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What is Endometriosis-

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					Endometriosis. What is it? A lot of people, maybe most, haven’t even heard of
endometriosis. In a lot of ways it is hard to really understand what it is and even
harder for people to get what having this disease can do to a patient’s life. It can be
difficult for even the most articulate patient to effectively communicate how
devastating endometriosis can be on one’s life and ability to function. In this first of a
series of posts I will review the medical definition. In the following posts I will
discuss what it really means to have endometriosis.

Endometriosis is defined as the presence of endometrial tissue outside of the uterus,
the organ in which the baby grows during pregnancy. When it is time to deliver, the
uterus pushes the baby out. Most of the uterus is made up of muscle, but it is lined on
the inside by a thin layer of glands called the endometrium. This layer provides the
nutritional support to the developing fetus prior to the development of the placenta
(also known as the after-birth).

During the first two weeks of the menstrual cycle the endometrial lining responds to
the estrogen, growing in thickness. You can think of estrogen as "fertilizer" for the
endometrial lining. The last half of the cycle, after ovulation occurs (about two weeks
after the first day of bleeding during a period), the other female hormone,
progesterone, helps to stabilize and mature the endometrial lining. If a woman is not
pregnant, both the estrogen and progesterone levels drop at the end of the cycle, the
endometrial lining sloughs off, and her period starts the next day.

The menses are made up of the endometrial lining, blood and clots. Most of the
menses comes out through the vagina, but some flows back up through the fallopian
tubes and remains inside of the body. Endometriosis is formed when some of this
tissue implants and starts to grow. We don’t completely understand why some women
develop endometriosis, and others do not. It is probably related to both the amount of
tissue that a woman’s body has to get rid of each month, genetics, environmental
exposure and her body’s inability to recognize or get rid of the endometrial tissue
inside of the body cavity. Research to date points to a selective decrease in the
immune system as a cause of endometriosis. Several studies, as well as our own
personal experiences, also have shown a decrease in the natural "killer-cell" function
(a type of white blood cell) in women who have endometriosis.

As discussed in the previous paragraph, in the vast majority of cases, retrograde
menstruation (backward flow) with implantation of endometrial tissue is the cause of
endometriosis. Endometrial tissue also can form or spread via other, less common
mechanisms. Extra-pelvic endometriosis (endometriosis outside of the pelvic cavity)
has been reported in virtually every organ of the body.

Most of these rare endometrial implants, and are formed as a result of the spread of
endometrial tissue through the blood stream (hematogenous spread).
Endometriosis also has been reported in the lymph nodes (e.g., obturator lymph
nodes). Thus, endometriosis can also spread through the lymphatic system.

Endometrial tissue can spread during surgery as well. The most common example of
surgical spread is endometriosis that is found in the abdominal wall following a
C-section. Endometriosis has even been reported in the belly button. This usually
presents with bleeding from the navel with menses.

Finally, another theory states that endometriosis can form as a result of what is called
coelomic metaplasia. Coelomic cells are those formed as a fetus, and metaplasia
means one cell-type turns into another cell-type. In other words, in adult life some of
the primitive cells turn into endometriosis. This probably accounts for the case of
endometriosis reported in men. All of the men who had endometriosis were on
estrogen therapy (most likely for prostatic cancer), which probably stimulated the
transformation of the coelomic cells into endometriosis (Ladies, please do NOT slip
your significant other a few birth control pills if he is not understanding of your
pain!).

In conclusion, endometriosis is the presence of endometrial tissue outside of the
uterus. In the vast majority of cases, the back flow of menstrual tissue through the
fallopian tubes with implantation of endometrial tissue is probably the cause of
endometriosis.

Much of this can be seen as dry and boring, but is the medical aspect of "What is
Endometriosis." I will talk about the reality of what having endometriosis means for
women and the impact on their lives in the next couple of posts.

We would like to hear your thoughts. Post a comment below and tell us what you
think.\

Vital Health Institute

Leading Specialist in Women's Health & Endometriosis Treatment

Treating women in US, Canada, Switzerland & Many Other Countries

15055 Los Gatos Blvd, Suite 250

Los Gatos, CA 95032

(408) 358-2511 or (888) 256-7705

For More Information Visit:
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