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Endometriosis

To understand endometriosis, let us first get familiarised with the word “endometrium”. The endometrium is the tissue that lines the uterus in females.

The thickness of the endometrium varies throughout the menstrual cycle, depending on the levels of different hormones at the time.  The endometrium grows in thickness after the end of menstruation and develops to maximum thickness during ovulation when it is laden with blood, expecting a fertilised embryo to embed into it. The female hormone oestrogen plays a role up till this part and then progesterone is secreted in larger quantities to maintain its thickness. If implantation does not take place, the endometrium breaks down and is dispelled through the vagina as menses. This tissue is renewed every month.

Endometriosis is derived from the word “endometrium”. In females who suffer from endometriosis, endometrial tissue grows outside the uterus. It can occur in other parts of the reproductive system such as the outer surface of uterus, ovaries, fallopian tubes, uterosacral ligaments (that support the uterus); it can also occur elsewhere in the abdominal cavity such as the space between the uterus and bladder and that between the uterus and rectum, and lining of the pelvic cavity. Rarely, it can also be seen in the intestines, rectum bladder, cervix, vagina, and vulva. This “rogue” tissue responds to hormones responsible for the menstrual cycle in a similar manner. Thus, it too, builds up and breaks down causing bleeding. As this tissue cannot be expelled, it can lead to inflammation, scar tissues, and form cysts. It can also cause adhesions wherein the tissue acts as an adhesive binding pelvic organs together.

One must also be aware of endometrioma. When the endometrial tissue makes its way into the ovaries, menstrual blood can get embedded inside the ovarian tissue, forming a cyst. Due to its colour, it is also referred to as “chocolate cyst”.

Endometriosis can impact normal functioning of reproductive organs, leading to infertility.

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