Even small growths can be extremely painful and problematic. Endometriosis is the leading cause of female infertility. When the growths first appear they look like tiny, dark spots scattered around the pelvic area. These small, flat patches are called implants. In some cases, the growths disappear, in others they become scar tissue or don't change at all.
Implants are small, flat patches of endometrial cells growing outside the lining the uterus.
If endometriosis spreads to the ovaries it can produce cysts filled with blood, called endometriomas, which can range from very small to grapefruit-sized. When they bleed or burst they can cause excruciating pain as well as inflammation and the creation of more scar tissue. The tissue can also become attached to the wall of the bladder. The repeated injury of the endometriosis creates scar tissue, called adhesions. A woman with moderate endometriosis may have scattered adhesions.