Clinical meaning
Endometriosis occurs when tissue similar to the endometrial lining of the uterus grows outside the uterus in abnormal locations such as the ovaries, fallopian tubes, pelvic peritoneum, and bowel. This misplaced tissue responds to the same hormonal changes of the menstrual cycle - it thickens, breaks down, and bleeds each month. However, because the tissue is located outside the uterus, the blood and debris have no way to exit the body. This leads to chronic inflammation, pain, scar tissue formation (adhesions), and the development of blood-filled cysts on the ovaries called endometriomas (chocolate cysts). The condition is estrogen-dependent, meaning it is fueled by estrogen and tends to improve after menopause when estrogen levels decline.
Exam relevance
Risk factors: - Family history of endometriosis (first-degree relative) - Early menarche (before age 11) - Short menstrual cycles (less than 27 days) - Heavy or prolonged menstrual periods - Nulliparity (never given birth) - Low body mass index - Mullerian anomalies (structural uterine abnormalities)