Obstetric & Gynaecology Malaysia


Endometriosis is a common condition affectis 1 in 10 women that can cause pelvic pain and for some women difficulty getting pregnant.

In endometriosis, endometrial cells found in the endometrial lining grow outside of the uterus. When these endometrial cells grow, they cause inflammation, adhesion and scarring which can lead to symptoms. 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.

Endometriosis Causes

The cause of endometriosis is not known. Retrograde menstruation theory is a common theory is that some menstrual blood and endometrium flows backward from the uterus through the fallopian tubes and into the pelvis during the monthly menstrual period.

Endometriosis Symptoms

Some people with endometriosis have no symptoms. The most common symptom is pain in the pelvic area, especially with periods. Endometriosis symptoms typically resolve when a person becomes pregnant or goes through menopause.

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

Pelvic pain can be caused by many other conditions, including pelvic infections, pelvic floor muscle spasm, myofascial pelvic pain syndrome and irritable bowel syndrome. If you have pelvic pain, your gynaecologist can help to figure out if endometriosis may be the cause.

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

In people who do become pregnant, endometriosis does not harm the pregnancy. In addition, symptoms of endometriosis often improve after pregnancy.

People with endometriosis can develop ovarian cysts containing endometriosis tissue; called endometriomas. Endometriomas are usually filled with old blood that resembles chocolate syrup; thus, they are sometimes called "chocolate cysts." Endometriomas are sometimes seen during a pelvic ultrasound. They are benign (not cancerous) but can cause pelvic pain; if this happens, surgery is usually recommended to remove them for symptom improvement or when the cyst increase in size.

There are several medical and surgical treatment options for endometriosis. The best treatment depends on your individual situation.

●Nonsteroidal anti-inflammatory drugs (NSAIDs)

●Hormonal birth control either combined oestrogen & progestogen pill or progestogen only pill

●Hormonal treatment that induce transient menopause eg gonadotropin-releasing hormone analog.


The best treatment depends on your symptoms and whether you might want to get pregnant in the future.