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About every twenty-eight days, in the process of menstruation, increasing levels of the female hormones estrogen and progesterone trigger the lining of the uterus, called the endometrium, to thicken in preparation for a fertilized egg. If a fertilized egg does not arrive, the lining is shed and leaves the body as menstrual flow.
Sometimes, tissue resembling the endometrium grows outside of the uterus-- most commonly on the ovaries and fallopian tubes, but sometimes on the pelvic walls, intestines, bowel, and even the lungs. This tissue, though it bleed like proper endometrium, cannot shed via menstruation, and causes small growths, called endometrial implants. This disease is called endometriosis.
The bleeding and inflammation of the implants cause the pelvic pain associated with endo. Each month, the implants of endometriosis bleed in response to the hormonal changes that control menstruation; when the bleeding occurs, surrounding areas can become inflammed, because, unlike menstrual flow, the bleeding from the implants cannot leave the body. This can also result in scar tissue, which can bind the organs in the abdomen together; sometimes a 'frozen pelvis' can arise, when all the organs in the region are bound together.
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Christine Jesensky, email@example.com