ENDOMETRIOSIS

disorder of the female reproductive system characterized by the growth of endometrial tissue (uterine lining) in an abnormal location. The condition is more common in those who are childless. Rather than flowing out of the uterus by way of the vagina (during menstruation), some fragments of the endometrium may leave via the fallopian tubes and move into the pelvic cavity and there become embedded on other pelvic structures. The most common location of the implants of endometrial tissue are the ovaries; other areas and organs that are affected (in order of incidence) are uterosacral ligaments (thickened portions of the sheet of connective tissue covering the pelvic organs), the rectovaginal septum (the membrane dividing the rectum from the vagina), the sigmoid colon (that portion of the large intestine that leads into the rectum), the lower genital tract, the round ligaments of the uterus, and the peritoneum (membrane) lining the pelvis. Symptoms associated with this disease include (1) progressive, severe pain associated with menstruation or occurring just before it, (2) dyspareunia (painful intercourse), (3) painful defecation, (4) slight bleeding before menstruation and excessive flow during menstruation, (5) painful urination and blood in the urine, and (6) infertility. The condition is best diagnosed by laparoscopy, a surgical procedure that allows a physician to examine visually the pelvic organs for endometrial adhesions. Treatment of endometriosis includes surgery and the suppression of ovulation for six to nine months by administration of hormones. In the late 1980s researchers suggested that endometriosis was linked to relatively thin bonesby means of the circulation of an immune-system hormone that suppresses bone growthand put women with endometriosis at higher risk for osteoporosis.