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Endometriosis disease anatomy concept as a female infertility condition as a uterus avaries and fallopian tubes with tissue growth with 3D illustration elements. Source:

ENDOMETRIOSIS: Let’s manage it.

Our series of articles in the patient education category continues, and today, let’s talk about endometriosis. 

We define endometriosis as the occurrence of the endometrial tissue anywhere outside the uterine cavity.


The uterus lies between the bladder and rectum. The inner layer of the uterus is called the endometrium. In endometriosis, this kind of tissue that usually lines the inside of the uterus is present in other places. The most usual parts are; ovaries, Fallopian tubes, pelvic peritoneum, especially behind the uterus.

The hormones that affect the uterine lining also affect this extra tissue. Each month, during a period, this ectopic tissue also bleeds, and this causes pain. This blood cannot go anywhere, so cysts and scar tissue form.

Endometriosis affects approximately 5% to 15% of women of childbearing age.

We can manage endometriosis; we cannot prevent it. 


The cause isn’t lucid. Several theories explain endometrial tissue that happens to occur in places other than the inside of the uterus, which include Sampson’s theory of retrograde menstruation.

However, endometriosis may run in families.

Scar tissue from endometriosis around pelvic organs can cause pain and infertility by blocking Fallopian tubes. It may block the intestines or ureters.

Microscopic photo of a professionally prepared slide demonstrating Abdominal wall Endometriosis. Caesarean section scar
Microscopic photo of a professionally prepared slide demonstrating Abdominal wall Endometriosis. Caesarean section scar
Source: credit: OGphoto


Endometriosis may cause no symptoms. It may be found incidentally during abdominal or other pelvic surgeries.

Abdominal cramps during periods that are worse than the usual pain. Dull constant pain in the lower abdomen and back. Pain during sex or bowel movements.

Periods that occur more than once a month. Heavier periods that last longer than usual.

Trouble getting pregnant.


The health care provider does a pelvic examination and a pregnancy test. They may do blood and urine tests to have infections ruled out.

Ultrasonography, CT or MRI can be done to look at the organs inside the body.

However, laparoscopy is the only way to a definite diagnosis. Taking the tissue to the laboratory for histology complements it. 

At laparoscopy, a telescope-like tool is put through a small cut into the abdomen to see the extra tissue. Clinicians can also use it for treatment.


Treatment depends on symptoms, the woman’s age and if children are wanted.

Medicines like ibuprofen and its counterparts, birth control pills or other hormonal based counterparts work well.

Removing the tissue laparoscopically by cauterization (burning) or using lasers can be attempted.

Endometriosis can return, but surgery can relieve pain and help chances of getting pregnant.

Hysterectomy is lucid if the woman is older and doesn’t want to have more children.

Problems can continue until menopause when estrogen levels fall. Lower levels of estrogen during menopause cannot stimulate this tissue, so the pain will eventually subside.

DOs and DON’Ts in Managing endometriosis

  • Do take your pills as instructed by your health care provider
  • Do see your health care provider regularly
  • Do exercise and take ibuprofen or similar drugs to help relieve painful periods and cramps
  • Do call your health care provider if treatment isn’t alleviating the symptoms
  • Do contact your health care provider if you cannot take your medicine or birth control pills
  • Don’t forget to keep follow-up appointments
  • Don’t take herbal therapies without checking with your health care provider

Credit to for the brochure about endometriosis. Get a copy from .

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MBChB (MUK), Graduate Fellow, Department of Physiology, Makerere University Founder and Content Creator Peer reviewer, Associate Editor

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