The lining of the uterus called endometrium .A tissue similar to this lining grows outside the uterus as in your ovaries, your tubes, around the uterus and the bowel, these tissues called endometriosis. When you have your period these tissues will bleed same way as your uterus and will also cause  pain  similar to your period pain but in different places where the endometriosis tissue is present.

Causes of endometriosis

The cause is unknown but there are some theories one of them stated it is a backward flows of some menstrual blood through the tubes into the pelvis and it grows where it lands

Symptoms of Endometriosis

  • No symptoms, or
  • Pain— before, during or between your periods. Pain may come during or after sex. and sometimes during bowel movement or when you urinate during your period
  • Difficultto conceive—Endometriosis can cause scar tissue, which may damage your ovaries or tubes. Sometimes the pregnancy becomes difficult even without scar tissue but once you become pregnant your symptoms may improve
  • Endometriomas called (chocolate cysts)—cysts with endometriosis which contain blood similar to chocolate in your ovaries.

Diagnosis of Endometriosis

The diagnosis usually suspected based on clinical symptoms but to confirm the diagnosis you have to have a surgery.

Some doctors may recommend a medicine to treat a suspected endometriosis for three or more months if failed,the second step is the surgery ( see treatment below)


There are several treatment options :

  • Nonsteroidal anti-inflammatory drugs; like Advil or Aleve
  • Hormonal birth control which includes :pills, patches, , vaginal rings , IUDs (mirena) and injection . they should be taken continuously for few months
  • Other forms of hormone treatment (gonadotropin releasing hormone agonists) like Lupron
  • Surgery

         The treatment choice depends if you want to become pregnant or just to control the pain

Removal of the uterus or ovaries — it might be recommended if all treatment options have failed, severe pain that effects on your quality of life and if you don’t want to become pregnant. You may need hormonal treatment if you remove your ovaries especially if you are under 50.

Treatment of infertility in Endometriosis:

Depending on your endometriosis, age or other problems your doctor will individualize your treatment which may include clomid or may refer you to fertility center for more treatment options like IVF