Endometriosis: what you need to know

Endometriosis is a puzzling condition that affects females in their reproductive years. If you think you might have this painful condition, here's what you should know.

• The word "endometriosis" is derived from the name of the lining inside a woman's uterus, or endometrium.
• When that lining grows elsewhere—most commonly the ovaries, the ligaments supporting the uterus, or the lining of the pelvis, including the bowel, bladder, and rectum—the resulting pain can be severe. Infertility is also a hallmark of the condition.

• The endometrial tissue that grows outside the uterus respond to a woman's hormones just like the uterine lining does. Every 28 to 30 days, the lining thickens, preparing for a pregnancy. When that doesn't happen, the body sheds the lining by bleeding and a woman has her period.
• But with endometriosis, the lining and blood have nowhere to go and they wind up trapped inside the body, causing irritation and pain. Sometimes a blood cyst called an endometrioma can also form.
• Trapped blood and ruptured cysts can result in scar tissue, or adhesions, that can bind pelvic organs together. When your cycle ceases during pregnancy, many of your symptoms may vanish, only to return after the baby is born and you've finished breast-feeding.

• Some women experience no symptoms. Most have pelvic pain, often during sex, during their periods, or when they urinate or have a bowel movement.
• You may have more severe cramping, pelvic, back, and stomach pain before and during your period than you used to. You may have heavier periods and bleed between your periods as well.

• There is most likely a genetic component: You have a nearly eightfold increase in risk of endometriosis it if you have a mother or sister who has it.
• "It is also considered an autoimmune disease," says Barbara Soltes, MD, associate professor of obstetrics and gynecology, Rush University Medical Centre, Chicago. "Only women who have an immune defect in their reproductive systems will develop endometriosis."

• Without treatment, the condition tends to get worse. Although it can't be cured, hormone treatments, pain medications, and some lifestyle measures can help make you more comfortable.
• In a Northwestern University study, aromatase inhibitors cut pain by more than half in nine out of 10 patients.