Periods are a part of many women’s lives, and with them can come cramps, headaches and pain. However, for many women, the pain that comes with their periods is excruciating and can prevent them from living their lives normally. If you are one of these women, experiencing such painful periods, you may have endometriosis.
Endometriosis is a condition where the tissue that lines the womb (endometrium) is found outside the womb, such as in the ovaries and fallopian tubes, where it induces a chronic inflammatory reaction that may result in scar tissue.  It is a fairly common condition, affecting approximately 176 million women around the world. 
Normally, as part of the menstrual cycle, estrogen causes the lining of the uterus to grow and thicken, preparing the uterus to receive a fertilised egg. If an egg doesn’t get fertilised, the lining of the uterus breaks down. This lining then leaves the body as menstrual blood. However, in endometriosis, the endometrial tissue that would normally line the uterus is found outside it. This tissue will thicken, break down and bleed with your menstrual cycle, but this tissue and blood have no way of leaving the body. This can lead to pain, swelling and scarring. 
The symptoms of endometriosis include: pain in the lower tummy or back (pelvic pain), painful periods that prevent you from doing normal activities, painful ovulation, infertility (due to the changes in structure and functions of the reproductive organs), pain during or after sexual intercourse, pain when urinating or pooing during your period, heavy bleeding, fatigue, nausea, constipation, diarrhea or blood in your pee during your period. Endometriosis can have a huge impact on general physical health and social well being, as it makes it hard to do many things. It can also have an impact on your mental health and can lead to feelings of depression which could be due to the mental strain of coping with symptoms. 
If you have symptoms of endometriosis, you should see your doctor. It can be difficult to diagnose endometriosis because the symptoms can vary considerably, and many other conditions can cause similar symptoms. You will be asked about your symptoms, and an examination may be completed on your tummy and vagina, to be able to recommend the best treatment for you. If these don’t help, your doctor may refer you to a gynaecologist for some further tests, such as an ultrasound scan or laparoscopy. A laparoscopy is where a surgeon makes a tiny incision in the skin and passes a thin tube through so they can see any patches of endometriosis tissue. This is the only way to be certain you have endometriosis. A laparoscopy can provide information about the location, extent and size of the endometrial implants (abnormal growth of endometrial outside of the uterus) to help determine the best treatment options. 
Currently, there is no cure for endometriosis, but there are a number of treatments that can help to manage symptoms. Treatments include:
- painkillers – such as ibuprofen and paracetamol.
- hormone medicines and contraceptives – including the combined pill, the contraceptive patch, and medicines called gonadotrophin-releasing hormone (GnRH) agonists and antagonists.
- aromatase inhibitors – a class of medicines that reduce the amount of estrogen in the body.
- progestin therapy – can halt menstrual periods and the growth of endometrial implants, which may relieve endometriosis signs and symptoms.
- surgery to cut away patches of endometriosis tissue
- an operation to remove part or all of the organs affected by endometriosis – such as surgery to remove the womb (hysterectomy) 
It is not yet known what causes endometriosis to occur but there are lots of theories and ideas about how it develop, including: genetics, a problem with the immune system, endometrium cells spreading through the body in the bloodstream and retrograde menstruation (when some of the womb lining flows up through the fallopian tubes and embeds itself on the organs of the pelvis, rather than leaving the body as a period). It is likely that endometriosis is caused by a combination of various factors. 
By Bernice Mangundu.