Endometriosis

Presented by:
Alysha Marie Echano
Laidy Louelainne Castro
BACKGROUND
Endometriosis is a condition where tissue similar to the lining of your uterus
grows on other parts of your body. When this tissue grows in the wrong places,
it can cause you to experience uncomfortable symptoms that can impact your
daily life. Some people with endometriosis also have issues getting pregnant.

• Endometriosis is associated with a small increased risk of developing

epithelial ovarian cancer, mainly including clear cell and endometroid
carcinomas

Source: Cleveland Clinic, 2022

Endometriosis
BACKGROUND
A few places you can develop endometriosis include the:
• Outside and back of your uterus.
• Fallopian tubes.
• Ovaries.
• Vagina.
• Peritoneum (the lining of your abdomen and pelvis).
• Bladder and ureters.
• Intestines.
• Rectum.
• Diaphragm (a muscle near the bottom of your chest that plays an
important role in breathing).
Source: Cleveland Clinic, 2022
PREVALENCE
It is especially common among women in their 30s and 40s and may
make it harder to get pregnant.

SOURCE: USDHHS OASH, 2021

PREVALENCE
Who can get endometriosis?

• Endometriosis is a condition that most commonly impacts people between the ages of 25 and
40. It can also happen to younger people during their teenage years. Although many people
find relief from endometriosis symptoms after menopause, it can still cause discomfort and
pain.

SOURCE: Cleveland Clinic, 2021

CAUSES
The cause of endometriosis is unknown. When you have endometriosis, tissue
similar to the lining of your uterus grows in the wrong places. When it
develops in places like the outside of your uterus, fallopian tubes, ovaries,
intestine and within your pelvic cavity, it can cause painful symptoms. This
pain is related to increased inflammation and often fibrosis and adhesions.

When endometrial-like tissue grows outside of your uterus, it can cause scar tissue
(adhesions). These sections of scar tissue can fuse your organs — creating connections
between

Source: Cleveland Clinic, 2022

PATHOGENESIS
• Several different pathogenetic pathways have been considered,
including retrograde menstruation, benign metastasis, immune
dysregulation, coelomic metaplasia, hormonal disbalance, involvement
of stem cells and alterations in epigenetic regulation, but the true
pathogenesis of endometriosis remains poorly understood.
• External environmental factors such as lifestyle (lack of physical
activity, smoking, caffeine and alcohol intake, diet)
• Dioxins and polychlorinated biphenyls (PCBs) are organic pollutants
produced by industrial processes.
Source: Lamceva et al., 2023
TRANSMISSION
Endometriosis is a chronic non-communicable condition
affecting approximately 10% of women of reproductive age,
with approximately 176 million women diagnosed worldwide

Source: Privitera et al., 2023

RISK FACTORS
• Two known risk factors are starting menstruation before the age of 11 years and heavy and
prolonged menstruation, but other factors may play a role.

• Genetic factors, as it appears to run in families

• problems with menstrual flow, resulting in blood and tissue not leaving the body
• immune system problems, in which the immune system does not eliminate unwanted tissue
• high levels of the hormone estrogen in the body
• surgery to the abdominal area, such as a cesarean delivery or hysterectomy
• Shorter menstrual cycle
• alcohol and caffeine consumption

Source: Medical News Today, 2022

SIGNS AND SYMPTOMS
People who do experience symptoms of endometriosis may have:
• Very painful menstrual cramps.
• Abdominal pain or back pain during your period or in between periods.
• Pain during sex.
• Heavy bleeding during periods or spotting (light bleeding) between
periods.
• Infertility (difficulty becoming pregnant).
• Painful bowel movements.
Source: Cleveland Clinic, 2022
DIAGNOSIS
• Perform pelvic imaging starting with an ultrasound
• Depending on your symptoms, physical exam and
ultrasound results, an MRI may also be ordered for
further endometriosis mapping.
• A laparoscopy may be offered for both definitive
diagnosis and treatment. It can be a useful way to
confirm endometriosis because your surgeon doing the
procedure can use a small camera (laparoscope) to
look inside your body.
• A biopsy (small tissue sample) might be taken during
this procedure. The biopsy will be sent to a lab to
confirm the diagnosis.

Source: Cleveland Clinic, 2022

TREATMENT
Hormonal options for suppressing endometriosis can include:
1. BIRTH CONTROL: These come in multiple forms including oral birth control pills, patch,
vaginal ring, birth control shot, Nexplanon implant or IUD. This hormonal treatment often helps
people have lighter, less painful periods.
2. Gonadotropin-releasing hormone (GnRH) medications: This medication is actually used to stop
the hormones that cause your menstrual cycle. This basically puts your reproductive system on
hold as a way to relieve your pain.
3. Danazol (Danocrine®): This is another form of hormonal medication that stops the production of
the hormones that cause you to have a period.

Source: Cleveland Clinic, 2022

TREATMENT
Medications for endometriosis pain relief can include:
• Over-the-counter pain relief.
• Non-steroidal anti-inflammatory drugs (NSAIDs).

Surgical options to treat endometriosis include:

• Laparoscopy: In this procedure, your surgeon will make a very small cut in your abdomen (< 1
centimeter) and insert a thin tube-like tool called a laparoscope into your body.
• Hysterectomy: In severe cases, your surgeon may suggest removing your uterus based on the
amount of endometriosis and scar tissue present

• Source: Cleveland Clinic, 2022

PREVENTION
A few factors that can reduce your risk of endometriosis include:

• Pregnancy
• Breastfeeding
• Maintaining a weight that's healthy for you
• Starting your menstrual period at a later age

Source: Cleveland Clinic, 2022