Endometriosis is the presence of fragments inside the uterus (endometrium) outside of their normal location: plots of this organ to colonize other organs, resulting in "small spheres, well-defined lesions bleeding.
There is talk of adenomyosis when these cysts are located on the wall of the uterus.
Endometriosis affects mainly white women between 25 and 40 years and is one of the most common causes of infertility (30 to 40% of patients suffering from endometriosis are infertile).African Women and Asians are not immune but are less affected than Western women.
The mechanism of this disease is poorly understood. It is possible that fragments of the uterine lining is not removed during menstruation. These fragments date back along the fallopian tubes to go and settle in other organs of the pelvic cavity (peritoneum, ovary, bladder, rectum, colon) and sometimes even into the lungs and brain. This attachment is in the form of cysts that are most often located on the muscle of the uterus itself: the disease is in this case the name of adenomyosis or endometriosis internally.
Are occasionally found fragments of uterine lining on the skin and scars of the bladder.
The endometrium undergoes hormonal fluctuations during the menstrual cycle. Similarly, the fragments that have migrated to another part of the body will also respond to hormones. The endometrium is sensitive to estrogen and progesterone which the fall in concentration in the blood causes a bleeding resulting rules. It is the same for fragments migrating, which will begin to bleed during menstruation, as the uterus.
We sought to understand the mechanism of this disease without really clarifying. It seems to be the result of trauma to the cervix, after a biopsy, electrocautery, laser surgery or a cone biopsy (removal of a cone-shaped piece of tissue at the base of the cervix uterus).
The pain can be explained by the fact that in the abdominal cavity, the organs are in contact with each other. There is a thin membrane that separates them, but which may come to be grafted fragments of endometriosis. During the course of the disease, hemorrhagic buttons may eventually heal and cause adhesions in the manner of healing as we can see it on a wound in the skin. Depending on the organs affected by these adhesions, location of pain varies.
Thus, for the rules, the peritoneum diagnosed with endometriosis will begin to bleed. The inflammation that accompanies the bleeding and fibrosis resulting from wound healing home, by the tension it exerts on the peritoneum, will cause pain.
On the other hand, the peritoneum can be irritated by some of the products of menstruation (blood clots, endometrial fragments to be eliminated during menstruation) that pass through the bell of the fallopian tube into the abdomen and exacerbate the pain.
In the ovaries, endometriosis causes pain explained by compression and possibly by the collapse of these hemorrhagic cysts, leading to bleeding.
The combination of adhesions due to scarring, pressure, tension, bleeding, inflammation and fibrosis, which causes the pain in endometriosis.
That is essentially what is called internal endometriosis, that is to say, adenomyosis, which causes the bleeding.
But do not systematically consider the bleeding before menstruation as a sign suggestive of endometriosis.
Pregnancy and endometriosis
The pregnancy of women with endometriosis is not a problem. Quite the contrary, studies have shown that pregnancy would tend to curb endometriotic lesions. But a young woman under 25 years of ovarian endometriosis must necessarily be followed regularly in a gynecology peak, given the severity of ovarian endometriosis.