Endometriosis

Overview

Endometriosis is a condition that causes tissue similar to the tissue that grows inside of the uterus – called endometrium – to grown outside your uterus. Because it occurs in the female reproductive organs, this condition only affects women. Endometriosis can be a painful condition and can lead to problems with fertility.

Endometriosis causes

Experts don’t yet know the exact cause of endometriosis, but they believe that these situations may play a role:

• Embryonic cell transformation. In this phenomenon, the hormone estrogen transforms cells in the early stages of development into endometrial-like cells during puberty.
• Immune system condition. Having an autoimmune condition can cause the body to not correctly identify and destroy endometrial-like tissue growing outside of the uterus.
• Retrograde menstruation. This occurs when menstrual blood containing endometrial cells flows back through the fallopian tubes, instead of out of the body.
• Surgical scars. If you’ve undergone a hysterectomy or C-section, endometrial cells can attach to a surgical incision.
• Transformation of peritoneal cells. In this process, the peritoneal cells that line that inner side of the abdomen transforms into endometrial-like cells.

Endometriosis risk factors

Factors that put you at an increased risk for developing endometriosis include:

• Having a family history of endometriosis
• Having a low body mass index (BMI)
• Having abnormalities of the reproductive system
• Having heavy periods lasting longer than seven days
• Having short menstrual cycles (less than 27 days)
• Not having given birth
• Starting menopause at an older age
• Starting your menstrual cycle at an early age

Endometriosis symptoms

Signs and symptoms of endometriosis include:

• Bleeding between periods (intermenstrual bleeding)
• Bloating
• Heavy, painful periods (dysmenorrhea)
• Constipation
• Diarrhea
• Fatigue
• Infertility
• Nausea
• Pain during or after sex
• Pain while urinating or having a bowel movement (especially during your period)
• Pelvic pain

Endometriosis diagnosis

Your specialist will use one or more of the following diagnostic tools to check for endometriosis:

• Pelvic exam. In this test, your specialist uses their hands to feel your pelvis for abnormalities, such as abnormalities or scars.
• Imaging tests. Your specialist may recommend you undergo imaging tests – such as ultrasound or magnetic resonance imaging (MRI) – to obtain detailed images of the inside of your reproductive organs.
• Laparoscopy. You will be under general anesthesia (fully asleep) for this procedure. The specialist will make a small incision near your belly button and insert a thin, flexible viewing instrument – called a laparoscope – to check for visible signs of endometriosis or other abnormalities.

Endometriosis treatment

Your specialist may recommend one or more of the following treatments for endometriosis:

• Pain medication. Your specialist may recommend you take over-the-counter pain medication – such as ibuprofen (Advil or Motrin) or naproxen sodium (Aleve) – to help you manage your pain.
• Hormone therapy. Your specialist may prescribe hormone therapy to help slow the growth of endometrial tissue and prevent new areas of endometrial tissue.
• Surgery. If you are trying to become pregnant or you are experiencing severe pain, you may need to undergo surgery to remove the endometriosis cell implants.
• Fertility treatment. If endometriosis has caused problems getting pregnant, you may need to see a fertility specialist for specialized treatment.

When should I seek care?

If you experience any of these symptoms, start by voicing your concerns and symptoms to your primary care provider. From there, your doctor may suggest seeing a women’s health provider for more specialized treatment.