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Diagnosis is often made by taking a history of symptoms and using transvaginal ultrasound to locate lesions. However, a definite diagnosis is usually made using laparoscopy that shows the precise location, size, and extent of the growths. A woman is usually diagnosed as having mild, moderate, or severe endometriosis, based on the amount of scarring and diseased tissue found. The exact cause of endometriosis is still unknown, and most experts believe it is a combination of several factors. <

Probable theories include:

Retrograde menstruation Some endometrial cells back up from the uterus through the fallopian tubes, implant in the abdomen and grow. Although many experts believe this migration occurs in all women, an immune or hormonal problem may allow the tissue to grow in women who develop endometriosis. However, this theory alone does not explain why women who undergo tubal ligation or hysterectomy can still experience symptoms of endometriosis.

Immune system dysfunction Immunological changes have been observed in women with endometriosis and it is believed that an abnormality in the immune system allows the endometrial cells that are shed normally to attach elsewhere and grow. However, scientists are not sure whether the changes are responsible for the endometriosis, or vice versa.

Lymph or blood system transfer Some scientists believe that endometrial tissue is distributed to other parts of the body through the lymph system or bloodstream.

Embryonic tissue - Some tissues present in the abdomen retain the ability they had in the embryo stage to transform into endometrial cells.

Genetic cause Endometriosis tends to run in families, although the mode of inheritance is not understood. Women with an affected mother or sister are more likely to develop endometriosis.

Environmental causes A link between exposure to dioxin and endometriosis has been demonstrated in research. Dioxin is a byproduct of pesticide and bleached pulp and paper products manufacturing.

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