Endometrium is the tissue that lines the uterus and is shed during the menstrual period. This same tissue can be found growing outside the uterus (where it does not belong) in some women. Endometriosis is said to be present when this is the situation. The tissue that normally lines the uterus may be found in or on the ovaries, the fallopian tubes, the outer surface of the uterus or other areas of the peritoneum (the membrane that lines the abdominal cavity and surrounds the internal organs). Occasionally, endometriosis may be found on the bowel or bladder. And very rarely, it has been found in locations far from the pelvis, such as in an old abdominal scar or even the lungs.

During the menstrual period, as normal uterine lining cells begin to bleed, the endometrial cells present outside the intestine - endometriosis - also begins to bleed. The blood from these endometrial cells, however, is contained inside the body and accumulates. This accumulation of blood and other substances given off by the endometriosis often causes irritation, and even damage, to the surrounding areas. And, if these cells are present near the uterus, bladder or the bowel, the irritation may lead to pain in those locations. The body's natural response to irritation and injury often ends with the formation of scar tissue, which also increases the likelihood that discomfort will be experienced (see chapter on pelvic pain). The scar tissue can also interfere with the passage of the egg into the tube and lead to infertility. Thus, the abnormal location of uterine lining cells leads to the symptoms and problems that we associate with the condition called endometriosis.

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