Endometriosis is a condition that affects women. It can cause pain in the lower part of the belly and trouble getting pregnant.

Endometriosis is a condition where tissue similar to the tissue that normally grows inside the uterus, also grows outside of the uterus. The tissue inside the uterus is called "endometrium” and when this tissue grows outside of the uterus, it is called "endometriosis”. The most common places where endometriosis occurs are the ovaries, the fallopian tubes, the bowel, and the areas in front, in back, and to the sides of the uterus.

Some women with endometriosis have few or no symptoms while others have pain or difficulty becoming pregnant. There is no cure for endometriosis, but there are several treatment options. The best treatment depends on one’s individual situation.

The cause of endometriosis is not known. There are several theories to explain the condition. A common theory is that some menstrual blood and endometrium flows backwards through the fallopian tubes and into the pelvis during a menstrual period. This tissue then grows where it lands in the pelvis.

Some women with endometriosis have no symptoms. The most common symptom is pain in the pelvic area, especially with periods.

Pelvic pain caused by endometriosis can occur; just before or during the menstrual period (In some women, painful periods get worse over time), between menstrual periods with worsened pain during the period, during or after sex or with bowel movements or while urinating, especially during the period.

Pelvic pain can also be caused by many other conditions, such as pelvic infections, hence, proper medical consult will help to figure out if the endometriosis may be the cause of one’s pain.

Endometriosis can make it more difficult to become pregnant. This might occur because endometriosis causes scar tissue to develop, which can damage the ovaries or fallopian tubes. Even women with endometriosis who do not have scar tissue can have difficulty becoming pregnant.

In women who become pregnant, endometriosis does not harm the pregnancy. Symptoms of endometriosis often improve after pregnancy.

Women with endometriosis can develop ovarian cysts containing endometriosis, sometimes seen during a pelvic ultrasound or felt during a pelvic exam.

Your doctor or nurse might suspect that you have endometriosis based on your symptoms of pelvic pain or painful menstrual periods. However, the only way to know for sure if you have endometriosis is to have surgery.

The doctor might suspect that one has endometriosis based on one’s symptoms of pelvic pain or painful menstrual periods. However, the only way to know for sure if one has endometriosis is for a doctor to do surgery and look for those endometriosis tissues outside the uterus.

Endometriosis can be treated in different ways. The right treatment for you will depend on your symptoms, and on whether you want to be able to get pregnant in the future.

One’s doctor might recommend pain medicines, birth control medicines (certain birth control medicines can help reduce pain symptoms, although this treatment is not appropriate for women who are trying to get pregnant) or hormones that stop monthly periods.

Surgery might be an option to treat endometriosis if one has; severe pain, tried medicines but still have bothersome pain (attributable to endometriosis), a growth or mass in the pelvic area, trouble getting pregnant and endometriosis might be the cause.

The goal of surgery is to remove endometriosis tissues and the scar tissues. More than 80 per cent of women who have surgery have less pain for several months after surgery. However, there is still a chance that the pain will come back, unless one takes some other form of treatment after surgery (like hormonal birth control).

Dr. Ian Shyaka Resident in Surgery, Rwanda Military Hospital, iangashugi@gmail.com