Endometriosis

Endometriosis is a condition where tissue similar to the uterine lining (endometrium) grows outside the uterus. The exact cause of endometriosis is not fully understood, but it is believed to result from a combination of genetic, hormonal, immune, and environmental factors.

Where Can Endometriosis Develop?

Endometrial-like tissue can grow in various areas of the abdomen and pelvis, including:

• Ovaries
• Fallopian tubes
• Uterine ligaments
• Bladder
• Rectum
• Ureters & kidneys
• Pelvic nerves

In rare cases, endometriosis has been found in the chest cavity.

Possible Causes & Theories of Endometriosis

• Retrograde Menstruation– Menstrual blood flows backward into the pelvic cavity instead of leaving the body, allowing endometrial cells to implant and grow.
• Genetics– Having a close relative with endometriosis increases risk.
• Immune Dysfunction– A weakened immune system may fail to eliminate misplaced endometrial cells.
• Hormonal Factors– Estrogen may promote the growth of endometriotic lesions.
• Lymphatic or Blood Spread– Endometrial cells may travel through the blood or lymphatic system to distant locations.
• Environmental Factors– Certain toxins and chemicals may contribute to disease development.
• Surgical Scars– Previous surgeries (e.g., C-section, hysterectomy) can trigger endometrial cell implantation.
• Autoimmune Factors– Inflammation and autoimmune responses may play a role in disease progression.

Endometriosis can develop even in the absence of these risk factors, and its severity varies greatly among individuals.

Symptoms of Endometriosis

• Severe menstrual pain (dysmenorrhea)
• Pain during urination or bowel movements
• Constipation, diarrhea, or blood in urine
• Nausea
• Heavy menstrual bleeding
• Chronic pelvic or lower abdominal pain
• Pain during or after sexual intercourse
• Infertility due to adhesions
• Gastrointestinal issues

Endometriosis significantly impacts daily life, affecting social, professional, and emotional well-being.

Diagnosis & Treatment Options

Early diagnosis is crucial, as delayed detection worsens the condition and reduces quality of life.

Diagnosis Methods

• Clinical examination
• Imaging tests: Transvaginal ultrasound & MRI
• Diagnostic laparoscopy – A minimally invasive procedure used when imaging results are inconclusive. It allows direct visualization and biopsy of endometriotic lesions.

Treatment Approaches

• Medical treatment:Hormonal treatments may help suppress symptoms but do not eliminate the disease.
• Laparoscopic surgery:The gold standard treatment, aiming to remove all endometriotic lesions and restore fertility.
• Tailored treatment plansbased on age, medical history, pregnancy goals, and disease severity.

Expert Endometriosis Care at Thely Clinic

At Thely Clinic, our specialists have advanced training in endometriosis management, with expertise from leading UK endometriosis centers, including:

• Chelsea and Westminster Hospital
• Norwich Hospital