Endometriosis Quiz: Test Your Medical IQ

Endometriosis occurs when endometrial cells similar to those that form the inside of the uterus grow in an abnormal location outside of the uterus. These areas are called endometriosis implants. Endometriosis implants are most commonly found on the ovaries, Fallopian tubes, and on the outer surface of the uterus or intestines.

The word endometriosis comes from the word "endometrium"— endo means "inside" and metrium (pronounced mee-tree-um) means "mother." Health care professionals use this term to refer to the tissue that lines the inside of the endometrium.

Endometriosis is one of the most common gynecological diseases, affecting more than 5.5 million women in North America. Some women don't have any symptoms from endometriosis. Others may not find out they have the disease until they have problems trying to conceive.

Endometrial cells, or cells that line the uterus, are shed each month during menstruation. Normally, if a woman is not pregnant, the endometrial tissue builds up inside the uterus, breaks down into blood and tissue, and is shed as her menstrual flow or period. This cycle of growth and shedding happens every month or so.

Most women who have endometriosis do not have symptoms. Of those who do experience symptoms, the common symptoms are pain (usually pelvic) and infertility. Pelvic pain in women with endometriosis depends partly on where the implants of endometriosis are located.

Other symptoms related to endometriosis include:
- extremely painful (or disabling) menstrual cramps; pain may worsen over time
- lower abdominal pain
- diarrhea and/or constipation
- chronic pelvic pain (includes lower back pain and pelvic pain)
- pain during or after sex
- premenstrual spotting or bleeding between periods
- irregular or heavy menstrual bleeding
- blood in the urine

Note: Rare symptoms of endometriosis include chest pain or coughing blood due to endometriosis in the lungs and headache, and/or seizures due to endometriosis in the brain.

Women with endometriosis seem to have a mildly increased risk for development of certain types of cancer of the ovary, known as epithelial ovarian cancer (EOC), according to some research studies. This risk seems to be highest in women with endometriosis and primary infertility (those who have never borne a child), but the use of oral contraceptive pills, which are sometimes used in the treatment of endometriosis, appears to significantly reduce this risk.

Infertility is a common symptom of endometriosis. However, the condition usually does not fully prevent conception. Up to 70% of women with mild and moderate endometriosis will conceive within three years without any specific treatment.

Endometriosis is rare in postmenopausal women. Most cases of endometriosis are diagnosed in women aged around 25-35 years; however, endometriosis has been reported in girls as young as 11 years of age.

In most cases, the symptoms of endometriosis lessen after menopause because the endometrial implants become smaller in size. For some women, however, this is not the case.

Endometriosis is usually a long-lasting (chronic) disease, which means there is no cure. However, there are a variety of treatments, including pain medications, hormone therapy such as birth control pills, hormone-blocking treatments, or surgery.

Some women have no pain even though their endometriosis is extensive, meaning that the affected areas are large, or that there is scarring. However, some women have severe pain even though they have only a few small areas of endometriosis. The amount of pain a woman feels is not linked to the extent of the endometriosis.

The endometriosis areas growing outside of the uterus also go through a cycle similar to menstruation. Endometriosis areas grow, break down into blood and tissue, and are shed once a month. But, because this tissue isn't where it's supposed to be, it can't leave the body the way a woman's period normally does. As part of this process, endometriosis areas make chemicals that may irritate the nearby tissue, as well as some other chemicals that are known to cause pain.

Endometriosis is not the same as endometrial cancer. Endometrial cancer is a type of cancer that affects the lining of the inside of the uterus. Endometriosis itself is not a form of cancer. Current research does not prove an association between endometriosis and endometrial, cervical, or uterine cancers. In very rare cases (less than 1%) endometriosis is seen with a certain type of cancer, called endometrioid cancer, but, endometriosis is not known to cause this cancer.