International Adhesions Society





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Endometriosis is a painful, chronic disease that affects 5 1/2 million women and girls in the USA and Canada, and millions more worldwide. It occurs when tissue like that which lines the uterus (tissue called the endometrium) is found outside the uterus -- usually in the abdomen on the ovaries, fallopian tubes, and ligaments that support the uterus; the area between the vagina and rectum; the outer surface of the uterus; and the lining of the pelvic cavity.

Other sites for these endometrial growths may include the bladder, bowel, vagina, cervix, vulva, and in abdominal surgical scars. Less commonly they are found in the lung, arm, thigh, liver, diaphragm and other locations.

Talk with your doctor if you are experiencing problems.........Keep a journal of symptoms so you can remember to tell the doctor.

This misplaced tissue develops into growths or lesions which respond to the menstrual cycle in the same way that the tissue of the uterine lining does: each month the tissue builds up, breaks down, and sheds.

Menstrual blood flows from the uterus and out of the body through the vagina, but the blood and tissue shed from endometrial growths has no way of leaving the body. This results in internal bleeding, breakdown of the blood and tissue from the lesions, and inflammation -- and can cause pain, infertility, scar tissue formation, adhesions, and bowel problems.

What are the Symptoms of Endometriosis?

  • Pain before and during periods
  • Pain with sex
  • Infertility
  • Fatigue
  • Painful urination during periods
  • Painful bowel movements during periods
  • Other Gastrointestinal upsets such as diarrhea, constipation, nausea.

In addition, many women with endometriosis suffer from:

  • Allergies
  • Chemical sensitivities
  • Frequent yeast infections

Diagnosis is considered uncertain until proven by laparoscopy, a minor surgical procedure done under anesthesia. A laparoscopy usually shows the location, size, and extent of the growths. This helps the doctor and patient make better treatment choices.

What Causes Endometriosis?

The cause of endometriosis is unknown. The retrograde menstruation theory (transtubal migration theory) suggests that during menstruation some of the menstrual tissue backs up through the fallopian tubes, implants in the abdomen, and grows.

Some experts believe that all women experience some menstrual tissue backup and that an immune system problem or a hormonal problem allows this tissue to grow in the women who develop endometriosis.

Another theory suggests that endometrial tissue is distributed from the uterus to other parts of the body through the lymph system or through the blood system. A genetic theory suggests that it may be carried in the genes in certain families or that some families may have predisposing factors to endometriosis.

Surgical transplantation has also been cited in many cases where endometriosis is found in abdominal scars, although it has also been found in such scars when accidental implantation seems unlikely.

Another theory suggests that remnants of tissue from when the woman was an embryo may later develop into endometriosis, or that some adult tissues retain the ability they had in the embryo stage to transform reproductive tissue in certain circumstances.

Research by the Endometriosis Association revealed a startling link between dioxin (TCCD) exposure and the development of endometriosis. Dioxin is a toxic chemical byproduct of pesticide manufacturing, bleached pulp and paper products, and medical and municipal waste incineration. The EA discovered a colony of rhesus monkeys that had developed endometriosis after exposure to dioxin. 79% of the monkeys exposed to dioxin developed endometriosis, and, in addition, the more dioxin exposure, the more severe the endo.


General Articles on Endometriosis

- Endometriosis – A guide for Patients from ASRM
- Endometriosis – National Library of Medicine.
- Endometriosis: Does It Cause Infertility? – from ASRM
- Endometriosis and Infertility: Can Surgery Help? From ASRM
- Endometriosis and Infertility – Georgia Reproductive Specialists

- Endometriosis, a modern syndrome, a review from a leading Belgian expert.
- Teen Endo
- Endometriosis. Overview from the Mayo Clinic
- Medical Treatment of ENDOMETRIOSIS and PELVIC PAIN by Dr. Lichten

Endometriosis and other CAPPS Components
- Patients with chronic pelvic pain: endometriosis or interstitial cystitis/painful bladder syndrome?
- The relationship between interstitial cystitis and endometriosis in patients with chronic pelvic pain
- Interstitial cystitis and endometriosis in patients with chronic pelvic pain: The "Evil Twins" syndrome

Patient Advocacy and Support
- Endometriosis Association
The Endometriosis Association is dedicated to providing information and support to women and girls with endometriosis, educating the public as well as the medical community about the disease, and conducting and promoting research related to endometriosis.
- Endometriosis Association Support Groups

General Endometriosis Information and Resources
- Endometriosis Association
- Endometriosis Zone
- Endozone - Where Endometriosis Patients Find Surgeons & Solutions
- Endometriosis Research Center
- Endometriosis Information forum

Photographs of Endometriosis
- Laparoscopic Images of Endometriosis
- Endometriotic on the pelvic peritoneal wall
- Several images from
- Endometriosis: Conquering the Silent Invader: scroll down to view an image of endometriosis.
- Endometriosis Photographs from Georgia Reproductive Specialists
- Photos from Womens’ Surgery Group

Videos on Endometriosis
- Robotic resection of endometrioma, lysis of adhesions, and LUNA procedure
- Endometriosis surgery - No adhesions in this video but a good description of fairly normal anatomy except for endometriosis and some enlarge veins as well as adenomyosis in the uterus.
- Severe endometriosis with adhesions - follow the additional parts posted for this video
- The use of bipolar electrosurgery in: Microlaparoscopy, Ovarian Drilling, Resection of Endometriosis, Lysis of Adhesions, and Norplant Removal.
- Adhesiolysis & Excision of Endometriosis using the Everest Medical BiLap Probe by Mark Perloe, M.D. "Resection of Endometriosis" and "Lysis of Adhesions"
- Atlanta Reproductive Health Centre (ARHC): scroll down to a video demonstrating: the excision of endometriosis.

Research in Endometriosis
- Clinical trials in Endometriosis from
- Clinical Trials in Endometriosis from CenterWatch
- Pubmed – Medical and Scientific Articles on Endometriosis

- Stress Reduction for Relief of Fibroids & Endometriosis by Susan Lark
- Treatment with Lupron




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