mayoclinic.org/diseases-conditions/endometriosis/symptoms-
causes/syc-20354656.

Riggins Nwadike, MD, MPH, Valinda, et al. “Endometriosis.” Healthline, 28 Mar. 2019,
www.healthline.com/health/endometriosis.