What is endometriosis?

Endometriosis is a disorder in which tissue similar to the uterine lining grows outside the uterus, commonly forming on the fallopian tubes, ovaries, the lining of the pelvis, and the outer surfaces of organs like the uterus, intestines, rectum, and bladder.

Occasionally, this type of tissue that forms outside of the uterus — also referred to as endometrial implants — can form outside the area containing the pelvic organs, but this is rare. So, how does this affect a woman’s body? The endometrial implants work similarly to the tissue lining the uterus, growing, thickening and building up, and breaking down over the course of a menstrual cycle. However, because the tissue has no way to leave the body, it becomes trapped in the pelvis and can cause irritation, swelling, the scarring of surrounding tissue, and adhesions, which are tissues that can cause your pelvic organs to become stuck to one another.

Endometriosis affects up to an estimated 10% of women, and it is often diagnosed in women in their 30s and 40s.

How is endometriosis diagnosed?

No one currently knows the actual prevalence of the disorder, due to the fact that the most certain way of diagnosing endometriosis is through a laparoscopy. According to John Hopkins Medicine, “Laparoscopy is a minor surgical procedure in which a laparoscope, a thin tube with a camera at the end, is inserted into the abdomen through a small incision. Laparoscopy is also used to determine the location, extent and size of the endometrial growths.”

Depending on a person’s doctor or gynecologist, an examination for endometriosis may first start with a review of the patient’s medical history, a pelvic exam, or trying other methods before or instead of a laparoscopy, such as an ultrasound, MRI scan, or a CT scan.

One of the more common symptoms of endometriosis is pelvic pain, although this isn’t the case for all women, and some women may not experience any symptoms or pain at all.

What are the common symptoms of endometriosis?

• abdominal and lower back pain (may continue for several days before or after period)
• infertility 
• heavy menstrual bleeding or bleeding in between periods
• discomfort during bowel movements or urination
• pain during intercourse
• fatigue
• bloating
• nausea 
• gastrointestinal problems like constipation or diarrhea 

What causes endometriosis?

The exact cause for endometriosis is still unknown, but there have been several theories as to what might cause it. According to John Hopkins Medicine, one possible theory offers that during menstruation, some tissue flows backward through the fallopian tubes and into the abdomen where it attaches and forms more tissue like a “reverse menstruation.”

Another theory suggests that endometrial implants spread more like cancer cells, by moving and forming by way of lymphatic or blood networks. Yet another theory proposes that cells in any location may be prone to turning into endometrial cells. While the exact cause is unknown, there are certain circumstances that can place a person at an increased risk for the disorder. 

Some potential risk factors for the disorder include: 

• having a first-degree relative with the disorder (mother, sister, etc.) 
• low body mass index 
• giving birth for the first time after age 30 or never giving birth
• reproductive tract disorders
• going through menopause at an older age

Endometriosis can typically present itself in four stages: minimal, mild, moderate, and severe; and these stages can present differently depending on the person. 

Is endometriosis treatable?

Endometriosis can be treated with a range of treatment options depending on symptom severity and what stage a person’s endometriosis might be in. 

Primary treatments for endometriosis include:

• over-the-counter pain medications
• hormone therapy
• hormonal contraceptives like birth control pills
• surgery to remove the endometrial implants 
• a hysterectomy (as a last-resort surgery only)

Depending on the severity of your symptoms, your treatment preference, how your body responds to some forms of treatment, and whether or not you want to have kids, your doctor or gynecologist will help you determine the best course of action. 

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Read about collagen, hysterectomy, varicose veins, and other health and medical terminology in our Women’s Health Glossary of Terms.