- 1 Overview
- 2 Endometriosis diseases
- 2.1 Endometriosis
- 2.2 Enlargement of the endometrium
- 2.3 Endometrial cancer
- 2.4 Asherman Syndrome
- 2.5 Endometrial polyps
- 2.6 Endometriosis
- 2.7 The luteal phase defect
- 2.8 Adenomyosis
- 3 References
The endometrium (Endometrium) is defined as the inner layer of the uterus which is located in the lower abdomen and is one of the parts of the female reproductive system , and is the place where the egg is fertilized and the embryo grows, and in fact the endometrium is the most active layer level Forming the uterus, as it responds to periodic ovarian hormonal changes. It also has a fundamental and highly specialized role in relation to menstruation and childbearing,   It should be noted that the endometrium is structurally composed of two layers, which can be explained as follows: 
- The basal layer: The stratum basale represents the deeper tissue of the endometrium, as it is adjacent to the uterine muscle, in addition to being the fixed layer of the endometrium that does not undergo any changes in its structure during the uterine cycle, and its function is to compensate Tissue that the endometrium loses during menstruation.
- Functional layer: The functional layer is the thickest layer, and it is the layer that provides the actual and appropriate place for implantation of the fertilized egg, and is the only layer that is shed from the lining of the uterus and exits during the menstrual period in the absence of fertilization.
There are many types of endometriosis that a woman can have, and each of them can be explained in some detail as follows:
The endometriotic or migratory uterine lining growth and accumulation of tissue lining of the uterus , which consists of a gland, and the cells of the blood and tissues of connective somewhere other than the uterus, where they grow anywhere in the body but usually it happens in the pelvic area; As it is in the normal situation that these tissues grow inside the uterus to prepare the endometrium for the process of ovulation , and then leave the body of the woman during the menstrual period, but it does not do so in the event of endometriosis, and it can affect both: Ovaries, fallopian tubes, the peritoneum, and lymph nodes,  and according to a study published in the Journal of Reproductive Sciences in 2013, endometriosis affects 6-10% of women of childbearing age around the world. 
Symptoms of endometriosis
It should be noted that the symptoms of endometriosis can differ from one woman to another, and in fact some women do not suffer from the appearance of these symptoms at all, and the amount of pain does not necessarily correlate with the severity of the uterus. The patient may not suffer from the emergence of any symptoms even if the menstruation is severe, while the patient may suffer from severe pain if the euphoria is mild. The most common symptoms that may appear in the case of endometriosis can be explained as follows: 
- Feeling pain; Especially severe menstrual cramps in the abdomen or lower back.
- Feeling of pain during sexual intercourse.
- Heavy or abnormal menstrual bleeding.
- Sterility .
- Feeling pain during urination during menstruation.
- Feeling painful bowel movements during menstruation.
- Suffering from other digestive problems; Like diarrhea, or constipation, and they may be accompanied by nausea.
Causes of endometriosis
In fact, the exact cause of endometriosis is unknown, but the possible reasons for its occurrence can be explained as follows: 
- Menstruation retrovirus : The case of menstruation retrovirus flow loaded blood cells lining of the uterus in reverse through the tubular tubes into the pelvic cavity , rather than going out to the outside of the body, and stick to these cells to each of the wall of the pelvis and the members in the pelvic area surfaces, They continue to grow and thicken over time, in addition to continuing to bleed throughout the menstrual period.
- Change in the appearance of peritoneal cells: or what is called the theory of induction or induction, where experts believe that hormones or immune factors stimulate the peritoneal cells that line the inner surface of the human abdomen to change their appearance to a body that resembles cells Endometrial.
- Changing the form of primitive cells : (Embryonic Cell Transformation) Certain hormones such as estrogen may change the appearance of the primitive or embryonic cells that were formed in the initial stages of development into cells that resemble endometrial cells that implant during adulthood.
- Surgical scarring : Endometriosis may occur due to scarring resulting from certain surgery, such as: hysterectomy or cesarean delivery; The endometrial cells may stick to the incision.
- Endometrial cell transmission : Both blood vessels or tissue fluid (lymph fluid) may transport endometrial cells to other parts of the body.
- Immune system disorder : A problem with the immune system may prevent the body from recognizing and disposing of endometrial-like cells that grow outside it.
Endometrial hyperplasia is an abnormal proliferation of the glands and parenchyma of the lining of the uterus that is more than 10 millimeters thick. Of all ages, and can be categorized into two forms; They are: 
- Hyperplasia Without Cellular Atypia.
- Hyperplasia With Cellular Atypia.
Symptoms of endometriosis
There are many symptoms that may appear on women as a result of endometrial hyperplasia, and can be explained as follows: 
- Abnormal bleeding during menstruation; One of the primary symptoms of endometriosis.
- Longer or heavier than usual bleeding during menstruation.
- Short menstrual cycle duration ; The period between menstruation and the next is less than 21 days.
- Menstrual bleeding between menstruation and the other.
- No menstruation, called pre-menopause.
- Uterine bleeding after menopause.
Causes of endometrial hyperplasia
Endometriosis may occur as a result of too much estrogen or too little progesterone. These two hormones play an important role in the menstrual cycle. Any imbalance in this hormonal balance may lead to an imbalance in the number or type of cells, and in fact changes to the endometrium occur during the menstrual cycle in response to the change in the level of both of these hormones. During the first period of the cycle, the ovaries produce the hormone estrogen, which causes the growth and thickness of the uterine lining to prepare the uterus for pregnancy, and in the middle period of the cycle, one of the ovaries releases one egg in a process known as ovulation, followed by the start of the high level of the hormone progesteroneWhich in turn prepares the lining of the uterus to receive and nourish the fertilized egg, and in the absence of pregnancy, the level of these two hormones decreases, as the decrease in the level of progesterone stimulates the occurrence of menstruation or the shedding of the lining of the uterus, so that a new menstrual cycle begins at the time the lining ends,  [9 ] It should be noted that there are many factors that may increase the risk of developing endometrial hyperplasia, including the following: 
- Women over the age of 35.
- Women whose menstrual cycle begins at an early age.
- Women who have menopause at a later age.
- White women.
- The woman has not previously experienced pregnancy.
- A personal history of certain conditions such as: diabetes, PCOS , thyroid disease, and gallbladder disease.
- A family history of cancer of the ovaries, colon or uterus.
- Suffering from obesity.
Endometrial cancer is the most common type of cancer affecting the female reproductive organs, and it is a cancer of the endometrium, and it can be divided into two types. The first type is found inside the uterus, is characterized by slow growth and is the most common type of the second; Which grows rapidly and tends to spread to other parts of the body,  and according to a study published by Obstetrics and Gynecology Clinics of North America in 2013, endometrial cancer is the fourth most common type of cancer. In women; Where the number of women diagnosed with the disease is estimated at 46,470 cases during the year 2011. 
Symptoms of uterine cancer
There are many symptoms that may appear on a woman in the event of uterine cancer, and these symptoms differ according to the time of infection. Whether it is before or during menopause, or in the advanced stages of menopause, but in general vaginal bleeding is the most common symptom, and symptoms may include menstrual disturbance. In terms of abundance and length of period, the period between one menstrual cycle and the next, vaginal secretions, feeling pain during sexual intercourse, unexplained weight loss, and so on. 
Causes of uterine cancer
In fact, the causes of uterine cancer are still unknown until now, but there are many risk factors that may increase the likelihood of developing it, and it should be noted that the presence of these factors does not necessarily mean that there is a certain incidence of the disease, and the absence of these factors does not mean that there is no suffering. Of the disease, and it is not possible to know the underlying cause of cancer if there is more than one risk factor at the same time. The risk factors that may lead to uterine cancer can be explained as follows:  
- Suffering from obesity.
- Things that affect hormone levels, such as: taking estrogen after menopause, taking birth control pills , or using Tamoxifen, number of menstrual cycles in a woman's life, pregnancy, presence of a certain ovarian tumor, and PCOS.
- Type 2 diabetes.
- A family history of endometrial cancer or colorectal cancer.
- A personal history of breast cancer, ovarian cancer, or endometrial hyperplasia.
- Previous exposure to radiation therapy in the pelvic area to treat another type of cancer.
Asherman's Syndrome is a rare condition characterized by the presence of adhesions inside the uterus resulting from damage to the basal layer of the endometrium due to the use of a group of tools inside the uterus or as a result of infection, which results in hardening of the endometrium The formation of adhesions and thus the occurrence of partial or complete blockage of the uterine cavity,   In fact, it is difficult to know how often they occur in women because it is difficult to diagnose them through routine examinations or diagnostic procedures such as ultrasound examination, and some women may be affected; Especially women who are not trying to conceive, with Asherman syndrome without their knowledge or without a diagnosis of the syndrome. This is due to their inability to recognize the symptoms, or even their indifference to them. 
Symptoms of Asherman's syndrome
In fact, not all affected women may suffer from the appearance of symptoms in the event of Asherman syndrome, and some women may have a normal menstrual cycle despite the infection, while symptoms may appear on some affected women, which may include the following: 
- Oligomenorrhea ; The presence of a light period.
- Amenorrhea , which is the absence of a period.
- Feeling severe pain or cramps.
- Inability to become pregnant or to maintain it if it occurs.
Causes of Asherman's syndrome
There are many possible causes behind the occurrence of Asherman syndrome, and can be explained as follows: 
- Intrauterine surgical procedures; Which may include surgery to remove fibroids , or to repair structural defects, or procedures related to the use of an IUD .
- Infection Such as: inflammation of the mucous membrane that lines the uterus (endometriosis), endometriosis due to tuberculosis infection , or some other infectious disease that may cause Asherman's syndrome.
- Dilatation and curettage (D&C) According to the study published by the National Center for Biotechnology Information in 2019, the incidence of Asherman syndrome may reach 13% of women who undergo termination of pregnancy in the first trimester of pregnancy, while it may reach 30% of women who undergo the procedure of dilation and curettage after the occurrence of Spontaneous abortion late in pregnancy.  
Endometrial polyps are defined as a benign growth inside the uterine cavity that originates from the endometrium itself, and is usually located in the upper part of the uterus, and it is worth noting that endometrial polyps vary in size. Where it ranges from a few millimeters to a few centimeters, it may exist singly or in multiples. 
Symptoms of uterine polyps
The patient may not experience any symptoms if endometrial polyps are present. In this case, suffering from this condition can be discovered when performing tests or when treating another disease, but the following symptoms and signs may appear if suffering from it: 
- Irregular bleeding during the childbearing years or difficulty getting pregnant .
- Heavy bleeding during the menstrual period.
- Presence of blood stains; Especially after having sexual relations.
- Having vaginal bleeding after menopause.
Causes of uterine polyps
The exact cause of uterine polyps is unknown. But uterine polyps tend to grow as long as the levels of the estrogen hormone in the body are high, and it should be noted that most uterine polyps are non-cancerous, yet there is a small percentage of uterine polyps that are precancerous or precancerous, and in fact the percentage increases. Cancer in the postmenopausal period, during the period of receiving tamoxifen treatment, or in the event of heavy or irregular menstruation, and there are many factors that increase the likelihood of uterine polyps, which can be explained as follows: 
- Suffering from obesity.
- Use of tamoxifen; It is a medicine for treating breast cancer.
- Hormone replacement therapy after menopause.
- A family history of suffering from Cowden Syndrome or Lynch Syndrome, which are two inherited genetic conditions.
Inflammation of the lining of the uterus is an inflammation or irritation of the lining of the uterus,  It should be noted that the use of the antibiotic is usually sufficient to treat the inflammation and eliminate the infection, and the prevention of any potential complications; As the inflammation may spread if treatment is not used, and this may lead to infection and other complications, so treatment must begin as soon as symptoms appear and the condition is diagnosed. 
Symptoms of endometriosis
The symptoms that may appear in the case of endometriosis that require seeing a doctor as soon as they appear can be explained as follows: 
- Feeling of pain in the pelvis or abdomen.
- The presence of vaginal bleeding or secretions that differ from the usual secretions.
- Fever or chills.
- Feeling very unwell and tired.
- Suffering from constipation or feeling pain during bowel movements.
Causes of endometriosis
Endometriosis is caused by an infection. It may arise as a result of exposure to an infection from organisms present in the vagina naturally, or from chlamydia , or from gonorrhea , and herpes and tuberculosis are rare causes of its occurrence, and in fact it can Having any surgery performed through the cervix increases the risk of developing endometriosis, and some of these surgical procedures can be explained as follows:  
- Dilation and curettage.
- Endometrial Biopsy.
- Putting the IUD inside the uterus.
- Birth; The risk of developing endometriosis with a cesarean delivery is greater than with a natural delivery.
Luteal phase defect
The luteal phase defect arises as a result of an abnormal development of the endometrium, and if there is a defect in the luteal phase, the secretion of progesterone is less than the normal level or the endometrium does not respond to the natural stimulation of the hormone progesterone, and it should be noted that the phase The luteal is defined as a part of the menstrual cycle for women, as it usually begins during the second half of the menstrual cycle and ends 12-14 days after ovulation, and the corpus luteum is formed immediately after the end of ovulation and is therefore called the luteal phase, which is responsible for the production of the hormone progesterone During the luteal phase, the hormones progesterone and estrogen increase, which help prepare the uterine lining for the possibility of a fertilized egg, and menstruation occurs in the absence of a fertilized egg or the hormones are not at the desired level. 
Symptoms of a luteal phase defect
The following are the symptoms of a luteal phase defect. 
- The frequency of the menstrual cycle more than once a month.
- Difficulty getting pregnant.
- The presence of blood stains other than during menstruation.
- Miscarriage .
Causes of the luteal phase defect
The possible causes of a luteal phase defect can be explained as follows: 
- Thyroid imbalance.
- Excessive exercise.
- Eating disorders; Such as loss of appetite .
- Age: older than 35 years.
- Suffering from obesity .
- Hyper prolactin blood .
- Artificial insemination; Which includes the use of gonadotropin-releasing hormone (GnRH).
Adenomyosis is defined as a benign disease that affects the uterus, especially the tissues of the endometrium and uterine muscles, and most often affects women in the age group of 40-50 years, and it is associated with the presence of a previous birth, in addition to its association with other diseases of the uterus, such as: endometriosis Uterine polyps and fibroids  It is noteworthy that, in adenomyosis, abnormal cell growth occurs deep in the uterine muscle wall; So that this growth does not go beyond the uterus, unlike endometriosis in which cells grow and spread outside the uterus to reach the ovaries, fallopian tubes and bladder, and in which pregnancy is very difficult, and therefore the name internal endometriosis is usually called . Adenomyosis. 
In some cases, adenomyosis may be diagnosed without the patient suffering from the presence of any symptoms, but some symptoms may appear on the patient in other cases, and the following is a statement of these symptoms: 
- Heavy and prolonged menstrual bleeding.
- Severe cramps during menstruation.
Causes of adenomyosis
It should be noted that adenomyosis is a common disease, and it is often diagnosed in middle-aged women and women who have given birth to children, in addition to some studies indicating that the risk of developing adenomyosis is increased in women who have undergone uterine surgeries. Adenomyosis is not known to this day. However , it is believed that some of the hormones in the body 's role in it,  It should be noted that there are some theories about the causes of this, and in the statement of each follows: 
- Invasive tissue growth: Some scientists believe that the cause of adenomyosis is due to the invasion of endometrial tissue cells into the muscles that make up the uterine wall, and it should be noted that the uterine incisions that result from surgeries such as cesarean section may enhance this invasion.
- Congenital developments: Some experts believe that the origin of adenomyosis is the formation of the endometrial tissue inside the uterine muscles during the formation of the uterus in the fetus.
- Inflammation in the uterus resulting from childbirth: Another theory suggests that there is a link between adenomyosis and childbirth, as endometriosis during the postpartum period may lead to a rupture of the cells lining the uterus that form a natural barrier, and on the other hand, uterine surgeries may have the same This effect.
- Origins of stem cells: A new theory suggests that adenomyosis may occur as a result of stem cell invasion in the bone marrow of the uterine muscles.
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