RISK FACTORS
D I AGNOS I S
To diagnose endometriosis and other conditions that can cause pelvic pain, your doctor will ask you to describe your symptoms, including the location of your pain and when it occurs. Tests to check for physical clues of endometriosis include: Pelvic exam. During a pelvic exam, your doctor manually feels (palpates) areas in your pelvis for abnormalities, such as cysts on your reproductive organs or scars behind your uterus. Often, it's not possible to feel small areas of endometriosis unless they've caused a cyst to form. Ultrasound. This test uses high-frequency sound waves to create images of the inside of your body. To capture the images, a device called a transducer is either pressed against your abdomen or inserted into your vagina (transvaginal ultrasound). Both types of ultrasounds may be done to get the best view of the reproductive organs. A standard ultrasound imaging test won't definitively tell your doctor whether you have endometriosis, but it can identify cysts associated with endometriosis (endometriomas). Magnetic resonance imaging (MRI). An MRI is an exam that uses a magnetic field and radio waves to create detailed images of the organs and tissues within your body. For some, an MRI helps with surgical planning, giving your surgeon detailed information about the location and size of endometrial implants. Laparoscopy. In some cases, your doctor may refer you to a surgeon for a procedure that allows the surgeon to view inside your abdomen (laparoscopy). While you're under general anesthesia, your surgeon makes a tiny incision near your navel and inserts a slender viewing instrument (laparoscope), looking for signs of endometrial tissue outside the uterus.
Never giving birth Starting your period at an early age Going through menopause at an older age Short menstrual cycles — for instance, less than 27 days Heavy menstrual periods that last longer than seven days Having higher levels of estrogen in your body or a greater lifetime exposure to estrogen your body produces Low body mass index One or more relatives (mother, aunt or sister) with endometriosis Any medical condition that prevents the passage of blood from the body during menstrual periods Disorders of the reproductive tract Endometriosis usually develops several years after the onset of menstruation (menarche). Signs and symptoms of endometriosis may temporarily improve with pregnancy and may go away completely with menopause unless you're taking estrogen.
COMPLICATIONS: INFERTILITY
Fertilization and implantation The main complication of endometriosis is impaired fertility. Approximately one-third to one-half of women with endometriosis have difficulty getting pregnant. For pregnancy to occur, an egg must be released from an ovary, travel through the neighboring fallopian tube, become fertilized by a sperm cell and attach itself to the uterine wall to begin development. Endometriosis may obstruct the tube and keep the egg and sperm from uniting. But the condition also seems to affect fertility in less-direct ways, such as by damaging the sperm or egg. Cancer Ovarian cancer does occur at higher-than-expected rates in those with endometriosis. But the overall lifetime risk of ovarian cancer is low to begin with. Some studies suggest that endometriosis increases that risk, but it's still relatively low. Although rare, another type of cancer — endometriosis-associated adenocarcinoma — can develop later in life in those who have had endometriosis.
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