Endometriosis

Definition
The presence and growth of functioning endometrial tissue (gland and stroma) outside the uterine cavity is called endometriosis.
EndometriosisThe most common site of occurrence is ovary (known as Endometrioma)and then pouch of Douglas.It can occus anywhere in the body including abdominal wall, lungs,pleura,brain and arm but usually occurs in pelvic area-fallopian tube,overy etc.
Normally endometrial tissue contains gland,blood cells,connective tissue and grows in the uterus,to prevent the lining of the womb for ovulation, During menstruation, these tissues expelled out as normal physiological processes but in endometriosis due to displace tissue cannot do this.
Common site-ovaries
Follopian tube
Peritoneum
Lymph nodes
Pouch of Douglas
Abdominal scar following hysterotomy
Uterosacral ligament
Sigmoid colon
Cause-
Reflux of menstrual flow
Embryonic cell growth
Fetal development
Surgical scar
Endometriomal cell transport
Genetics
Hormones immune system 
Risk factors-
Family history
Obstetrics anomalies of genital tract
Nulliparity
Late marriage and late childbirth
Clinical features-
May be asymptomatic
Severe menstrual cycle
Long term lower back and pelvic pain
Period lasting longer than 7day
Heavy menstrual period
Bowel and urinary problems including pain.. infertility
Nausa and vomiting..etc
Treatment-
Management pain
Management infertility
Pain- NSAIDs
OCP
GnRH agonist
Danazol
Surgical procedures

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