Virginia Mason's Hospital & Seattle Medical Center, as well as Virginia Mason Bellevue Medical Center and Virginia Mason Lynnwood Medical Center, are committed to helping our patients fight endometriosis through careful analysis and treatment of symptoms, ongoing disease management and support, and participation in clinical trials that help bring the latest research discoveries into the clinic setting.
Endometriosis is the growth of endometrial cells outside of the uterus. Normally, endometrial cells make up the endometrium, which is the membrane that lines the inside of the uterus. When cells migrate outside of the uterus, they can grow on tissues and organs in the pelvic cavity, such as the outer surface of the uterus, the ligaments that support the uterus, the ovaries, fallopian tubes, bowel, bladder and rectum. Endometrial cells also can grow on the cervix and in the vagina.
Because these cells still respond to the menstrual cycle, they grow, thicken and bleed, and cause the formation of blood-filled cysts. Over time, these cysts turn dark brown in color and are often referred to as "chocolate cysts." The cysts can grow quite large — to the size of a grapefruit, for example — and cause considerable pain.
Endometriosis also causes the development of adhesions — web-like structures of endometrial tissue that grow on internal organs, such as the ovaries and the abdomen, sometimes causing them to stick together. In severe cases, the adhesions cannot be removed without also removing the organs, such as the ovaries.
Endometriosis primarily occurs in women between the ages of 25-40 although it has been seen in girls as young as 11 and in teenagers. Endometriosis can cause scarring of the reproductive organs, which can lead to infertility. It is also a common cause of ovarian cysts.
Endometriosis is a chronic, disabling disease and presently there is no prevention or cure. However, treatment options in the form of drug therapy and surgery are helping many women find relief from the debilitating symptoms of this disease.
Endometriosis and Fertility
Endometriosis is the cause of about 25 percent of all cases of infertility. It is thought to occur when endometrial tissue adheres to the fallopian tubes and ovaries, causing inflammation and scarring to these organs.
Additionally, if cysts form on the ovary, they can prevent the release of an egg. If a cyst forms on or in the fallopian tubes, it can block an egg’s passage to the uterus. Adhesions also can fix the ovaries and fallopian tubes in place so that an egg released by the ovary never reaches the fallopian tube.
Recent studies suggest that electrocautery of endometrial tissue, usually in lower-stage disease, helps some women achieve pregnancy.
Infertility in women with endometriosis also may be caused by other factors. In a normal pregnancy, the developing embryo attaches to the endometrium, the lining of the uterus. (If an egg is not fertilized, it is shed along with blood and tissue from the endometrial wall during menstruation.)