What is Endometrium?

The endometrium is the lining of the uterus. Each month, as part of the menstrual cycle, the body prepares the endometrium to host an embryo. If pregnancy doesn’t occur, the endometrium sheds through menstruation and renews itself.


An often-painful disorder that occurs when endometrial tissue grows outside your uterus.

Most often, endometriosis is found on the:


  • Ovaries
  • Fallopian tubes
  • The tissue lining your pelvis
  • The outer surface of the uterus

Other sites for growth can include the vagina, cervix, bowel, bladder, vulva, or rectum.


What are the different stages?

There are several classification systems for the severity of endometriosis have been proposed. Of these, the revised American Society for Reproductive Medicine classification is the most well-known.

The stages of endometriosis as classified by the ASRM are;


Stage 1 (1-5 points) Minimal   Few superficial implants  
Stage 2 (6-15 points) Mild More and deeper implants
Stage 3 (16-40 points) Moderate   Many deep implants, small cysts on one or both ovaries, Presence of filmy adhesions  
Stage 4 (>40 points) Severe   Many deep implants, large cysts on one or both ovaries, Many dense adhesions  




  • Dysmenorrhea (painful periods)
  • Excessive bleeding during menstruation
  • Pelvic pain during menstruation or ovulation
  • Painful bowel movements or urination
  • Pain with intercourse
  • Infertility



Retrograde menstruation

In Retrograde menstruation, menstrual blood and uterine tissue enter the peritoneal cavity by flowing through the fallopian tubes and into the pelvic cavity instead of out of the body. These endometrial cells stick to the pelvic walls and surfaces of the pelvic organs, where they grow and continue to thicken and bleed during each menstrual cycle.

Endometrial cell transport

Blood vessels or the tissue fluid system (lymphatic system) can transport endometrial cells to other parts of the body.

Embryonic cell transformation

Hormones such as estrogen may transform embryonic cells — cells in the earliest stages of development — into endometrial-like cell implants during puberty.

Transformation of peritoneal cells

The hormones or immune factors of the body promote the transformation of peritoneal cells — cells that line the inner side of your abdomen — into endometrial-like cells.

Surgical scars implantation

Surgery to the abdominal area, such as cesarean delivery or hysterectomy

Immune system disorder

A dilemma with the immune system and the body’s inflammatory response may cause endometriosis.


If your mother or other close relatives or family members have had endometriosis, you too may have inherited the disease.


high levels of the hormone estrogen in the body can cause endometriosis.


Risk factors include :


It usually affects women between the ages of 25 and 40, but symptoms can occur during the adolescence

Family History

If you have a family member who had endometriosis, you too may have a higher risk of developing the disease.

Menstrual History

The issues can include shorter cycles, heavier and longer periods, or menstruation that starts at a young age.

Pregnancy History

Women who haven’t had children run a greater risk of developing the disorder. However, endometriosis can still occur in women who’ve had children.


What are the Complications ?





  • Tests to check for physical clues of endometriosis include:
  • Pelvic exam
  • Ultrasound
  • Magnetic resonance imaging (MRI)
  • Laparoscopy



  • Pain Medication
  • Hormonal medications
  • Conservative surgery
  • Hysterectomy
  • Fertility treatment