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$Unique_ID{BRK03708}
$Pretitle{}
$Title{Endometriosis}
$Subject{Endometriosis Endometrial Implants Endometrial Growths Pelvic
Inflammatory Disease Polycystic Ovary Syndrome Ovarian Cancer}
$Volume{}
$Log{}

Copyright (C) 1991 National Organization for Rare Disorders, Inc.

788:
Endometriosis

 ** IMPORTANT **
It is possible that the main title of the article (Endometriosis) is not
the name you expected.  Please check the SYNONYM listing to find the
alternate names and disorder subdivisions covered by this article.

Synonyms

     Endometrial Implants
     Endometrial Growths

Information on the following diseases can be found in the Related
Disorders section of this report:

     Pelvic Inflammatory Disease
     Polycystic Ovary Syndrome
     Ovarian Cancer

General Discussion

** REMINDER **
The information contained in the Rare Disease Database is provided for
educational purposes only.  It should not be used for diagnostic or treatment
purposes.  If you wish to obtain more information about this disorder, please
contact your personal physician and/or the agencies listed in the "Resources"
section of this report.

Endometriosis is a prevalent gynecological condition that affects women.
It is characterized by an inability to shed the build-up of tissue that
normally forms in the uterus (endometrium) before menstruation.  As a result
the built-up tissue escapes from the uterus and spreads to other parts of the
pelvic area, sometimes spreading as far as the lungs.  Major symptoms may
include lower back pain, pain in the thighs or excessive pain during the
menstrual cycle, repeated miscarriages, and infertility.  Bleeding from the
rectum or bladder may also occur.

Symptoms

Endometriosis occurs in women of reproductive age when the ectopic tissue
(endometrium) of the uterus, usually shed during the menstrual cycle, is not
completely shed.  The tissue escapes the uterine cavity and spreads to other
parts of the body.  When this happens, the endometrial tissue can bleed
during the menstrual cycle causing cramping, severe pain, heavy or irregular
menstrual bleeding or bleeding from the rectum or bladder.  This endometrial
tissue can attach itself to the ovaries, fallopian tubes, lymph nodes,
intestines, rectum or in rare cases, the lungs.  Endometriosis can cause
infertility or sterility in some cases; however, most women with
endometriosis can have children.

Causes

The cause of Endometriosis is unknown.  Some of the theories concerning the
cause of Endometriosis are that it may be caused by a lack of sufficient
female hormone that is needed to induce a complete shedding of the
endometrial tissue during menstruation.  It may also be caused by the
backward flow of tissue through the fallopian tubes, or carried from the
uterus to other sites in the body by the blood or lymphatic systems.
Research is ongoing into the cause of Endometriosis.

Affected Population

Endometriosis is a very common disorder that affects women of childbearing
age.  Some estimate that as many as 5 million females are afflicted with
Endometriosis and that it may be responsible for 25% to 50% of all cases of
infertility in women.

Related Disorders

Symptoms of the following disorders can be similar to those of Endometriosis.
Comparisons may be useful for a differential diagnosis:

Pelvic Inflammatory Disease (PID) is the infection of the fallopian
tubes, cervix, uterus or ovaries.  It occurs most often in young women who
are sexually active.  PID is transmitted by sexual intercourse, childbirth or
abortion.  In 40-60% of cases the infecting agent is the organism Neisseria
Gonorrhoeae.  Other cases may be caused by organisms such as Chlamydia
trachomatis, gram-positive cocci, mycoplasmas, or viruses.  PID causes severe
pain and abdominal tenderness.  Aggressive treatment is necessary to cure the
infection.

Polycystic Ovarian Syndrome (Stein-Leventhal Syndrome) usually appears
shortly after puberty and before age twenty.  Menstrual flow becomes
irregular and gradually decreases over several months, until it ceases.
Menstrual pain occurs as does infertility.  Male virilization (growth of hair
on the face, etc.), along with obesity occurs.  (For more information on this
disorder, choose "Stein-Leventhal" as your search term in the Rare Disease
Database).

The symptoms of Ovarian Cancer may also mimic symptoms of Endometriosis.
This type of cancer usually arises from the ovarian epithelium and tends to
spread through the lymphatic system to the abdomen and pelvis.  The ovary may
increase in size dramatically before the patient is aware of the change.
Symptoms may include lower abdominal pain, digestive complaints, endometrial
bleeding, pelvic pain and anemia.  Since ovarian cancer can remain unnoticed
and undiagnosed for longer than most types of gynecologic tumors it is one of
highest ranking types of cancer fatalities in women.  Early detection and
treatment is extremely important.

Therapies:  Standard

Treatment of Endometriosis may consist of drugs such as danazol or progestin,
or the use of oral contraceptives.  Surgery may be considered in the most
severe cases when pain and unusual bleeding cannot controlled by drugs, or
when large ovarian cysts occur containing endometriosis.  Pregnancy, if
possible, may improve symptoms for several years.  However, women who have
Endometriosis before childbirth usually find that the disorder reoccurs after
they have had children.

A nasal spray containing nafarelin acetate was approved in 1990 by the
FDA as a treatment for Endometriosis.  Nafarelin acetate works by suppressing
pituitary hormones that regulate ovulation and menstruation.  It is not a
cure for the condition.  The drug is manufactured by Syntex Corp. under the
name Synarel.

Women with Endometriosis may find that the disease usually resolves
itself during or after menopause.

Therapies:  Investigational

This disease entry is based upon medical information available through
August 1991.  Since NORD's resources are limited, it is not possible to keep
every entry in the Rare Disease Database completely current and accurate.
Please check with the agencies listed in the Resources section for the most
current information about this disorder.

Resources

For more information on Endometriosis, please contact:

     National Organization for Rare Disorders
     P.O. Box 8923
     New Fairfield, CT  06812-1783
     [phone]

     Endometriosis Association
     8585 North 76th Pl.
     Milwaukee, WI  53223

     NIH/National Institute of Child Health and Human Development
     9000 Rockville Pike
     Bethesda, MD  20892
     [phone]

     National Women's Health Network
     1325 G St., NW, Lower Level B
     Washington, D.C.  20005
     [phone]

References

INTERNAL MEDICINE, 2nd Ed.:  Jay H. Stein, ed.-in-chief; Little, Brown and
Co., 1987.  Pp. 1978

CECIL TEXTBOOK OF MEDICINE, 18th Ed.:  James B. Wyngaarden, and Lloyd H.
Smith, Jr., Editors; W.B. Saunders Co., 1988.  Pp. 1428-9.

NASAL SPRAY FOR ENDOMETRIOSIS, FDA Consumer, (May, 1990, issue (4)).
Updates.