Endometriosis and your fallopian tubes

Endometriosis can implant on the outside surface of the fallopian tubes and cause scarring. Just like burn scars can lead to contractures that distort limbs and other body parts, the endometriosis scarring can distort the fallopian tubes so they can't function properly.

How endometriosis blocks your tubes

Endometriosis inside the fallopian tube can partially or totally block that tube. This blockage may cause infertility or ectopic pregnancy. Unfortunately, even good imaging techniques, such as X-rays or ultrasounds, can't see inside the tubes. Likewise, during surgery, doctors have a difficult time seeing directly in the narrow tubes because the instruments used to view the pelvic cavity are too big to enter the tubes.

Endometrial implants can also disrupt the function of the fimbriae (which means fringe in Latin), the ends of the tubes that pick up the egg. Endometri-osis can cause these fine, delicate fimbriae to stick to each other or other structures. In the worst-case scenario, these tiny fingers are destroyed and lose all function. In that case, the chance for pregnancy in general is greatly reduced, but the risk of an ectopic pregnancy is high.

Even if the fimbriae aren't destroyed, any decrease in their functionality can lead to problems. For example, endometriosis may cause them to stick to the ovary, tube, uterus, intestines, or pelvic wall, so they can't move around to pick up an egg. Inflamed fimbriae can also be painful and can cause additional pain by adhering to another structure. This pain may be the result of the stuck tube pulling as a woman goes about normal activity. (Remember, tubes are usually free and can move around a bit.)

What blocks your tubes

Endometrial implants can totally block the fallopian tube by forming scar tissue that destroys the fimbriae and sticks these tiny fingers together. As these delicate fingers become distorted and stuck, the end of the tube can close off, literally, keeping sperm and egg separated.

The following three substances can damage a fallopian tube:

^ Blood: A blocked tube filled with blood (from endometriosis in the tube or some other reason) is called a hematosalpinx (hemato means blood and salpinx means tubes). Visually, a hematosalpinx can look similar to an ectopic pregnancy.

^ Inflammatory fluid: Endometriosis that totally blocks the tube near the fimbriae can lead to a swollen, chronically inflamed fallopian tube called a hydrosalpinx. (Hydro means fluid.)

Imagine a water balloon with fluid coming in and filling the balloon (tube). Because the end is closed, the balloon swells up. The inflammatory fluid in a blocked fallopian tube contains many chemicals, cells, and tissue that cause inflammation, which can lead to pain, fever, infertility, and even miscarriage.

i Pus: Infection is another common cause of tubal blockage, although it's not a result of endometriosis. When an infection results in tubal blockage and it fills with pus, it's called a pyosalpinx.

All three of the salpinxes (substances) can cause pain because a tube is swollen and stretched — and all of these conditions are obvious causes of infertility. (Just like having your tubes tied, the sperm and egg can't meet.) Check out Figure 3-2 for examples of how endometriosis can affect the fallopian tubes.

Endometriosis and your ovaries

Endometriosis is common on the surface of the ovaries, but it can also invade the meat, or interior, of the ovary. This section looks at the three ways endometriosis can affect the ovaries.

Echinoderm Ovary

On the ovary's surface

The fact that the surface of the ovary is a very common site for endometriosis makes sense, because retrograde menstrual flow coming out of the tube spills right onto the ovaries. (Check out Chapter 4 for more on retrograde menstruation.) This endometrial tissue can implant onto the surface of the ovary and do all sorts of damage.

Endometriosis can also start directly from the surface cells of the ovary by a process called metaplasia. The resulting implants can be on any part of the ovary and cause the same problems that retrograde spills produce. (Check out Chapter 4 for more on metaplasia.)

When endometriosis develops on the surface of the ovary by retrograde menstruation or metaplasia, the inflammatory process begins and leads to adhesions (scar tissue). As a result, the ovary can become stuck to the tube, uterus, intestines, or pelvic wall. These adhesions (check out Figure 3-3) can cause pain and problems with the intestines and they can cause infertility.

Figure 3-3:

Adhesions in the female reproductive system.

Figure 3-3:

Adhesions in the female reproductive system.

Scarred Fallopian

In the most severe cases, all contents of the pelvis — such as the uterus, fallopian tubes, and intestines — can be stuck together in a frozen pelvis. In addition to causing pain and problems with the intestines, these adhesions can cause infertility.

Forming painful cysts

Another severe problem is endometrioma (cysts) inside the ovary. These cysts (see Figure 3-4) are a result of inflamed endometrial tissue implants on the ovary surface that develop scar tissue (to wall off the implants like a pimple). But this dense, firm scarring causes the endometriosis implants (lesions) to take the path of least resistance — into the stroma (the relatively softer ovarian tissue).

Over time these cysts fill with endometrial tissue and old blood. A more appetizing name for these cysts is chocolate cyst because their dark brown fluid looks like liquid chocolate. If the cysts burst, the contents spill out into the pelvic cavity and can cause severe pain. In this case, because the fluid is highly inflammatory, scar tissue can also form in the pelvic cavity. Other structures or organs in contact with the fluid can also stick to it. The results can be dramatic and severe.

Figure 3-4:

Endometriosis in the ovaries leads to cysts over time.

Figure 3-4:

Endometriosis in the ovaries leads to cysts over time.

X

These cysts continue to grow each month because their endometrial tissue, which responds to menstrual cycle hormones, deposits more and more tissue implants and blood into the cysts each month. As these cysts enlarge, they put pressure, literally, on normal ovary tissue, distorting it and often making the tissue unrecognizable. Worse yet, the ever-increasing pressure actually destroys the normal tissue of the ovary. This loss of functioning ovarian tissue significantly decreases the number and function of primordial follicles, or future eggs (we cover the menstrual cycle in detail in Chapter 5), causing infertility and early menopause.

Resulting in LUF

Endometriosis may also result in luteinized unruptured follicle syndrome (LUF). With LUF, an egg has developed inside the follicle (the fluid-filled sac that the egg develops in) to supposed maturity and is ready to be released into the world (so to speak!). But for some reason, the egg never leaves the ovary. Obviously, an egg that stays in its follicle can't be fertilized, so LUF leads to infertility. But what causes this failure of the egg to leave its home? Doctors don't really know. Again, the body is wonderfully complex, and the series of events leading to follicle rupture are many. Any one of the following processes may cause LUF:

^ Scar tissue from endometriosis surrounding the ovary can physically prevent release of the egg.

^ The presence of endometriosis can interfere with the surface of the ovary in the usual cascade of events that leads to ovulation.

^ Some women are prone to endometriosis; LUF may be a marker of the defect that causes endometriosis.

Doctors really aren't sure what causes LUF. It's the chicken-and-egg story. That is, do some women have a problem that causes LUF and endometriosis, or does the endometriosis cause the LUF? (See Chapter 7 for more on LUF and how the menstrual cycle works.)

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Responses

  • lea
    Can a blocked fallopian tube cause pain?
    7 years ago
  • murray
    Can getting your tubes tied cause endometrious?
    7 years ago
  • carter
    Where are your intestines located in a female?
    7 years ago
  • bryn
    Does retrograde menstruation block fallopin tubes?
    2 years ago
  • Linda
    What causes tubal blockage?
    2 years ago
  • aune
    What does fluid in the fallopian tubes mean?
    2 years ago
  • maurizia
    WHAT HAPPEN WHEN YOUR FALLOPIAN TUBE IS DESTROY?
    1 year ago
  • Mathias Wagner
    Why fimbrae on too swelling?
    11 months ago
  • S TUIMALA
    How does blood get in a fallopian tube?
    11 months ago
  • Diamond
    How to remove menstrual blood struck in fallopian tubes?
    11 months ago
  • rodrigo
    What can block your fallopian tubes?
    10 months ago
  • rosario
    Can endometriosis cause hydrosalpnix?
    9 months ago
  • cora nielson
    Can endometriosis cause hydrosalpinx?
    8 months ago
  • stefan
    Is endometriosis cyst occurs blocked tubes?
    7 months ago
  • marcus
    Can indometrosis block the filopion tubes?
    7 months ago
  • hyiab hamid
    When fallopian tubes are destroyed?
    7 months ago
  • rudibert
    Can blocked tubes cause uterus pain?
    6 months ago
  • luigia
    How can tubes open during endometriosis?
    5 months ago
  • deodato
    Can fallopian tubes be treated if destroyed?
    4 months ago
  • Chica Bunce
    Why endometria block tubes?
    4 months ago
  • rose
    Do endometriosis cause tubal block?
    3 months ago
  • melody
    Does endometriosis block the fallopian tubes?
    3 months ago
  • ari salpa
    Can endometriosis surgeries damage fallopian tubes?
    2 months ago
  • Anniina
    How can mirick acid destroy a females fallopian tubes?
    2 months ago
  • Mebrahtu
    What happens whenblood fill up in the fallopian tubes?
    23 days ago
  • brett
    Does endometrioma mean tube is blocked?
    20 days ago
  • Tanta
    Can endometriosis cause your fallopian tube to be blocked?
    1 day ago

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