# Endometriosis --- **Endometriosis** is a condition where parts of the [[uterus|endometrium]] of the uterus become accidentally displaced, and end up on the external surface of the organs of the [[abdominopelvic cavity]]. This is problematic because the displaced endometrium still grows under the influence of hormones, but cannot be expelled normally through the vagina. This causes hemorrhaging and breakdown of the endometrium that is extremely painful and can cause [[adhesions]], which can cause deformities in the [[uterus|uterine tubes]] or even [[infertility]]. It's also thought that endometriosis can lead to ovarian cancer. The pathophysiology of endometriosis is not well understood (I wonder why) but It's thought that the endometrium becomes displaced if it accidently travels the wrong way out of the [[uterus]], and comes out from the opening at the end of the uterine tubes. ## Risk Factors/Cause - late childbearing or nulliparous people - bearing fewer children - family history - short menstrual cycle/dysmenorrhea ## Signs & Symptoms The signs and symptoms of endometriosis are - dysmenorrhea (severe and frequent menstral cramps during the period) - dyspareunia (discomfort during sex) - pelvic pain/discomfort - dyschezia (difficulty pooping) ## Diagnostic Tests Endometriosis can be diagnosed with a pelvic exam (they can see fixed tender nodules, and limited mobility of the uterus which indicates adhesions) or a laparoscopic exam. ## Treatment Fortunately, once diagnosed (which often takes way too long) meds can resolve 80-90% of cases. Treatment takes into account symptoms, extend of the disease and the individual's desire for pregnancy: Meds: - oral contraceptives - tricks the body into thinking it's pregnant, so they don't go though the cycle. - [[gonadotropin-releasing hormone|GnRH]] antagonists (decrease estrogen production) - NSAIDS Surgical: - laparoscopy to remove endometrial tissue in abdominal cavity - [[hysterectomy]] - oophorectomy or salpingo-oophorectomy ## Nursing Considerations Endometriosis is woefully underdiagnosed and undertreated due pervasive unconscious bias against uterus-havers. We can do better. ___