No one knows exactly what causes this. Sometimes cells from the endometrium, the tissue that normally lines the womb, become displaced and grow somewhere else. They may move up the Fallopian tubes to the ovaries, or even into the gut. This disease is called endometriosis. It’s more common in women over the age of 30, especially if they haven’t had any children.

Just as the normal lining tissue of the womb bleeds each month, so do the endometrial deposits which have developed in different places outside the womb. If the bleeding occurs inside the abdomen, for example, scar tissue will form between the deposit and other nearby organs.

Endometriosis and infertility

This scar tissue often adheres to the nearest organ, sometimes restricting or interfering with its function. If one or other of the Fallopian tubes is affected, the adhesion often hinders the movement of the tube. As a result, it may be unable to pick up the egg released from the ovary each month and direct it down the tube towards the sperm moving in the opposite direction. So although endometriosis doesn’t necessarily make you infertile, it can make becoming pregnant very difficult.

Symptoms of endometriosis

The usual symptoms of this disorder are very painful periods – the pain being caused by the build up of blood from the endometrial deposits in areas from which it cannot escape. Sexual intercourse is usually painful as well.

Endometrial deposits may form as small, hard, tender bumps in the tissue behind the womb and in front of the rectum – your doctor will probably be able to feel these during a vaginal examination. If, however, endometriosis develops in the wall of the womb, the whole of the womb will become enlarged and feel tender.

If there is any doubt as to whether or not you have endometriosis, then your doctor will arrange for you to go into hospital for a This involves examining the womb and other reproductive organs while you are under a general anaesthetic by inserting a lighted telescopelike instrument into your abdomen via a small cut madejust below rvour navel. ( The first course of action is usually hormonal treatment. Your doctor will probably prescribe progestogen which quietens the activity of the womb lining and all its displaced cells. A new, very expensive drug called Danazol, has recently been developed which can in some cases completely cure the disease. Both types of drug are usually taken for six months. They may cause your periods to stop and will prevent you from becoming pregnant during that time.

If medical treatment is not successful then your doctor may suggest an operation to clear out the active spots of endometriosis and their deposits.