ABSTRACT
Endometriosis is a fascinating condition and is a major cause of infertility and pelvic pain. It may be the underlying cause of pelvic pain in 50% of women. Similarly, it aff ects up to 50% of women with infertility. It is characterised by the presence of endometrial tissue outside the uterus. Th is ‘ectopic’ endometrial tissue may be found on the pelvic peritoneum, the ovaries and the rectovaginal septum, a layer of fascia separating the anorectum from the vagina. In rare cases, the endometrial tissue may be found in distant places such as the diaphragm, pleura and pericardium. Th e underlying mechanism thought to be responsible for this is retrograde menstruation. Th is results in intraperitoneal spilling of endometrial cells through the fallopian tubes. Since most women have retrograde menstruation but do not develop endometriosis, other important factors are also likely to be important. It is thought that local peritoneal infl ammatory factors, which promote the adherence of endometrial tissue in the peritoneum, may be involved. It is also likely that the endometrial cells of endometriosis suff erers have unique adhering and proliferating capacities that make the development of the condition more possible.
