As these cysts have a small period every month, they soon fill with a thick, menstrual-type blood, which, as the water is absorbed out of it, starts to look like melted chocolate. This sort of endometriosis often forms cysts, which we think may grow in from the pelvic wall, which slowly take over a lot of the ovarian substance. More severe forms of endometriosis can grow inside the ovary, rather than just on the ovarian surface. It less commonly grows on the fallopian tubes and, therefore, disrupts their function. It can also occur on the peritoneum in front of the uterus, between the uterus and the bladder. Endometriosis is most commonly found to be sitting on the peritoneum of the pelvis behind the vagina and uterus, underneath the ovaries and sometimes on the ovaries. The diagram below shows the most likely sites. Common sites for endometriosisĮndometriosis can occur at almost any site in the pelvis. This smooth, glistening membrane allows bowel and other organs to slide around inside the abdominal cavity without sticking and, also, it protects the abdominal cavity from such things as infection. This is continuous with the peritoneum of the abdomen, which lines the abdominal cavity all the way from the bottom of the pelvis up to the diaphragm. Internally, the pelvis is lined with a glistening, membrane-like material called pelvic peritoneum. It contains the bladder, the rectum and other bowel, and, most importantly, the female reproductive organs, including the vagina, uterus, tubes and ovaries. The female pelvis is a space continuous with the abdominal cavity. Typically, endometriosis occurs in the pelvis.
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