Endometriosis

Endometriosis is an gynacological disease in which the cells and layer of tissue that resembling endometrium (the lining of the uterus) grow outside of it, for example in the ovaries and fallopian tubes. This causes chronic inflammation that can result in scar tissue (adhesions, fibrosis), especially in the pelvis. Endometriosis is a potential co-morbidity of chronic fatigue syndrome.

Endometriosis can affect teenagers as well as older adults, and is a long term condition. It is estimated to affect around 10% of women (people assigned female at birth), particularly during their reproductive years.

Lesions
Lesions in endometriosis may occur on the ovaries, recto-vaginal septum, bladder, and bowel. In rare cases, endometriosis has also been found outside the pelvis.

Signs and symptoms
Endometriosis symptoms may include:
 * Dysmenorrhea
 * Heavy or irregular bleeding
 * Pelvic pain
 * Lower abdominal pain or back pain
 * Dyspareunia
 * Dyschezia (pain on defecation) - Often with cycles of diarrhea and constipation
 * Bloating, nausea, and vomiting
 * Inguinal pain
 * Pain during urinartion and/or urinary frequency
 * Pain during exercise
 * Pain during sex
 * Fertility problems
 * Depression or anxiety

One third of women with endometriosis have no symptoms.

ME/CFS
Patients with ME/CFS may have higher rates of gynecologic disorders including endometriosis, ovarian cysts, polycystic ovaries, uterine fibroids, menstrual abnormalities and galactorrhea.

A 2018 study by the Centers for Disease Control and Prevention stated that more than a third of women with CFS (36.1%) reported endometriosis as a comorbid condition. Women with both CFS and endometriosis report more chronic pelvic pain, earlier menopause, hysterectomy, and more CFS-related symptoms compared to women with CFS-only. Sinali et al (2002) also found high rates of chronic fatigue syndrome in endometriosis patients.

Fibromyalgia
Sinali et al (2002) found people with endometriosis had high rates of fibromyalgia.

Other comorbidities
Sinali et al (2002) also found people with endometriosis often had autoimmune diseases, endocrine (hormone) diseases, and atopic or allergy-related conditions.

Treatments
Treatments include:
 * Contraceptive steroids
 * Nonsteroidal anti-inflammatory drugs
 * Gonadotropin-releasing hormone (GnRH) agonists, which reduce estrogen llevels
 * Infertility treatments
 * Surgery may sometimes be used to remove endometriosis lesions, adhesions, and scar tissue

Research studies

 * 2019, Endometriosis as a Comorbid Condition in Chronic Fatigue Syndrome (CFS): Secondary Analysis of Data from a CFS Case-Control study
 * 2002, High rates of autoimmune and endocrine disorders, fibromyalgia, chronic fatigue syndrome, and atopic diseases among women with endometriosis: A survey analysis - (Abstract)

News and articles

 * Genetic map of cells linked to endometriosis could improve treatments - New Scientist

Learn more

 * Endometriosis factsheet - World Health Organization
 * Gonadotropin-releasing hormone (GnRH) agonists - Endometriosis.org
 * Endometriosis - NHS