What is endometriosis? Replacement of the tissue of the inner wall of the uterus in other areas of the body is called endometriosis. There are four theories about the cause of endometriosis: ۱- اندومتریوز می تواند به دلیل برگشت خون قاعدگی از لوله های رحمی به داخل حفره شکم و لگن اتفاق بیفتد البته این علت و نظریه قطعی نیست چون این اتفاق در همه خانم ها رخ می دهد ولی همه دچار اندومتریوز نمی شوند. 2- Another theory about **the cause of endometriosis** is the presence of multipotential cells in the pelvis that can become endometrial tissue and cause endometriosis. 3- Another theory about **the cause of endometriosis**, the implantation of endometrial tissue through surgeries in other areas following incision related to natural childbirth or cesarean section or other abdominal surgeries. 4- Immune system disorder in women, which can cause the growth of endometrial tissue in other areas of the body. Symptoms of endometriosis 1- In many cases, endometriosis is asymptomatic and sometimes it is accidentally discovered during pelvic surgery such as caesarean section. 2- Pelvic pains: Endometriosis can cause severe pelvic and abdominal pains before menstruation, which usually subsides after menstruation. 3- Painful intercourse is another symptom of endometriosis. 4- Infertility, one of the causes of infertility in women can be the presence of endometriosis. 5- Pain during pelvic examination can also be one of the symptoms of endometriosis. **Symptoms of endometriosis** can stop temporarily during pregnancy, also with menopause **endometriosis pain** stops permanently. Who are at risk for endometriosis? 1- Those who were not pregnant 2- Late menopause 3- Early onset of puberty 4- A first-degree relative suffering from endometriosis (mother, sister or aunt) 5- Short period cycles 6- Being exposed to a lot of estrogen 7- Low weight 8- Alcohol consumption These reasons do not necessarily mean that every person who has the above conditions will definitely get endometriosis, but having the above factors can make a person susceptible to endometriosis. What is the cause of pain in endometriosis? 1- Deep implantation of endometrial tissue in areas where there are many nerves. 2- The release of substances from the endometriosis tissue, which mediate pain. Note that the severity of pelvic pain in endometriosis is not directly related to the severity of the disease, that is, a lot of pain is not a sign of the severity of the disease. Does endometriosis cause infertility? About 70% of women who have endometriosis get pregnant without problems, but if endometriosis: 1- Cause a disturbance in the anatomy of the pelvis, that is, if endometriosis causes large ovarian cysts (**endometrioma**) or causes severe adhesion between the ovary and the uterus and other pelvic organs, it can cause infertility. 2- Because endometriosis causes hormonal secretions and inflammatory substances, it can have a negative effect on ovulation and implantation, and in this way it can also cause infertility. Is endometriosis preventable? There are no scientific reasons in favor of the effect of diet on the prevention and treatment of endometriosis. Diagnosis of endometriosis Endometriosis can be diagnosed by a gynecologist. 1- History and examination 2- Ultrasound which can be helpful in diagnosing endometrioma cysts and sometimes adhesions. 3- Blood test: measuring CA125 can be helpful, but it is not specific. 4- Laparoscopy is helpful for diagnosis and sampling of suspicious tissue. درمان اندومتریوز We treat endometriosis when a person has severe pelvic pain or infertility. 1- Drug treatments 2- Surgical treatments The choice of treatment method depends on the severity of the patient's symptoms. Drug treatment includes all kinds of painkillers and the use of hormonal drugs, which are usually used in cases of severe pelvic pain and painful menstruation in endometriosis patients. Surgical treatments are also used depending on whether the patient has had a previous pregnancy or not and whether she wants to get pregnant or not. Even with surgery, endometriosis may recur, so the decision to have surgery or not depends on the individual's condition and the severity of the symptoms.